Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Dec 2024
Risk profiles of common brachial plexus block sites: results from the net-ra registry.
Regional anesthesia is frequently used for upper limb surgeries and postoperative pain control. Different approaches to brachial plexus blocks are similarly effective but may differ in the frequency and severity of iatrogenesis. We, therefore, examined large-scale registry data to explore the risks of typical complications among different brachial plexus block sites for regional anesthesia. ⋯ The axillary approach to the brachial plexus had the highest odds for block failure and neurological dysfunction after catheter placement, as well as a significant risk for catheter failure. However, considering that the axillary approach precludes other complications such as pneumothorax, none of the four common approaches to the brachial plexus has a fundamentally superior risk profile.
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Reg Anesth Pain Med · Dec 2024
Timing of intravenous dexamethasone and analgesia after brachial plexus block: a randomized, double-blind, placebo-controlled trial.
The addition of intravenous dexamethasone can significantly prolong analgesia and reduce opioid-related side effects after brachial plexus blockade, but the most effective administration time is yet unknown. The objective of this study is to determine if the timing of administration of dexamethasone affects the duration of analgesia after supraclavicular brachial plexus block. ⋯ Our results suggest that perioperative administration of 8 mg of intravenous dexamethasone (from 1 hour prior and up to 2 hours postblock) provides similar duration of analgesia to administration at the time of brachial plexus block.
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Reg Anesth Pain Med · Dec 2024
Popliteal plexus block in total knee arthroplasty: a single-center randomized controlled double-blinded trial.
Whether a popliteal plexus block improves postoperative pain following total knee arthroplasty remains debated. This randomized trial tested if adding a popliteal plexus block to a continuous femoral nerve block decreases postoperative opioid requirement. ⋯ Adding a popliteal plexus block to a continuous femoral nerve block decreases 12-hour opioid utilization, but the effect size is small, calling into question its clinical relevance.