Articles: nerve-block.
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Reg Anesth Pain Med · Oct 2020
Analgesic efficacy of adding the IPACK block to a multimodal analgesia protocol for primary total knee arthroplasty.
Peripheral nerve blocks have been integrated into most multimodal analgesia protocols for total knee arthroplasty (TKA). The adductor canal block (ACB) has gained popularity because of its quadriceps muscle sparing. Similarly, local anesthetic injection between the popliteal artery and the posterior capsule of the knee, IPACK block, has been described to provide analgesia to the posterior capsule of the knee with motor-sparing qualities. This prospective randomized controlled trial aimed to assess the analgesic efficacy of adding the IPACK block to our current multimodal analgesic regimen, including the ACB, in patients undergoing primary TKA. ⋯ The IPACK block reduced the incidence of posterior knee pain 6 hours postoperatively.
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Reg Anesth Pain Med · Oct 2020
Randomized Controlled TrialBilateral ultrasound-guided thoracic erector spinae plane blocks using a programmed intermittent bolus improve opioid-sparing postoperative analgesia in pediatric patients after open cardiac surgery: a randomized, double-blind, placebo-controlled trial.
Postoperative pain after pediatric cardiac surgery is usually treated with intravenous opioids. Recently, the focus has been on postoperative regional analgesia with the introduction of ultrasound-guided erector spinae plane blocks (ESPBs). We hypothesized that bilateral ESPB with a programmed intermittent bolus (PIB) regimen decreases postoperative morphine consumption at 48 hours and improves analgesia in children who undergo cardiac surgery. ⋯ In pediatric cardiac surgery, the results of this study confirm our hypothesis that bilateral ESPB analgesia with ropivacaine decreases the postoperative morphine consumption at 48 hours and demonstrates better postoperative analgesia compared with a control group. Trial registration number NCT03593642.
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Journal of anesthesia · Oct 2020
Case ReportsCombination of ultrasound-guided lumbosacral plexus block with anterior quadratus lumborum block in supine position for hip surgery: a case report.
It was widely recognized that the procedure of ultrasound-guided lumbar and sacral plexus block is required to be performed in a lateral decubitus position that patients' hips and knees were bended. It is difficult, however, for patients with hip fractures to change position because of severe pain and confined movements. We here reported a new modified combination of ultrasound-guided lumbosacral plexus block with anterior quadratus lumborum block in supine position that had been successfully applied in one elderly patient who underwent hip surgery.
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Korean J Anesthesiol · Oct 2020
Case ReportsUltrasound-guided percutaneous intercostal nerve cryoneurolysis for analgesia following traumatic rib fracture -a case series.
Rib fractures are a common injury in trauma patients and account for significant morbidity and mortality within this population. Local anesthetic-based nerve blocks have been demonstrated to provide significant pain relief and reduce complications. However, the analgesia provided by these blocks is limited to hours for single injection blocks or days for continuous infusions, while the duration of this pain often lasts weeks. ⋯ Ultrasound-guided percutaneous cryoneurolysis is a modality that has the potential to provide analgesia matching the duration of pain following rib fractures.