Articles: nerve-block.
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Randomized Controlled Trial Comparative Study
Randomized clinical trial of continuous transversus abdominis plane block, epidural or patient-controlled analgesia for patients undergoing laparoscopic colorectal cancer surgery.
The optimal analgesia regimen after laparoscopic colorectal cancer surgery is unclear. The aim of the study was to characterize the beneficial effects of continuous transversus abdominis plane (TAP) blocks initiated before operation on outcomes following laparoscopic colorectal cancer surgery. ⋯ Continuous TAP analgesia not only improved gastrointestinal motility but also shortened duration of hospital stay. A decreased opioid requirement and attenuating surgical stress response may be potential mechanisms. Registration number: ChiCTR-TRC-1800015535 ( http://www.chictr.org.cn).
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Regional anaesthesia involves targeting specific peripheral nerves with local anaesthetic. It facilitates the delivery of anaesthesia and analgesia to an increasingly complex, elderly and co-morbid patient population. Regional anaesthesia practice has been transformed by the use of ultrasound, which confers advantages such as accuracy of needle placement, visualisation of local anaesthetic spread, avoidance of intraneural injection and the ability to accommodate for anatomical variation. ⋯ Much research has been done, and is ongoing, with the aim of improving needle visualisation; this is also reviewed. Image interpretation requires the application of anatomical knowledge and understanding of the typical sonographic appearance of different tissues (as well as the needle). Years of practice are required to attain expertise, although it is hoped that continuing advances in nerve and needle visualisation, as described in this chapter, will expedite that process.
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Comparative Study
Efficacy of pectoral nerve block type II versus thoracic paravertebral block for analgesia in breast cancer surgery.
Ultrasound-guided pectoral nerve block type II is a recently proposed technique for postoperative analgesia after breast cancer surgery. The thoracic paravertebral block is widely used for this purpose by decades. The presented study compares the efficacy of these two techniques for postoperative analgesia. ⋯ In breast cancer surgery, the pectoral nerve block type II with ropivacaine 0.375% can provide postoperative analgesia that is comparable to the single-level thoracic paravertebral block.
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Randomized Controlled Trial
Efficacy of pectoral nerve block type II versus thoracic paravertebral block for analgesia in breast cancer surgery.
The aim: to compare the efficacy of pectoral nerve block type II and thoracic paravertebral block for analgesia during and after breast cancer surgery. ⋯ Conclusions: in breast cancer surgery pectoral nerve blocktype II can provide postoperative analgesia comparable to thoracic paravertebral block with lower complications rate.