Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2021
Randomized Controlled TrialTransmuscular quadratus lumborum block for total laparoscopic hysterectomy: a double-blind, randomized, placebo-controlled trial.
The population of patients scheduled for total laparoscopic hysterectomy at our surgical center is heterogeneous concerning a multitude of demographic variables such as age, collateral surgery and malign or benign pathogenesis. A common denominator is moderate to severe postoperative pain and a substantial opioid consumption. A recent procedure specific postoperative pain management (PROSPECT) review found no gain from the regional techniques included. The transmuscular quadratus lumborum (TQL) block has shown promising results in recent trials for other types of surgery. The aim of the current study was to investigate the analgesic efficacy of the ultrasound-guided TQL block for total laparoscopic hysterectomy. ⋯ Preoperative bilateral ultrasound-guided TQL block did not reduce opioid consumption after total laparoscopic hysterectomy.
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Reg Anesth Pain Med · Jan 2021
Safety and outcomes of outpatient compared to inpatient total knee arthroplasty: a national retrospective cohort study.
Many factors are driving total knee arthroplasty to be performed more commonly as an outpatient (<24 hour discharge) procedure. Nonetheless, the safety of total knee replacements performed in the outpatient setting is not well established when compared with inpatient setting. The purpose of this study is to compare the postoperative outcomes of outpatient and inpatient total knee arthroplasties. ⋯ Outpatient total knee arthroplasty is associated with a higher composite risk of serious adverse events than inpatient procedures. Anesthesiologists and surgeons should inform patients and discuss this information when obtaining consent for surgery and planning for discharge timing.
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Reg Anesth Pain Med · Jan 2021
American Society of Regional Anesthesia and Pain Medicine Local Anesthetic Systemic Toxicity checklist: 2020 version.
The American Society of Regional Anesthesia and Pain Medicine (ASRA) periodically updates its practice advisories and associated cognitive aids. The 2020 version of the ASRA Local Anesthetic Systemic Toxicity checklist was created in response to user feedback, simulation studies and advances in medical knowledge. This report presents the 2020 version and discusses the rationale for its update.