Current opinion in anaesthesiology
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The study focuses on neural blocks with local anesthetics in postoperative and chronic pain. It is prompted by the recent publication of several systematic reviews and guidelines. ⋯ Recent literature strongly supports the use of regional anesthesia for postoperative pain, whereby infusions at peripheral nerves and surgical site are gaining increasing importance. Local anesthetic blocks are valid for the diagnosis of facet joint pain and effective in treating headache. There is a need for further research in diagnostic and therapeutic blocks for chronic pain.
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Curr Opin Anaesthesiol · Oct 2016
ReviewSafety and efficiency of dexmedetomidine as adjuvant to local anesthetics.
To review the current knowledge of dexmedetomidine as an additive drug to local anesthetics in peripheral and neuraxial regional anesthesia. ⋯ Dexmedetomidine has a potency to ameliorate pharmacodynamic characteristics of peripheral and neuraxial regional anesthetic techniques and is therefore currently the most promising additive drug in regional anesthesia. Future scientific efforts should focus on dose finding studies for particular regional anesthetic techniques. Approval of dexmedetomidine for regional anesthetic indications should be the final target.
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Abdominal wall blocks in adults have evolved much during the last decade; that is, particularly with the introduction of ultrasound-guided (USG) blocks. This review highlights recent advances of block techniques within this field and proposes directions for future research. ⋯ USG abdominal wall blocks in adults are commonplace techniques today. Most abdominal wall blocks are assigned evidence grade A or B according to the US Agency for Healthcare Policy and Research guidelines.
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Curr Opin Anaesthesiol · Oct 2016
ReviewNew modalities of neurostimulation: high frequency and dorsal root ganglion.
Neurostimulation is a well tolerated, cost-efficient, and effective method to treat chronic pain. Although spinal cord stimulation (SCS) has been shown to help patients, newer modalities such as burst, kilohertz-frequency, and dorsal root ganglion stimulation may provide greater pain relief, fewer paresthesias, and better outcomes. ⋯ Improvements in pain control and patient satisfaction suggest that these new stimulation patterns will greatly increase the utility of neurostimulation; however, clinical trials with broader patient populations have to be done to support more extensive use of these therapies.