Articles: nerve-block.
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Randomized Controlled Trial
Analgesic efficacy of ultrasound guided bilateral transversus thoracis muscle plane block in pediatric cardiac surgery: a randomized, double-blind, controlled study.
Adequate perioperative pain control in children undergoing cardiac surgery is mandatory. Intravenous opioids and neuraxial anesthetic techniques have been used but didn't gained any popularity. The aim of the current study was to evaluate the analgesic efficacy of transversus thoracis plane (TTP) block in pediatric cardiac surgery. ⋯ The use of TTP block decreased perioperative fentanyl consumption and reduced postoperative pain intensity.
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Reg Anesth Pain Med · Dec 2020
Randomized Controlled TrialIlioinguinal/Iliohypogastric versus quadratus lumborum nerve blockade for elective open inguinal herniorrhaphy: a prospective, randomized, double-blinded, equivalency trial.
Open inguinal herniorrhaphy (OIH) is a commonly performed surgical procedure with expected postoperative pain. Historically, an option for regional analgesia has been an ilioinguinal and iliohypogastric nerve block (IINB). More recently, the transmuscular quadratus lumborum block (QLB) has been used as an analgesic technique for a variety of abdominal and truncal surgical procedures. Given our own institutional experiences with the performance of QLB combined with the body of literature supporting the proximal blockade of the ilioinguinal and iliohypogastric nerves via this approach, we compared the analgesia provided by an IINB to a QLB. We hypothesized that the two blocks would provide equivalent analgesia, as defined by a difference of less than±2 points on the pain scale (0-10 numeric rating scale (NRS)), for patients undergoing OIH. ⋯ An IINB and a transmuscular QLB are equivalent with regards to their ability to provide postoperative analgesia after OIH.
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Review Case Reports
Opioid-sparing multimodal analgesia with bilateral bi-level erector spinae plane blocks in scoliosis surgery: a case report of two patients.
Postoperative pain following scoliosis correction surgery is severe and usually requires prolonged intravenous opioid therapy. Regional anesthesia options are limited and include intrathecal opioid and epidural analgesia; however, they remain little used because of side effects and inconsistent efficacy. We describe a novel multimodal anesthetic regimen incorporating bilateral bi-level erector spinae plane (ESP) blocks together with a combination of several evidence-based intraoperative opioid-sparing analgesic strategies. ⋯ Bilateral bi-level ESP blocks are a simple method of providing pre-emptive regional analgesia in extensive multi-level spine surgery. Integration of ESP blocks into a multimodal regimen that employs other opioid-sparing strategies may have additive, and potentially synergistic, benefits in improving postoperative analgesia and reducing opioid requirements.
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Eur J Trauma Emerg Surg · Dec 2020
ReviewA systematic review of the effect of regional anesthesia on diagnosis and management of acute compartment syndrome in long bone fractures.
Peripheral nerve blockade (PNB) is a useful tool for pain control in the perioperative period. However, there are significant concerns about the use of PNBs following acute orthopaedic trauma due to the theoretical risk of masking acute compartment syndrome (ACS). This study aims to systematically review the effects of PNBs on diagnosis of ACS following long bone fractures. ⋯ Due to the low incidence of ACS, there is a paucity of literature available on ACS following PNB use in the setting of orthopedic trauma. There is no consensus in the literature about the safety of PNB use in the setting of acute long bone fractures, and this review could draw no conclusions from the literature, as the level of evidence is limited to case reports. PNBs should be administered to orthopedic trauma patients only in strictly controlled research environments, and surgeons should be highly cautious about using PNBs for orthopedic long bone fractures, particularly in cases at increased risk for developing ACS.