Articles: nerve-block.
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Reg Anesth Pain Med · Nov 2020
Observational StudyDistribution of injectate administered through a catheter inserted by three different approaches to ultrasound-guided thoracic paravertebral block: a prospective observational study.
Despite the popularity of continuous thoracic paravertebral block (TPVB), there is a paucity of information on catheter tip position and distribution of injectate through the catheter. We observed, in real time, the spread of dye, the catheter tip position and sensory block levels produced with three different (intercostal (IC), transverse process sagittal (TS) and paralaminar (PL)) approaches to ultrasound-guided TPVB in patients undergoing video-assisted thoracoscopic surgery. ⋯ Although a bolus injection through a catheter for ultrasound-guided TPVB produced multiple levels of spread and sensory blockade in more than half the patients, considerable differences existed in the spread regardless of approach.
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J. Cardiothorac. Vasc. Anesth. · Nov 2020
Systemic Absorption of Lidocaine from Continuous Erector Spinae Plane Catheters After Congenital Cardiac Surgery: A Retrospective Study.
To examine postoperative serum lidocaine levels in patients with intermittent lidocaine bolus erector spinae plane block (ESPB) catheters after cardiac surgery with or without cardiopulmonary bypass (CPB). ⋯ Postoperative serum lidocaine concentrations did not appreciably differ due to CPB. Serum lidocaine concentrations did not reach near- toxic doses despite the presence of additional lidocaine in the cardioplegia. The results suggested that lidocaine for ESPBs after cardiac surgery is below systemic toxic range at the doses described.
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Suprascapular nerve block (SSNB) is an effective therapeutic approach for shoulder pain and has been increasingly used by professionals in clinical practice. In the landmark-guided nerve block technique, it could be difficult to determine the exact localization of the suprascapular nerve. ⋯ Our results indicate that US-guided SSNB does not potentially offer a significantly greater clinical improvement over landmark-guided SSNB in patients with chronic shoulder pain. Further research is required to establish whether this hypothesis is consistently supported in practice.