Articles: nerve-block.
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Acta Anaesthesiol Scand · Oct 2019
Randomized Controlled TrialAre single-injection erector spinae plane block and multiple-injection costotransverse block equivalent to thoracic paravertebral block?
Thoracic paravertebral block (TPVB) is considered the gold standard for hemithoracic regional anaesthesia. Erector spinae plane block (ESPB) is a new posterior thoracic wall block. Multiple-injection costotransverse block (MICB) mimics TPVB but with injection points within the thoracic intertransverse tissue complex and posterior to the superior costotransverse ligament. We aimed to compare the spread of injectate into the thoracic paravertebral space (TPVS) resulting from single-injection ESPB and MICB, respectively, with TPVB. ⋯ Consistent spread of dye into the TPVS colouring the ventral rami, the communicating rami, and the sympathetic trunk was observed with MICB; in this respect equivalent to TPVB. ESPB exhibited only partial success and was not equivalent to TPVB. No epidural spread was found with neither MICB nor ESPB.
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Journal of anesthesia · Oct 2019
A laser mount probe holder facilitates fixation of the optimized ultrasound image and needle alignment in-plane to the ultrasound beam during ultrasound-guided peripheral nerve block.
Laser guidance facilitates needle alignment in-plane to the ultrasound beam. Once the ultrasound image is optimized, there is no further need to maneuver the probe. ⋯ The needle brightness was quantitatively measured using an image analysis software. We found that the laser mount probe holder is useful, not only to visualize the needle tip in the ultrasound plane, but also to fix the best ultrasound image.
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Our aim was to examine whether surgery with regional anesthesia (RA) is associated with accelerated long-term cognitive decline comparable with that previously reported after general anesthesia (GA). ⋯ Older adults undergoing surgery with RA experience decline of global cognition similar to those receiving GA; however, memory was not affected.
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Eur J Orthop Surg Tr · Oct 2019
Comparative StudyAdditive effect of continuous adductor canal block and liposomal bupivacaine periarticular injection in total knee arthroplasty.
Novel methods of postoperative analgesia for total knee arthroplasty (TKA) have demonstrated improved functional outcomes and decreased narcotic consumption. These approaches include continuous adductor canal blocks (CACB) and periarticular injection (PAI). There is a lack of current understanding regarding the effect of these modalities on narcotic usage, functionality, and pain when both PAI and CACB are utilized compared to PAI alone. ⋯ Here we identify an additive effect when utilizing both PAI and CACB for postoperative TKA analgesia. Our findings demonstrate significant decrease in patient total narcotic usage, pain scores, and an increase in walking distance when utilizing PAI and CACB compared with PAI alone. This analgesic technique may help reduce patients' narcotic use while also increasing functional outcomes.