Articles: nerve-block.
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Reg Anesth Pain Med · May 2024
Practice 'safe scans': why ultrasound transducer covers should be considered best practice.
Single-injection, ultrasound-guided nerve block procedures involve puncturing the skin in close proximity to an ultrasound transducer, creating a potential vector for transmission of microbial organisms when skin flora and blood come into contact with the probe. Practice patterns regarding disinfection of the transducer and the use of barrier protection are inconsistent, ranging from sterile sleeve probe covers to no cover at all. ⋯ This position is shared by multiple societies and authorities on ultrasound and acute care medicine. In this Daring Discourse, we outline the arguments supporting the utilisation of single-use sleeve probe covers to ensure patient safety with respect to vector-borne transmission of microbes during single-injection regional anaesthesia procedures.
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Meta Analysis Comparative Study
Comparison of fascia iliaca block with quadratus lumborum block for hip arthroplasty: A meta-analysis of randomized controlled trials.
The efficacy of fascia iliaca block (FIB) versus quadratus lumborum block (QLB) remains controversial for pain management of hip arthroplasty. We conduct a systematic review and meta-analysis to explore the influence of FIB versus QLB on the postoperative pain intensity of hip arthroplasty. ⋯ FIB may be better than QLB for pain control after hip arthroplasty, as evidenced by the lower pain scores at 2 and 24 hours.
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Reg Anesth Pain Med · May 2024
ReviewExtended reality navigation for pain procedures: a narrative review.
Extended reality (XR) technology, encompassing virtual reality, augmented reality, and mixed reality, has been widely studied for procedural navigation in surgical specialties. Similar to how ultrasound transformed regional anesthesia, XR has the potential to reshape how anesthesiologists and pain physicians perform procedures to relieve pain. ⋯ Early randomized controlled trials show potential for XR to improve procedural efficiency, but more comprehensive research is needed to determine if there are significant clinical benefits. Case reports demonstrate XR's utility in generating patient-specific navigation plans when difficult anatomy is encountered. Procedures that facilitate the generation and registration of XR images are most conducive to XR navigation, whereas those that rely on frequent re-imaging will continue to depend on traditional modes of navigation.
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Reg Anesth Pain Med · May 2024
No quadriceps muscle weakness following anterior quadratus lumborum block compared with placebo: a randomized, non-inferiority, blinded, volunteer trial.
Anterior quadratus lumborum block is a truncal block, applied in close proximity to the lumbar plexus, potentially causing lower limb weakness. This trial aimed to evaluate whether a unilateral anterior quadratus lumborum block caused quadriceps muscle weakness compared with placebo. ⋯ In this randomized controlled trial including healthy volunteers a unilateral anterior quadratus lumborum block does not cause statistical or clinical significant motor block of the quadriceps muscle compared with placebo. When administered correctly, the block can be used for procedures where early postoperative mobilization is essential.
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Reg Anesth Pain Med · May 2024
0.25% bupivacaine-1% lidocaine vs 0.5% bupivacaine for ultrasound-guided infraclavicular brachial plexus block: a randomized controlled trial.
In an effort to shorten onset time, a common practice is to add lidocaine to bupivacaine. In the setting of infraclavicular block, it is unclear what the block characteristics of this practice are compared with bupivacaine alone. We hypothesized that bupivacaine alone increases the duration of motor block, sensory block, and postoperative analgesia while resulting in a slower onset time compared with a bupivacaine and lidocaine mixture. ⋯ Compared with mixed bupivacaine-lidocaine, 0.5% bupivacaine significantly prolongs sensorimotor block and postoperative analgesia at the expense of a delayed onset time.