Articles: nerve-block.
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Best Pract Res Clin Anaesthesiol · Dec 2019
ReviewAdjuvants in clinical regional anesthesia practice: A comprehensive review.
Adjuvants are medications that work synergistically with local anesthetics to help enhance the duration and quality of analgesia in regional techniques. Regional anesthesia has become more prevalent as evidence continues to show efficacy, enhancement of patient care, increased patient satisfaction, and improved patient safety. Practitioners in the perioperative setting need to not only be familiar with regional techniques but also the medications used for them. ⋯ The aim of the present investigation, therefore, is to provide a comprehensive review of the most commonly used non-opioid adjuvants in clinical practice today. Regional adjuvants can improve patient safety, increase patient satisfaction, and enhance clinical efficacy. Future studies and best practice techniques can facilitate standardization of regional anesthesia adjuvant dosing when providing nerve blocks in clinical practice.
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Best Pract Res Clin Anaesthesiol · Dec 2019
ReviewRecent technological advancements in regional anesthesia.
Just two decades ago, regional anesthesia was performed blindly with dubious outcomes and little support from surgeons and patients. Technological advances in regional anesthesia have revolutionized techniques and largely improved outcomes. Ultrasound (US) technology continues to advance and has become more affordable. ⋯ To reduce variability and to reduce the anesthesiologist's workload, the use of robots in regional anesthesia has been assessed in recent years. Peripheral nerve stimulation (PNS) has also demonstrated efficacy in acute and chronic pain settings. Additional research and randomized controlled trials are necessary to evaluate novel technologies.
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Best Pract Res Clin Anaesthesiol · Dec 2019
ReviewThe role of regional anesthesia in the propagation of cancer: A comprehensive review.
New cancer incidences worldwide will eclipse 18 million in 2019, with nearly 10 million cancer-related deaths. It is estimated that in the United States, almost 40% of individuals will be diagnosed with cancer in their lifetime. Surgical resection of primary tumors remains a cornerstone of cancer treatment; however, the surgical process can trigger an immune-suppressing sympathetic response, which promotes tumor growth of any residual cancerous cells post surgery. ⋯ Recently, much evidence in the form of retrospective and prospective studies has come to light regarding the protective, antitumor properties of anesthetic and analgesic agents across a wide variety of cancers and patient demographics. It is believed that by blocking afferent pain signals, the body does not mount the sympathetic response that contributes to the perpetuation of disease after surgical treatment. This review, therefore, investigates these studies as they pertain to the treatment and outcomes of cancers treated surgically to elucidate the role of regional anesthesia in the propagation of cancer.
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Best Pract Res Clin Anaesthesiol · Dec 2019
ReviewPECS, serratus plane, erector spinae, and paravertebral blocks: A comprehensive review.
Thoracic planar blocks represent a novel and rapidly expanding facet of regional anesthesia. These recently described techniques represent the potential for excellent analgesia, enhanced technical safety profiles, and reduced physiological side effects versus traditional techniques in thoracic anesthesia. ⋯ In the present investigation, we describe the history, common indications, technique, and limitations of pectoral nerves (PECS), serratus plane, erector spinae plane, and thoracic paravertebral plane blocks. In summary, these techniques provide excellent analgesia and merit consideration in thoracic surgery.
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Meta Analysis Comparative Study
Continuous adductor canal block is a better choice compared to single shot after primary total knee arthroplasty: A meta-analysis of randomized controlled trials.
The advantages of continuous adductor canal block (CACB) over single shot ACB (SACB) are still debatable for pain management after total knee arthroplasty (TKA). The aim of this study was to investigate which ACB method provides better pain relief after TKA. ⋯ Compared with SACB, CACB provides better analgesia after TKA. Therefore, CACB is recommended as an analgesic method for early postoperative pain treatment after TKA.