Articles: nerve-block.
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Randomized Controlled Trial Comparative Study
Efficacy of a single injection compared with triple injections using a costoclavicular approach for infraclavicular brachial plexus block during forearm and hand surgery: A randomized controlled trial.
It was recently proposed that a costoclavicular (CC) approach can be used in ultrasound (US)-guided infraclavicular brachial plexus block (BPB). In this study, we hypothesized that triple injections in each of the 3 cords in the CC space would result in a greater spread in the 4 major terminal nerves of the brachial plexus than a single injection in the CC space without increasing the local anesthetic (LA) volume. ⋯ The TI of CC approach increased the consistency of US-guided infraclavicular BPB in terms of the rate of blocking all 4 nerves without increasing the procedure time despite administering the same volume of the LA.
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Total knee arthroplasty is accompanied by moderate to severe postoperative pain. Postoperative pain hampers the functional recovery and lowers patient satisfaction with the surgery. Recently, the adductor canal block (ACB) has been widely used in total knee arthroplasty. However, there is no definite answer as to the location of a continuous block within the ACBs. ⋯ Compared with the distal ACB, the proximal ACB showed similar analgesic efficacy for total opioid consumption, average VAS score, worst VAS score, block success rate, and time of catheter insertion. However, because of the limited number of involved studies, more high-quality studies are needed to further identify the optimal location of the ACB.
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In recent years, there has been an increasing interest in local infiltration analgesia (LIA) as a technique to control postoperative pain. We compared this technique to the gold standard the 3 in 1 femoral nerve block (FNB) in postoperative pain management after total knee arthroplasty (TKA) in a large patient population. This trial analyzes in the early postoperative phase the pain, range of motion, and consumption of pain medications after TKA. ⋯ Retrospective trial.
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Randomized Controlled Trial Comparative Study
Continuous block at the proximal end of the adductor canal provides better analgesia compared to that at the middle of the canal after total knee arthroplasty: a randomized, double-blind, controlled trial.
The optimal position for continuous adductor canal block (ACB) for analgesia after total knee anthroplasty (TKA) remians controversial, mainly due to high variability in the localization of the the adductor canal (AC). Latest neuroanatomy studies show that the nerve to vastus medialis plays an important role in innervating the anteromedial aspect of the knee and dives outside of the exact AC at the proximal end of the AC. Therefore, we hypothesized that continuous ACB at the proximal end of the exact AC could provide a better analgesic effect after TKA compared with that at the middle of the AC (which appeared to only block the saphenous nerve). ⋯ Continuous ACB at the proximal end of the AC has a better opioid-sparing effect without a significant influence on quadriceps motor strength compared to that at the middle of the AC after TKA. These findings indicates that a true ACB may not produce the effective analgesia, instead, the proximal end AC might be a more suitable block to alleviate pain after TKA.
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Randomized Controlled Trial
Erector spinae plane block for postoperative pain and recovery in hepatectomy: A randomized controlled trial.
The randomized controlled study aimed to examine the efficacy of preoperative ultrasound-guided erector spinae plane (ESP) block combined with ropivacaine in patients undergoing hepatectomy. ⋯ ESP block combined with ropivacaine treatment effectively reduced early postoperative pain and improved recovery after hepatectomy.