Articles: nerve-block.
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Arch Orthop Trauma Surg · Jan 2021
The continuous infusion fascia iliaca compartment block: a safe and effective analgesic modality in geriatric hip fracture patients.
Hip fractures are common orthopaedic injuries in the elderly. Opioids can provide peri-operative pain relief in hip fracture patients, but may have side effects. Peripheral nerve blocks such as the fascia iliaca compartment block (FICB) have become an established part of the multimodal analgesic regime administered peri-operatively to hip fracture patients. We compare the efficacy of the continuous infusion FICB (CFICB) on peri-operative pain relief, opioid usage, its associated complications and the short as well as long term rehabilitation status in geriatric hip fractures patients. ⋯ The CFICB provides safe and effective post-operative pain relief in geriatric hip fracture patients. Post-operative opioid usage is decreased in older hip fracture patients treated with CFICB. Rehabilitation milestones are slower in the short term, but have no significant difference at 1-year post surgery.
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Persistent headaches and migraines are common in pediatrics with various treatment options. The sphenopalatine ganglion (SPG) has been identified as communicating with the parasympathetic autonomic nervous system and pain receptors. In adults, SPG block is an established treatment but there is no published literature in pediatrics. ⋯ With 100% technical success, statistically significant pain reduction, and no complications, we support SPG block in the pediatric population as a simple, efficacious, and safe treatment option for refractory headaches. It is routinely performed in less than 10 minutes and commonly negates the need for inpatient headache pain management. Given its minimal invasivity, we support the use of SPG blockade as a therapeutic treatment in refractory pediatric migraines as it reduces the need for intravenous medications, prolonged pain control, or hospital admission.
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The use of paravertebral block (PVB) for postoperative analgesia in the thoracic surgery has increased in recent years. However, the traditional methods used to evaluate the success and adequacy of the block are time-consuming, subjective and depend on the patient's compliance. Therefore, the search still continues to find a method to objectively evaluate the success and adequacy of the paravertebral block. ⋯ The present study has shown that PI is an objective, fast, practical and non-invasive method, when compare with pinprick method, that can be used to evaluate PVB success.