Acta clinica Croatica
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Interfascial plane blocks (IPB) are truncal blocks with local anesthetic injected into space between two muscle layers. IPBs are easy to learn, simple to perform, provide satisfactory analgesia up to 24 hours, having a minimal risk of complications. ⋯ QLB and ESPB have great potential to improve and facilitate postoperative pain management in obstetric and gynecologic surgery.
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In 10% to 30% cancer-pain cases standard analgesic therapy fails to provide effective pain relief. Interventional techniques, such as peripheral nerve blocks, neuraxial analgesia along with neurolytic blocks may be used for such refractory pain. Peripheral nerve blocks can be used when pain occurs in the territory of one or more peripheral nerves, but rarely as main therapy. ⋯ Neurolysis is the targeted destruction of a nerve or nerve plexus, using chemicals, radiofrequency ablation (RFA), cryoablation, and neurosurgical procedures; however, it rarely completely eliminates pain because patients frequently experience coexisting somatic and neuropathic pain as well. Complex conditions of palliative patients along with limited high-quality randomized controlled trials limit the use of interventional procedures. Even so, some cancer patients benefit from interventional procedures to achieve pain alleviation and consequently improve quality of life.
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Acta clinica Croatica · Sep 2022
ReviewPERIOPERATIVE PREPARATION OF CARDIAC PATIENTS IN REGIONAL ANESTHESIA.
Preoperative cardiovascular management is an essential component of overall perioperative cardiovascular care. It involves preoperative detection and management of cardiovascular disease and prediction of both short-term and long-term cardiovascular risk. ⋯ This requires individualized management. Careful preoperative preparation at least a week before surgery, rational decisions regarding necessary tests and examinations, good cooperation with the cardiologist and surgeon and careful planning of early postoperative treatment are key for better outcome after surgery and reduction of postoperative complications.
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Acta clinica Croatica · Sep 2022
CLINICAL EFFECTS OF HYPERBARIC LIDOCAINE AND BUPIVACAINE IN SPINAL ANESTHESIA - OUR EXPERIENCE.
Various side effects and complications in the perioperative period can occur with the use of hyperbaric lidocaine and bupivacaine. ⋯ The compared incidence of adverse perioperative clinical effects and complications after administration of hyperbaric lidocaine and bupivacaine in spinal anesthesia was not statistically significant.
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Cancer pain is not a homogenous and clearly understood pathological process. The best treatment is a combination of drug and non-drug measures. Pain is divided into visceral, bone or neuropathic pain and has characteristics of continuous or intermittent pain. ⋯ Placement of epidural, intrathecal and subcutaneous catheters, conductive nerve blocks with continuous delivery of mixed local anesthetics are very successful for selected patients. Conventional physical therapy involving lymphatic drainage is useful. Acupuncture, psychotherapy and similar methods are also applicable.