Articles: nerve-block.
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Best Pract Res Clin Anaesthesiol · Sep 2019
ReviewPeripheral nerve catheters: A critical review of the efficacy.
Continuous peripheral nerve blocks are commonly used for postoperative analgesia after surgery. However, catheter failure may occur due to either primary (incorrect insertion) or secondary reasons (displacement, obstruction, disconnection). Catheter failure results in unanticipated pain, need for opioid use, and risk of readmission or delay in hospital discharge. ⋯ Thirty-three studies met the selection criteria, comprising 2711 catheters. Literature review suggests that peripheral nerve catheters have clinically significant failure rate when the assessment is performed using an objective (imaging) method. Subjective methods of assessment (without imaging) may underestimate the incidence of catheter failure.
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Randomized Controlled Trial
Analgesic and Respiratory Effects of Two Doses of Morphine as an Adjunct to Bupivacaine in Ultrasound-Guided Transversus Abdominis Plane Block in Upper Abdominal Surgery.
Opioid receptors are present at the terminals of afferent peripheral nerves; therefore, administration of opioids peripherally might provide a significant analgesic effect. ⋯ Abdominal surgery, analgesia, transversus abdominis plane block, morphine.
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Many novel interfascial plane blocks have been developed in the last 10 years in the effort to improve perioperative pain management that are safe, efficacious, efficient, and inexpensive. These blocks have been widely adopted into clinical practice despite relatively few high-quality clinical investigations of the techniques and how they affect perioperative outcomes. This article defines interfascial plane blocks, discusses the potential benefits, reviews the most common techniques and evidence supporting their indication, and guides clinicians in selecting an appropriate interfascial plane block for different types of surgical procedures.
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Anesthesia and analgesia · Sep 2019
Randomized Controlled Trial Comparative Study Pragmatic Clinical TrialBilateral Thoracic Paravertebral Blocks Compared to Thoracic Epidural Analgesia After Midline Laparotomy: A Pragmatic Noninferiority Clinical Trial.
Bilateral paravertebral block (PVB) is a suitable alternative to thoracic epidural analgesia (TEA) for abdominal surgeries. This randomized clinical trial aims to determine if PVB is noninferior to TEA in terms of analgesia after midline laparotomy. ⋯ As a component of multimodal analgesia, bilateral PVB provides noninferior analgesia compared to TEA for midline laparotomy.
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Review Meta Analysis Comparative Study
Comparison of adductor canal block with local infiltration analgesia in primary total knee arthroplasty: A meta-analysis of randomized controlled trials.
Currently, there remains a paucity of literature about the efficiency of adductor canal block (ACB) versus local infiltration analgesia (LIA) for pain management after total knee arthroplasty (TKA). The purpose of this study was to perform a relatively credible and overall assessment to compare the efficiency of ACB versus LIA for early postoperative pain treatment after TKA. ⋯ Both treatments provide similar overall pain relief after TKA. LIA may achieve earlier ambulation compared with ACB. More high-quality RCTs are still required to make the final conclusion.