Articles: nerve-block.
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Curr Pain Headache Rep · Sep 2024
ReviewNerve Injury Following Regional Nerve Block: A Literature Review of Its Etiologies, Risk Factors, and Prevention.
Postoperative nerve injury after nerve block is complex and multifactorial. The mechanisms, etiologies, and risk factors are explored. This review article conducts a literature search and summarizes current evidence and best practices in prevention of nerve injury. ⋯ Emerging technology such as ultrasound, injection pressure monitors, and nerve stimulators for peripheral nerve block have been incorporated into regular practice to reduce the rate of nerve injury. Studies show avoidance of intrafascicular injection, limiting concentrations/volumes of local anesthetic, and appropriate patient selection are the most significant controllable factors in limiting the negative consequences of nerve block. Peripheral nerve injury is an uncommon occurrence after nerve block and is obscured by surgical manipulation, positioning, and underlying neural integrity. Underlying neural integrity is not always evident despite an adequate history and physical exam. Surgical stress, independently of nerve block, may exacerbate these neurologic disease processes and make diagnosing a postoperative nerve injury more challenging. Prevention of nerve injury by surgical teams, care with positioning, and avoidance of intrafascicular injection with nerve block are the most evidence-based practices.
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Prior research has suggested that the rhomboid intercostal block (RIB) may contribute to postoperative analgesia after surgeries of the chest and breast. ⋯ RIB may be a new option for pain relief after chest and breast surgery.
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Curr Pain Headache Rep · Sep 2024
Review Case ReportsLacrimal Neuralgia: A Case Report and Comprehensive Review of the Literature.
Lacrimal neuralgia is a rare periorbital neuralgia. To date, only nine cases have been reported in the literature. Herein, we report a case and a comprehensive overview of the entity with a focus on the differential diagnosis of lacrimal neuralgia. Additionally, we propose putative diagnostic criteria for this rare neuralgia based on cases that have been reported. ⋯ Among the ten cases of lacrimal neuralgia reported (including the one in this review), seven out of ten were idiopathic, and the other three were considered secondary. Most patients reported stabbing and shooting pain that was either paroxysmal or continuous. The most effective therapy was nerve block for seven patients and pregabalin for three patients. The most important clues to differentiate lacrimal neuralgia from other causes of periorbital pain include pain topography and pain with features suggestive of neuralgia. The core feature of lacrimal neuralgia is neuralgic pain located in the area supplied by the lacrimal nerve, and the etiology could be primary or secondary. Responsiveness to anesthetic blockade might better serve as a confirmational, rather than mandatory, criterion for diagnosis.
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Meta Analysis Comparative Study
Comparison of the efficacy and safety of different puncture routes for ultrasound-guided fascia iliaca compartment block for early analgesia after hip arthroplasty: A meta-analysis.
This study aimed to compare the effect of ultrasound-guided fascia iliaca compartment block with different puncture sites on postoperative analgesia in patients undergoing hip arthroplasty. ⋯ This study demonstrates that the SA puncture pathway has a significant advantage over the IA pathway in reducing active pain in early postoperative pain management without increasing the risk of adverse events. This finding supports the prioritization of SA pathway in clinical practice where postoperative pain control is considered. Future research should continue to explore the use of SA pathway in different patient populations and types of surgery, as well as their impact on long-term postoperative recovery, with the aim of optimizing individualized postoperative pain management strategies.
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Review Meta Analysis Comparative Study
Quadratus lumborum block vs. transversus abdominis plane block for postoperative pain control in patients with nephrectomy: A systematic review and network meta-analysis.
This systematic review and network meta-analysis aimed to compare the analgesic efficacy of transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB) on nephrectomy. ⋯ QLB is more likely to be effective in reducing postoperative opioid use than TAPB, whereas both of them are superior to control with regard to the reduction in postoperative pain intensity and PONV.