Articles: nerve-block.
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Case Reports
Ultrasound-Guided Erector Spinae Plane Nerve Block for Relief of Acute Cholecystitis Pain.
Acute cholecystitis is a common surgical emergency and a painful condition that often requires frequent intravenous opioid analgesia. Sometimes, pain control of patients with acute cholecystitis is challenging. In this case, we present a potential alternative to managing acute cholecystitis pain. ⋯ A 40-year-old female presented to the emergency department (ED) with right upper quadrant pain. While awaiting testing and ultrasound, she received multiple doses of opioid analgesia. A point-of-care ultrasound of the right upper quadrant was performed and demonstrated findings of acute cholecystitis. Given that her pain was challenging to manage, even with intravenous opioids, an ultrasound-guided erector spinae plane (ESP) nerve block was discussed and subsequently performed at the T7 level. Thirty minutes after the procedure, the patient reported significant relief of her pain and did not require any opioid analgesia until ten hours later on the inpatient floor. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: ESP nerve blocks can potentially offer an alternative analgesic in the management of acute cholecystitis, subsequently reducing the use of opioids in the ED. ESP nerve blocks can potentially offer patients longer-lasting analgesia. ESP nerve blocks can potentially manage visceral pain in the ED.
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Chemical neurolysis of the genicular nerves is a treatment option for intractable non-cancer knee pain. This scoping review synthesizes the available literature on the effectiveness, adverse events, and procedural techniques of chemical neurolysis of genicular nerves for the management of knee pain. ⋯ Open Science Framework (https://osf.io/jg8wh).
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Coccygodynia results from traumatic, nontraumatic, or idiopathic causes. Chronic cases resistant to conservative treatments may necessitate surgery. ⋯ S-MPB was chosen for its simplicity, efficacy, and safety, providing postoperative analgesia without complications. This approach suggests that S-MPB is a promising addition to the pain management arsenal for coccygectomy, warranting further investigation to optimize its application and outcomes.
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Case Reports
Erector Spinae Plane Block Together With Inter-Transverse Process Block for Open Gastrectomy: Case Report.
Fascial plane blocks of the posterior thoracic wall (erector spinae plane [ESP] and intertransverse plane [ITP]) may offer advantages for high-risk patients requiring open abdominal surgery in whom thoracic epidural analgesia (TEA) combined with general anesthesia (GA) may be relatively contraindicated. As a primary anesthesia method, ESP/ITP (paravertebral by proxy) blocks proved effective in a case of open gastrectomy by avoiding airway intervention, mechanical ventilation, and effectively managing visceral pain. This article highlights the use of ESP/ITP blocks in a high-risk patient for whom GA and TEA posed substantial risks, with the patient who experienced favorable perioperative outcomes.
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Lung cancer surgery is associated with a high incidence of chronic postsurgical pain (CPSP), which necessitates long-term analgesic prescriptions. However, while essential for managing pain, these have shown various adverse effects. Current guidelines recommend using peripheral nerve blocks over epidural anaesthesia for perioperative analgesia in minimally invasive thoracic surgery (MITS). However, the impact of perioperative analgesia on chronic analgesic prescriptions remains unclear. Therefore, this study investigated chronic analgesic prescription patterns following MITS in patients with lung cancer who received either perioperative epidural anaesthesia or nerve block. ⋯ This nationwide retrospective study suggests that the choice between perioperative epidural anaesthesia or nerve block in patients with lung cancer undergoing MITS does not influence the proportion of postoperative chronic analgesic prescriptions.