Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2015
Case ReportsPhrenic nerve palsy following interscalene brachial plexus block; a long lasting serious complication.
Interscalene brachial plexus block (ISBPB) offers good analgesia for painful surgical procedures on the shoulder. We here describe two cases of long-term phrenic palsy following ISBPB that occurred in our practice in a relative short time period and both clearly illustrate the devastating impact of this complication for the patient. ⋯ When ISPBP is considered, the fact that the incidence of prolonged phrenic nerve palsy may be higher than previously expected should be taken into account carefully. A reevaluation on the indication and patient selection of ISBPB may even be warranted.
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Acta Anaesthesiol Belg · Jan 2015
Randomized Controlled TrialCombined spinal-epidural for labor analgesia with low-dose bupi- vacaine but without any opioid in the spinal component: can we improve upon the traditional?
To compare the efficacy and safety of combined spinal-epidural (CSE, with the spinal component using low-dose heavy bupivacaine without opioid) with low-dose epidural analgesia in labor. ⋯ CSE using low-dose heavy bupivacaine without opioid required less drug consumption produced faster onset of pain control and sensory block than low-dose epidural analgesia. There were no other significant inter-group differences.
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Acta Anaesthesiol Belg · Jan 2015
Editorial Review Comparative StudyRegional versus general anesthesia for spine surgery. A comprehensive review.
The use of regional anesthesia techniques for intra-operative anesthesia remains very controversial for patients scheduled to undergo spinal interventions. Spine surgery is still mostly performed under general anesthesia. This has to be explained by the patient's position required during surgery, the extent and duration of some procedures, the preference of the surgeon and/or anesthesiologist and a trend which becomes more and more prominent to abandon central nerve blocks in general. ⋯ The present overview will focus on the feasibility of different regional techniques to be used intra-operatively. These techniques may also be of interest or even intended for prolonged postoperative analgesia and benefit even after a single bolus injection, continuous or intermittent administration. Although all techniques described offered favorable success rates, future research is mandatory to determine their superiority over general intra-operative anesthesia and conventional pain therapy.
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Acta Anaesthesiol Belg · Jan 2015
Randomized Controlled Trial Comparative StudyComparison of conventional infrainguinal versus modified proximal suprainguinal approach of Fascia Iliaca Compartment Block for postoperative analgesia in Total Hip Arthroplasty. A prospective randomized study.
Fascia Iliaca Compartment Block (FICB) has been widely used as a postoperative analgesic adjunct to opioids for total hip arthroplasty (THA), either by the conventional infrainguinal approach or the modified proximal suprainguinal approach irrespective of any specific advantage of one over the other. This study was conducted to compare the analgesic efficacy of the two techniques of FICB for postoperative analgesia. The 40 patients scheduled for THA were recruited for Intervention (s) and randomized to receive FICB either by suprainguinal approach (group S) or infrainguinal approach (group I) for postoperative analgesia with 40 ml of 0.2% bupivacaine, in addition to postoperative patient controlled analgesia (PCA) with morphine. ⋯ Postoperatively, there was significant difference in time to first PCA morphine demand (356.28 ± 33.32 vs 291.48 ± 37.17, p = < 0.001, respectively) in-group S vs. group I. The postoperative morphine consumption was also significantly less in group S compared to group I at 6, 12 and 24 hours and the cumulative morphine consumption in 24 hours (6.95 ± 2.14 vs 10.50 ± 2.24, p = < 0.001 respectively) was also less. In conclusion, in THA, suprainguinal approach of FICB has a superior postoperative analgesic efficacy compared to infrainguinal approach of FICB along with significantly less morphine consumption in first 24 hours.
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Acta Anaesthesiol Belg · Jan 2015
Randomized Controlled Trial Comparative StudyA comparative evaluation of the Airtraq and King Vision video laryngoscope as an intubating aid in adult patients.
Airtraq has been shown to improve ease of intubation in patients with normal and difficult airway. King Vision video laryngoscope is a newly introduced intubating device with an attached monitor. We here hypothesized that the King Vision video laryngoscope with channeled blade performs better during intubation as compared to Airtraq. ⋯ The time required to intubate patients was significantly shorter when the King Vision video laryngoscope with channeled blade was used as compared to the Airtraq (p < 0.05). The number of attempts to successfully intubate patients was also significantly lower (p < 0.05) for the King Vision video laryngoscope than for the Airtraq. The use of the Kings Vision video laryngoscope with channeled blade should be encouraged in difficult intubation situations in adult patients with a mouth opening of more than 18 mm.