Articles: nerve-block.
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Meta Analysis
The efficacy of fascia iliaca compartment block for pain control after hip fracture: A meta-analysis.
To assess the effect of fascia iliaca compartment block (FICB) on pain control and morphine consumption in patients with hip fracture. ⋯ FICB has a beneficial role in reducing pain intensity and morphine consumption after hip fracture. Moreover, FICB has morphine-sparing effects when compared with a control group. More high-quality RCTs are needed to identify the optimal technique and volume of injectate for FICB.
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Closed malpractice claims can provide insight into low-frequency adverse events in many areas of perioperative and chronic pain care. Over the last decade, there have been changes in surgical and regional anesthetic practice, likely impacting adverse event patterns. Given the wide variability and low frequency of complications associated with peripheral nerve blocks, the study of closed malpractice claims offers an opportunity to examine adverse events, and the patient, technical, and provider factors that led to the claim. Knowledge gained from examination of closed claims has already resulted in multiple improvements in processes of care and patient safety. ⋯ Regional, pain, anesthesia, complications, closed claims, liability, nerve, block, injury.
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Minerva anestesiologica · Jul 2019
Clinical TrialPerfusion index and ultrasonography in the evaluation of infraclavicular block.
It has been reported that noninvasive, objective tests are needed for determining the success of peripheral nerve blocks because conventional methods necessitate the cooperation of the patient. It is also known that the brachial plexus block causes vasodilatation and an increase in blood flow due to its sympathectomy effect. Our study aimed to determine whether Perfusion Index (PI) and measured regional hemodynamic changes using ultrasound were reliable parameters in evaluating the early success of an infraclavicular block. ⋯ Changes in EDV, especially RI and PI, provide more effective and objective results for the assessment of early regional block success.
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The rate of chronic migraine (CM) has been shown to be 20% or greater in the post 9/11 combat veteran population with a history of traumatic brain injury, while the rate is much lower at 3-5% in the general population. Studies have shown that medications such as oral topiramate or intramuscular injections of onabotulinum toxin A (Botox) have been used for CM prevention, and occipital blocks have been shown to be helpful in treating occipital neuralgia and short-term relief of CM. However, there are no known studies that have specifically evaluated the use of Botox and occipital blocks for reducing headache frequency in the US veteran population. The purpose of this study was to evaluate the effectiveness of using occipital blocks and Botox as dual therapy for reducing headache frequency in post 9/11 combat veterans with CM, occipital neuralgia, and a history of TBI or neck trauma. ⋯ This study evaluated the effectiveness of using occipital blocks and Botox as dual therapy for reducing headache frequency for post 9/11 combat veterans with CM, occipital neuralgia, and a history of TBI or neck trauma. Results revealed a statistically significant reduction in the number of headache days per month after the dual therapy. There were multiple limitations to the study to include a small sample size, lack of a control group, self-reported headaches for only 1 month pre-and post-treatment, and no control for other interventions or events which may have influenced the outcome. There is a strong need for randomized, double blinded, placebo- controlled studies involving dual therapy in this population. This study, though small, may be helpful in stimulating additional studies and treatments in this veteran population.