Articles: analgesia.
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Minerva anestesiologica · Dec 2024
A randomized clinical trial comparing different combination of peripheral nerve blocks for intraoperative analgesia in patients on antithrombotic drugs undergoing hip fracture surgery: pericapsular nerve group (PENG) block versus femoral and obturator nerve block.
Locoregional anesthesia is commonly used in orthopedic trauma surgery, particularly in elderly patients. We conducted a prospective, monocentric, randomized controlled trial to evaluate the anesthetic and analgesic efficacy of pericapsular nerve group (PENG) block in patients on antithrombotic drugs undergoing hip fracture surgery, comparing it with femoral and obturator nerve block (FNB+ONB). ⋯ Our results suggest that PENG block is not inferior to FNB + ONB as anesthetic and analgesic technique in patients on antithrombotic drugs undergoing hip fracture surgery.
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Minerva anestesiologica · Dec 2024
Comparison of two approaches to quadratus lumborum block for postoperative analgesia in radical cystectomy: a randomized clinical trial.
The aim of this study was to evaluate the analgesic effects following radical cystectomy using two ultrasound guided QLB techniques: anterior and intramuscular. ⋯ Compared with QLBi, bilateral ultrasound guided QLBa provided a longer time to the first analgesic request, less postoperative opioid consumption, lower NRS at rest and on movement, and higher patients' satisfaction after radical cystectomy under general anesthesia.
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Increasing evidence indicates that neuropeptide FF (NPFF) produces analgesic effects and augments opioid-induced analgesia at the spinal level. However, our recent research demonstrated that NPFF exerted complex opioid-modulating effects in an inflammatory pain model after intrathecal (i.t.) injection. Consistent with previous findings, we found that i.t. ⋯ Moreover, these modulating effects of spinal NPFFR2 were selectively targeting mu-opioid receptor, had no effect on delta- and kappa-opioid receptor agonist-induced analgesia. Finally, the opioid-modulating effects of NPFF were further verified using in vitro calcium imaging assay, demonstrating that pretreated with NPFF in primary-cultured spinal neurons significantly attenuated the inhibitory effects of morphine on high-K+-induced neuronal excitability. Taken together, our results suggested that NPFF exhibited dual modulating effects on morphine-induced analgesia after i.t. administration, which provides a possible mechanism to explain the complex opioid-modulating effects of endogenous NPFF systems.
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Curr Opin Anaesthesiol · Dec 2024
Pro's and con's of different blocks for postoperative analgesia after video-assisted thoracic surgery.
Although there are a lot of studies examining the effects of different blocks for postoperative analgesia after video-assisted thoracic surgery (VATS), the results are controversial. ⋯ All three blocks can be suggested for daily practice, the choice should be based on personal experience and preference of the anesthetist. Better studies are required for objective decision.