Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Aug 2018
Ultrasound Assessment of Ice-Ball Formation by Cryoneurolysis Device in an Ex Vivo Model.
Real-time ice-ball formation during cryoneurolysis has sparsely been assessed with ultrasound (US). Cryoneurolysis in lower back pain syndrome represents a validated management option in cases of facet joint syndrome. Ultrasound may be a useful tool to perform facet joint cryodenervation. The objective of this study was to assess, ex vivo, the ability of US to assess the ice-ball formation of a cryoneurolysis device. ⋯ Ultrasound is a useful tool to monitor the formation of ice ball during a cryoneurolysis freezing cycle. Power Doppler appears as the only option to monitor the ice ball with low-frequency transducers. This novel finding may be useful in cases of lumbar medial branch cryoneurolysis, an application we plan to assess in a future pilot prospective study.
-
Reg Anesth Pain Med · Aug 2018
Case ReportsMajor Laparoscopic Intraperitoneal Surgery Performed With Combined Bilateral Subcostal Transversus Abdominal Plane Block and Celiac Plexus Block, Intravenous Sedation Without Tracheal Intubation: A Feasibility Study of 3 Cases.
Major abdominal surgery usually requires general anesthesia with tracheal intubation and may be supplemented with neuraxial anesthesia to provide intraoperative and postoperative pain relief. Attempts at using only neuraxial anesthesia for major abdominal surgery have often been shown to be poorly effective. This report demonstrates that laparoscopic colonic surgical procedures can be performed with ultrasound-guided blocks (bilateral transversus abdominal plane block and celiac plexus block) and intravenous sedation, while avoiding general or neuraxial anesthesia. ⋯ To date, celiac plexus block has been used almost exclusively to relieve pancreatic cancer pain. This is the first report in which it is shown that major intra-abdominal surgery can be performed almost exclusively with regional anesthesia while avoiding adverse effects and problems associated with either general or neuraxial anesthesia. In addition, prolonged postoperative pain relief facilitated early recovery.