Articles: nerve-block.
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Review Meta Analysis
Fascia iliaca block for hip fractures in the emergency department: meta-analysis with trial sequential analysis.
Fascia iliaca block (FICB) has been used to reduce pain and its impact on geriatric patients with hip fractures. ⋯ FICB is associated with significant pain relief both at rest and on movement lasting up to 4 h as well as a reduction in opioid requirement and associated nausea and vomiting in geriatric patients with hip fracture. However, the quality of evidence is low and additional trials are necessary.
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Curr Pain Headache Rep · Nov 2021
Review Case ReportsA Review of Techniques of Intercostal Nerve Blocks.
Intercostal nerve blocks are indicated for multiple chronic pain and acute pain conditions including rib fractures, herpes zoster, post-thoracotomy pain syndrome, and intercostal neuralgia. Intercostal neuralgia is a type of neuropathic pain that is in the distribution of intercostal nerves. The purpose of this review is to evaluate the different techniques used to perform intercostal nerve blocks and review their efficacy and safety including blind technique using anatomical landmarks, and fluoroscopically guided and ultrasound-guided intercostal nerve blocks. ⋯ Literature search was performed with the keywords including intercostal neuralgia, treatment, intercostal nerve blocks, and radiofrequency ablation on PubMed and Google Scholar. Three studies and one case report were identified. Literature review revealed that ultrasound-guided techniques and fluoroscopically guided techniques are superior to landmark-based technique in terms of efficacy. There was no difference in efficacy and complication rates between ultrasound and fluoroscopic guidance. Ultrasound-guided techniques and fluoroscopically guided techniques can both be performed safely and effectively for various chronic pain conditions. Ultrasound guidance has its advantages of direct visualization of nerves, vessels, muscles, and the lung. It is potentially a superior technique in terms of improving accuracy and decreasing complications. Further large population randomized control studies should be conducted to compare the efficacy of intercostal nerve blocks performed under ultrasound and fluoroscopy.
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Reg Anesth Pain Med · Nov 2021
Review Meta AnalysisPeripheral nerve block anesthesia/analgesia for patients undergoing primary hip and knee arthroplasty: recommendations from the International Consensus on Anesthesia-Related Outcomes after Surgery (ICAROS) group based on a systematic review and meta-analysis of current literature.
Evidence-based international expert consensus regarding the impact of peripheral nerve block (PNB) use in total hip/knee arthroplasty surgery. ⋯ PNB use is recommended for patients undergoing THA and TKA except when contraindications preclude their use. Furthermore, the alignment of provider skills and practice location resources needs to be ensured. Evidence level: moderate; recommendation: strong.
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J Shoulder Elbow Surg · Nov 2021
Pain management in shoulder arthroplasty: a systematic review and network meta-analysis of randomized controlled trials.
Postoperative pain management after total shoulder arthroplasty (TSA) can be challenging. Given the variety of pain management options available, the purpose of this investigation was to systematically review the literature for randomized controlled trials reporting on pain control after shoulder arthroplasty. We sought to determine which modalities are most effective in managing postoperative pain and reducing postoperative opioid use. ⋯ Interscalene blocks are superior to local injections alone at managing pain after TSA. Single-shot interscalene blocks are optimal for reducing early postoperative pain (< 24 hours), whereas pain at 24-48 hours after surgery may be best managed with cISBs or a combination of an ssISB with a local LB injection.
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Review Meta Analysis
Erector spinae plane block for postoperative analgesia in spine surgery: a systematic review and meta-analysis.
Although in recent years some randomized controlled trails (RCTs) have explored the analgesic effect of erector spinae plane block (ESPB) in spine surgery, their results are controversial. Our study aimed to examine the analgesic effect of preoperative ESPB in spine surgery by a meta-analysis of RCTs. ⋯ Our meta-analysis demonstrates that ESPB is effective in decreasing postoperative pain intensity and postoperative opioid consumption in spine surgery. Therefore, for the management of postoperative pain following spine surgery, preoperative ESPB is a good choice.