Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2024
GFAP palmitoylcation mediated by ZDHHC23 in spinal astrocytes contributes to the development of neuropathic pain.
Cancer pain has a significant impact on patient's quality of life. Astrocytes play an important role in cancer pain signaling. The direct targeting of astrocytes can effectively suppress cancer pain, however, they can cause many side effects. Therefore, there is an urgent need to identify the specific signaling pathways or proteins involved within astrocytes in cancer pain as targets for treating pain. ⋯ In a rodent model, targeting GFAP palmitoylation appears to be an effective strategy in relieving cancer pain and morphine tolerance. Human translational research is warranted.
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Reg Anesth Pain Med · May 2024
Comparative anatomical study of digital block with the WALANT, interdigital, and transthecal techniques.
Interdigital block and transthecal block through the flexor sheath are commonly used techniques for the anesthesia of isolated fingers. The wide-awake local anesthetic no-tourniquet technique is a relatively new approach for local anesthesia during finger procedures. The anatomical spread of local anesthetics with the wide-awake local anesthetic no tourniquet technique has not been described adequately.This anatomical study aimed to assess the distribution of a local anesthetic dye solution to the digital nerves. The study was designed to compare the nerve staining effect using the wide-awake local anesthetic no tourniquet and the transthecal and interdigital techniques in cadavers. We hypothesized that the wide-awake local anesthetic no tourniquet technique stains digital nerves more effectively than the interdigital and transthecal digital injection techniques. ⋯ The wide-awake local anesthetic no tourniquet technique was as effective as conventional techniques in the digital blockade, achieving specific spread on the targeted nerves.
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Reg Anesth Pain Med · May 2024
Pericapsular nerve group (PENG) block: what have we learned in the last 5 years?
This educational article discusses the current understanding of the pericaspular nerve group block (PENG) of the hip regarding its mechanism of action and spread patterns, as well as plausible explanations for postblock quadriceps weakness. Finally, we will discuss the recent evidence of PENG block as an analgesic block in hip fractures and in different hip surgeries.