Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Dec 2022
Randomized Controlled TrialComparison of sitting and prone positions for real-time ultrasound-guided thoracic epidural catheter placement: a randomized controlled trial.
Real-time ultrasound-guided thoracic epidural catheter placement (US-TECP) has been recently introduced. Patient's position is associated with the success of spine interventions; however, the effects of position on the outcome of the procedure remain unknown. We aimed to assess the clinical usefulness of patient positioning during real-time US-TECP. ⋯ This study shows that prone position may be preferred for real-time US-TECP, considering its better clinical usefulness.
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Reg Anesth Pain Med · Dec 2022
Randomized Controlled TrialEfficacy of ultrasound-guided single-injection erector spinae plane block for thoracoscopic wedge resection: a prospective randomized control trial.
Despite advances in minimally invasive thoracic surgery, patients remain at risk of adverse pulmonary events with suboptimal postoperative analgesia. Novel methods of regional analgesia are warranted. Our objective was to prospectively evaluate the impact of ultrasound-guided single-injection erector spinae plane (ESP) block with ropivacaine compared with placebo control on standard of care postoperative recovery in subjects undergoing video-assisted thoracoscopic surgery (VATS) wedge resection. ⋯ Following VATS wedge resection, the addition of an ESP block with ropivacaine to standard multimodal analgesia is unlikely to add meaningful clinical value.
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Reg Anesth Pain Med · Oct 2022
Randomized Controlled TrialImpact of an extrafascial versus intrafascial injection for supraclavicular brachial plexus block on respiratory function: a randomized, controlled, double-blind trial.
Hemidiaphragmatic paresis after ultrasound-guided supraclavicular brachial plexus block is reported to occur in up to 67% of patients. We tested the hypothesis that an injection outside the brachial plexus sheath reduces the incidence of hemidiaphragmatic paresis compared with an intrafascial injection while providing similar analgesia. ⋯ Ultrasound-guided supraclavicular brachial plexus block with an extrafascial injection does not reduce the incidence of hemidiaphragmatic paresis although it provides similar analgesia, when compared with an intrafascial injection. The longer time to surgery readiness is less compatible with contemporary operating theater efficiency requirements.
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Reg Anesth Pain Med · Sep 2022
Randomized Controlled TrialComparison of postoperative analgesic effects of posterior quadratus lumborum block and intrathecal morphine in laparoscopic donor hepatectomy: a prospective randomized non-inferiority clinical trial.
Posterior quadratus lumborum block (QLB) and intrathecal morphine are accepted analgesic strategies in laparoscopic liver resection, but their effects have not been compared after laparoscopic donor hepatectomy. This study was planned to perform this comparison. ⋯ Bilateral posterior QLB elicited higher resting pain scores at 24-hour after laparoscopic donor hepatectomy than intrathecal morphine and did not meet the definition of non-inferiority.
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Reg Anesth Pain Med · Sep 2022
Randomized Controlled TrialComparison of lateral quadratus lumborum and lumbar plexus blocks for postoperative analgesia following total hip arthroplasty: a randomized clinical trial.
Effective analgesia after total hip arthroplasty must minimize pain and optimize early ambulation. Lumbar plexus blocks (LPBs) provide analgesia but may cause motor weakness. Quadratus lumborum blocks (QLBs) may provide analgesia with preserved motor strength. ⋯ Although we were unable to demonstrate non-inferiority for opioid consumption at 12-hour postoperative, strength and mobilization were improved in lateral QLB subjects.