Articles: nerve-block.
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Pediatric femur fractures often necessitate surgical intervention, with pain management being critical for both immediate and long-term outcomes. Peripheral nerve blocks (PNBs) and neuraxial techniques are effective in providing targeted pain relief while minimizing systemic opioid exposure. Despite their benefits, the utilization of these anesthesia techniques in pediatric orthopedic surgeries is limited, particularly among socioeconomically disadvantaged patients. ⋯ The findings underscore significant disparities in the application of regional anesthesia, influenced by socioeconomic factors. Our study highlights the need for standardized guidelines and interventions to address these disparities, ensuring equitable access to effective pain management techniques in pediatric orthopedic care. Further research is warranted to understand the barriers to the utilization of PNB and to develop strategies to enhance its adoption, particularly among underserved populations.
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We investigated the intraneural spread of injected fluid in brachial plexus nerve roots, examining the potential for intrafascicular spread and identifying influencing factors. ⋯ In contrast with multifascicular peripheral nerves, intrafascicular spread was possible after deliberate intraneural injections near the neuroforaminal canal exit of the brachial plexus nerve roots in several monofascicular or bifascicular ventral rami if the fascicle diameter was more than twice the needle opening length and the entire opening was inside the fascicle.
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Peripheral and truncal nerve blocks provide effective analgesia facilitating perioperative care. However, thresholds for clinically relevant effects remain undetermined and are left for clinicians to choose. These choices are fundamental for sample size calculations and interpretation of study results. This systematic scoping review aimed to create an overview of primary outcomes and anticipated effect sizes in randomised clinical trials assessing peripheral and truncal nerve blocks. ⋯ The presented outcomes and effect sizes from published trials on peripheral and truncal nerve block literature can be used in future trials to increase homogeneity in regional anaesthesia research.
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Curr Opin Anaesthesiol · Feb 2025
ReviewPro's and con's of different blocks for postoperative analgesia after video-assisted thoracic surgery.
Although there are a lot of studies examining the effects of different blocks for postoperative analgesia after video-assisted thoracic surgery (VATS), the results are controversial. ⋯ All three blocks can be suggested for daily practice, the choice should be based on personal experience and preference of the anesthetist. Better studies are required for objective decision.
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Chemical neurolysis of the genicular nerves is a treatment option for intractable non-cancer knee pain. This scoping review synthesizes the available literature on the effectiveness, adverse events, and procedural techniques of chemical neurolysis of genicular nerves for the management of knee pain. ⋯ Open Science Framework (https://osf.io/jg8wh).