Articles: nerve-block.
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Reg Anesth Pain Med · Sep 2020
CommentPectoral block versus paravertebral block: a systematic review, meta-analysis and trial sequential analysis.
Pectoral (PECs) block was first described by Blanco et al for postoperative analgesia in breast surgery. It was proposed to be an easier and safer alternative to thoracic epidural or paravertebral block (PVB). In this systematic review and meta-analysis, we compare the perioperative analgesic efficacy and adverse events of PECs block and PVB. ⋯ CRD42020165137.
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Anesthesia and analgesia · Sep 2020
Comparative StudyAnatomical Evaluation of a Conventional Pectoralis II Versus a Subserratus Plane Block for Breast Surgery.
Pectoralis I and II (Pecs I/Pecs II) blocks are modern regional anesthetic techniques performed in combination to anesthetize the nerves involved in breast surgery and axillary node dissection. Pecs II spread and clinical efficacy is thought to be independent of whether injection occurs between pectoralis minor and serratus anterior or deep to serratus anterior. Injecting deep to serratus anterior onto the rib may be technically easier; however, our clinical experience suggests that this approach may be less effective for axillary dissection. We undertook a cadaveric study to evaluate a subserratus plane approach for use in breast and axillary surgery. ⋯ In our cadaveric study, injecting deep to serratus plane produced significantly less axillary spread. For breast surgery excluding the axilla, both techniques may be effective; however, for axillary dissection, the conventional Pecs II is likely to produce superior analgesia and additionally may help achieve complete coverage of the deeper pectoral nerve branches.
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Randomized Controlled Trial
Apical peri-prostatic nerve block versus intra-rectal xylocaine gel for trans- rectal ultrasound guided prostate biopsy among Nigerian patients: A prospective randomized study.
This study compared the analgesic effect of apical peri-prostatic block with that of intra-rectal xylocaine gel for trans-rectal ultrasound guided prostate biopsy (TRUS-PBx) in Nigeria. ⋯ This study demonstrated the superiority of apical peri-prostatic nerve block over intra rectal xylocaine gel instillation during TRUS-PBx with respect to its anesthetic efficacy. Therefore, centers providing TRUS-PBx in Nigeria should consider apical peri-prostatic nerve block as their mode of anesthesia for the procedure due to its efficacy and high safety profile.
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Observational Study
Interventional Management of Refractory Trigeminal Neuropathic Pain: A Prospective Audit of a Novel Management Pathway in 70 Patients.
Trigeminal neuropathic pain (TNP) can present as a constant, unremitting unilateral facial pain. Current management is based on expert recommendation that includes pharmacologic agents and psychological therapy. However, treatment success with pharmacologic management is poor. We adopted a novel strategy that proved to be effective in providing durable relief. ⋯ Standard treatment of TNP is ineffective. The novel set of interventions based on empirical evidence may have a role in managing patients with refractory TNP.