Articles: nerve-block.
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Anesthesia and analgesia · Jun 2020
Randomized Controlled Trial Multicenter StudyQuality of Recovery After Breast Surgery: A Multicenter Randomized Clinical Trial Comparing Pectoral Nerves Interfascial Plane (Pectoral Nerves II) Block With Surgical Infiltration.
For non-mastectomy breast surgery the PECS II block is no better than surgical local infiltration.
pearl -
Anesthesia and analgesia · Jun 2020
Multicenter Study Observational StudyVariation Between and Within Hospitals in Single Injection Caudal Local Anesthetic Dose: A Report From the Pediatric Regional Anesthesia Network.
Given that variation exists in health care utilization, expenditure, and medical practice, there is a paucity of data on variation within the practice of anesthesia. The Pediatric Regional Anesthesia Network (PRAN) data lend itself to explore whether different medical practice patterns exist and if there are nerve blocks with more local anesthetic dosing variation than others. The primary aim of this study was to quantify variation in single injection caudal block dosing, and the secondary aim was to explore possible causes for variation (eg, number of blocks performed versus geographic location). ⋯ Wide variation in caudal local anesthetic dosing and administered volume exists. This variation is independent of the number of cases performed at each center but rather is determined by study site (ie, variation between centers) with considerable additional variation within study centers, suggesting additional variability dependent on individual practitioners. While there are legitimate reasons to vary dosing, the current approach is inconsistent and not supported by strong evidence over giving a standardized dose.
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Review Meta Analysis
Single injection Quadratus Lumborum block for postoperative analgesia in adult surgical population: A systematic review and meta-analysis.
The Quadratus lumborum (QL) block was first reported as a postoperative analgesic technique for abdominoplasty, and since has been used for a variety of surgeries. In this systematic review and meta-analysis, we summarize the current literature on the postoperative analgesic effect of QL block. ⋯ QL block significantly reduces opioid requirement in cesarean delivery and in renal surgery. The evidence for other surgery types are limited. QL block may have analgesic effect for up to 24 h postoperatively, but the evidence is again limited. There is currently limited evidence comparing QL block to other analgesic techniques, further studies are needed in this area.
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Randomized Controlled Trial
Dexmedetomidine Added to Bupivacaine versus Bupivacaine in Transincisional Ultrasound-Guided Quadratus Lumborum Block in Open Renal Surgeries: A Randomized Trial.
General anesthesia (GA) is the preferred anesthetic modality for open renal surgeries to ensure a patent airway while the patient is in the lateral decubitus position. However, these surgeries are usually accompanied by severe postoperative pain with increased requirements for multimodal pain management strategies. Regional blocks provide better postoperative pain control with less systemic opioid consumption. ⋯ Quadratus lumborum block, dexmedetomidine, open renal surgery, postoperative pain, bupivacaine.
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Randomized Controlled Trial
Comparison of ultrasound guided Erector Spinae Plane Block and quadratus lumborum block for postoperative analgesia in laparoscopic cholecystectomy patients; a prospective randomized study.
Erector Spinae Plane Block (ESPB) is a recently described block. Both ESPB and Quadratus Lumborum block type II (QLB-II) have been reported to provide effective postoperative analgesia in patients undergoing laparoscopic cholecystectomy (LC). In this study, we compared the postoperative analgesic effects of ESPB and QLB-II in patients undergoing LC. ⋯ While ESPB and QLB-II are not significantly different, they improve analgesia quality in patients undergoing LC.