Articles: nerve-block.
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The optimal order of drug administration (sedative first vs. neuromuscular blocking agent first) in rapid sequence intubation (RSI) is debated. ⋯ Administration of either the neuromuscular blocking or the sedative agent first are both acceptable. Administering the neuromuscular blocking agent first may result in modestly faster time to intubation. For now, it is reasonable for physicians to continue performing RSI in the way they are most comfortable with. If future research determines that the order of medication administration is not associated with awareness of neuromuscular blockade, administration of the neuromuscular blocking agent first may be a logical default administration method to attempt to minimize apnea time during intubation.
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Randomized Controlled Trial
Continuous femoral nerve block is more effective than continuous adductor canal block for treating pain after total knee arthroplasty: A randomized, double-blind, controlled trial.
Previous studies comparing adductor canal block (ACB) with femoral nerve block (FNB) are inconclusive with regard to patient-controlled analgesia (PCA) induced by opioids. Moreover, some postoperative pain severity results differ between previous randomized controlled trials (RCTs). The primary aim of the current study was to compare total intravenous morphine consumption administered via PCA during the first postoperative day in continuous FNB and ACB groups after total knee arthroplasty (TKA). Secondary aims included evaluation of postoperative pain via a visual analog scale, degree of knee extension, quadriceps muscle strength, and ability to sit, stand upright, and walk. ⋯ FNB was associated with the perception of less severe pain after TKAs. However, ACB was associated with earlier mobility rehabilitation.
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Minerva anestesiologica · Sep 2019
ReviewInjection pressures measuring for a safe peripheral nerve block.
The performance of a precise and safe peripheral nerve blockade (PNB) can currently rely on the aid of the ultrasounds and nerve stimulators. The injection pressure monitoring may be beneficial to perform a safer procedure. This review focuses on the pressures measured during PNB among studies conducted on animal, and human models. ⋯ So it is desirable to make further studies in order to assess them. In the future, the monitoring of the pressure could allow the use of a minimal quantity of anesthetic, empowering the safety of the nerve blocks. Moreover, the sensitive system should not be invasive and it should not hinder the job of the anesthetists.