Articles: nerve-block.
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Regional anesthesia and acute pain management in otolaryngology uses multimodal techniques for perioperative pain control. Multiple methods for regional anesthesia and acute pain management are discussed, including indications and techniques for decreasing perioperative opioid requirements and enhancing recovery.
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Continuous peripheral nerve blocks refer to a local anesthetic solution administered via perineurally placed catheters in an effort to extend the benefits of a single-shot peripheral nerve block. They offer several advantages in the postoperative period including excellent analgesia, reduced opioid consumption and associated side effects, enhanced rehabilitation and improved patient satisfaction. ⋯ Should we routinely use continuous peripheral nerve blocks in our daily practice? This PRO-CON debate aims at answering the question from the experts' perspectives. Fascial compartment and wound catheters are outside the scope of this debate.
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Randomized Controlled Trial Comparative Study
Quadratus lumborum block versus transversus abdominis plane block for postoperative pain management after laparoscopic colorectal surgery: A randomized controlled trial.
This study aimed to compare the quadratus lumborum block (QLB) method with transversus abdominis plane block (TAPB) for postoperative pain management in patients undergoing laparoscopic colorectal surgery. ⋯ The QLB is a more effective postoperative analgesia as it reduces sufentanil consumption compared to TAPB in patients undergoing laparoscopic colorectal surgery.
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Randomized Controlled Trial
Less painful ESWL with ultrasound-guided quadratus lumborum block: a prospective randomized controlled study.
Objectives: Extracorporeal shock wave lithotripsy (ESWL) has been widely used for the treatment of urinary tract stones and is usually administered as an outpatient procedure, although the vast majority of patients do not tolerate it without sedoanalgesia. The quadratus lumborum block (QLB) is a newly-defined technique for abdominal surgery. The aim of this study was to evaluate the analgesic efficacy of ultrasound-guided QLB in ESWL. ⋯ The fragmentation success rate was significantly higher in Group QLB than in Group C (19/20 vs 14/20, respectively, p = 0.046). Patient satisfaction was also higher in Group QLB (p = 0.011). Conclusions: This study shows that QLB provided adequate analgesia for ESWL and that it reduced extra opioid consumption significantly compared to the control group.
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Case Reports
Perioperative analgesia during thymectomy via median sternotomy : Ultrasound-guided bilateral parasternal block.
Thymectomy is sometimes carried out via median sternotomy; however, patients undergoing thymectomy via median sternotomy may experience severe postoperative pain. In this study, an ultrasound-guided regional anesthetic technique called a parasternal block, which can be used to relieve postoperative surgical pain after thymectomy via median sternotomy by blocking the medial nerve branch of the anterior cutaneous branch is presented. ⋯ While these are preliminary findings, further confirmatory clinical trials will be conducted. In summary, ultrasound-guided bilateral parasternal block appears to be a safe, simple, effective and minimally invasive technique for surgery via median sternotomy.