Articles: nerve-block.
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Trauma remains one of the largest problems that the global healthcare system faces today. In the United States it remains the leading cause of death for young and middle-aged patients, and its economic burden in direct cost and loss of productivity is tremendous. ⋯ The purpose of this review is to summarize the current state of pain control and opioid use in acute orthopaedic injury and provide an understanding of the role of PNB to improve pain management. Finally, this review provides a specific diagnosis-based treatment guideline for the use of PNB in acute orthopaedic injury.
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Reg Anesth Pain Med · Jul 2020
Case ReportsNovel use of a continuous PECS II block for mastitis pain treatment.
Nipple trauma and mastitis (an inflammatory condition of the breast) are common causes of intense pain during breast feeding. Although such pain normally results in early weaning, which has negative impacts on both maternal and child health, little is understood about the treatment of pain experienced during breast feeding. Here, we describe our experience with a woman who presented at 26 days post partum with a 15-day history of deep nipple wounds that caused bilateral mastitis and excruciating pain that radiated dorsally. ⋯ We performed a bilateral pectoralis nerve block type II and inserted intrafascial catheters between the pectoralis minor and serratus muscles for continuous analgesia. Following block completion, the pain in her torso resolved immediately. The local anesthetic infusion continued for 40 hours and the patient had sustained analgesia with rapid healing of nipple lesions and her breast feeding commencing at 36 hours after block placement.
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Acta Anaesthesiol Scand · Jul 2020
Peripheral Nerve Blocks for Analgesia after Elective Total Hip Arthroplasty.
A significant subgroup of patients suffer from moderate or severe pain after total hip arthroplasty (THA). Regional analgesia has the potential to reduce post-operative pain and thereby spare patients from opioids, but regional analgesia of the hip is complicated as the area is innervated by multiple nerves. ⋯ A femoral nerve block is known to reduce pain after THA, but is unfortunately accompanied by an increased risk of fall. We have developed a novel nerve block-the iliopsoas plane block (IPB)-that has the potential to anaesthetize the hip articular sensory branches of the femoral nerve without causing motor blockade.