Articles: nerve-block.
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A 79-year-old woman with primary erythromelalgia underwent a left reverse total shoulder arthroplasty with a left interscalene nerve block, a superficial cervical plexus block, and a general endotracheal anesthetic, with no residual neurological deficits. Herein, we discuss the classification and pathophysiology of erythromelalgia along with the anesthetic considerations of peripheral nerve blockade in patients with primary erythromelalgia.
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Case Reports
Relocation of an Infected Cardiac Pacemaker Generator Under Ultrasound-Guided Pectoralis Nerve Block: A Case Study.
Reports on pacemaker placement/relocation surgery under pectoralis nerve block are limited. We herein report a case involving a 74-year-old woman with an infected cardiac pacemaker generator who underwent pacemaker relocation surgery under an ultrasound-guided pectoralis nerve block. On preoperative evaluation, she had congestive heart failure, type 2 diabetes mellitus, and a pacer-dependent heart rhythm. ⋯ Thus, an ultrasound-guided pectoralis nerve block was planned. The surgery was completed successfully, without notable complications. Our findings might help in the management of patients who require pacemaker implantation/relocation.
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Both adductor canal block (ACB) and local infiltration analgesia (LIA) are effective procedures for postoperative pain control in total knee arthroplasty (TKA) without motor blockade. However, whether ACB combined with LIA has synergistic effect than ACB alone remains unknown. We hypothesized that ACB combined with LIA would have better postoperative pain control, less rescue opioid consumption and faster rehabilitation than ACB alone, without higher adverse event rate. ⋯ As compared to ACB alone, ACB + LIA provides better analgesia and faster functional rehabilitation in patients who underwent TKA.
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Plane blocks have become very popular in recent years with the introduction of ultrasonography into the regional anesthesia and algology practice. Erector spinae plane (ESP) block involves injection of local anesthetics between erector spinae muscles and transverse process of vertebrae and can block the dorsal and ventral rami of thoracolumbar spinal nerves. ⋯ These characteristics mean that it will in all probability be widely used in the future, not just for anesthetists, but also for emergency physicians. Here we first report a novel indication for ESP block in emergency department; renal colic.
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Case Reports
Priapism following erector spinae plane block for the treatment of a complex regional pain syndrome.
Erector spinae plane block (ESPB) is a novel block where local anesthetic is deposited between the erector spinae muscle and the underlying transverse process. Safety of this technique is emphasized in the majority of reports, but with a continued increase of its use, the number of related complications and side effects is likely to expand. We report the case of a patient treated with ESPB for a complex regional pain syndrome, complicated by the development of a priapism.