Articles: nerve-block.
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The purpose of this manuscript is to provide a brief discussion of the current direction in pediatric regional anesthesia, highlighting both newer nerve blocks and techniques and traditional nerve blocks. ⋯ As the push for multimodal analgesia increases and the breadth of pediatric regional anesthesia continues to expand, further large prospective studies will be needed to demonstrate continued efficacy and overall safety.
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Despite their emerging therapeutic relevance, there are many discrepancies in anatomical description and terminology of the articular nerves supplying the human knee capsule. This cadaveric study aimed to determine their origin, trajectory, relationship and landmarks for therapeutic purpose. ⋯ The pattern of distribution of sensitive nerves supplying the knee joint capsule allows accurate and safe targeting of five constant genicular nerves for therapeutic purpose. This study provides robust anatomical foundations for genicular nerve blockade and radiofrequency ablation.
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Best Pract Res Clin Anaesthesiol · Dec 2019
ReviewRegional anesthesia considerations for cardiac surgery.
Pain is a significant consequence of cardiac surgery and newer techniques in cardiac anesthesia have provided an impetus for the development of multimodal techniques to manage acute pain in this setting. In this regard, regional anesthesia techniques have been increasingly used in many cardiac surgical procedures, for the purposes of reducing perioperative consumption of opioid agents and enhanced recovery after surgery. ⋯ The present investigation also summarizes indications, technique, complications, and potential clinical benefits of these evolving regional techniques. Cardiac surgery patients may benefit from application of these regional techniques with well controlled indications and careful patient selections.
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Best Pract Res Clin Anaesthesiol · Dec 2019
ReviewFascia iliaca block, history, technique, and efficacy in clinical practice.
The facsia iliaca block (FIB) is a relatively new regional technique where local anesthetic is delivered within the fascia iliaca region. Indications for a FIB include surgical anesthesia to the lower extremity after knee, femoral shaft, hip surgery, management of cancer pain or pain secondary to inflammatory conditions of the lumbar plexus, as well as treatment of acute pain in the setting of trauma, fracture, or burns. ⋯ The main targets of the FIB are the predominant nerves contained in the fascia iliaca compartment (FIC), namely the femoral nerve and the lateral femoral cutaneous nerve. The FIB US guided technique is beneficial to patients and the possibility to perform FIB should be discussed and coordinated with surgical staff appropriately, considering its superiority to general or epidural anesthesia.