Articles: nerve-block.
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Randomized Controlled Trial
Perineural and Systemic Dexamethasone and Ulnar Nerve Block Duration A Randomized, Blinded, Placebo-controlled Trial in Healthy Volunteers.
The authors hypothesized that both perineural and systemic dexamethasone as adjuncts to bupivacaine increase the duration of an ulnar nerve block compared with bupivacaine alone, and that systemic dexamethasone is noninferior to perineural dexamethasone. ⋯ Perineural dexamethasone as an adjunct to bupivacaine in healthy volunteers resulted in a greater duration of an ulnar nerve block when compared with placebo. Systemic dexamethasone resulted in a similar duration as placebo.
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Curr Opin Anaesthesiol · Jun 2023
ReviewRegional anesthesia as part of enhanced recovery strategies in pediatric cardiac surgery.
The purpose of this review article was to highlight the enhanced recovery protocols in pediatric cardiac surgery, including early extubation, rapid mobilization and recovery, reduction of opioid-related side effects, and length of pediatric ICU and hospital stay, resulting in decreased costs and perioperative morbidity, by introducing recent trends in perioperative anesthesia management combined with peripheral nerve blocks. ⋯ Recent remarkable advances in combined ultrasound techniques have made it possible to perform various peripheral nerve blocks. The major strategy underlying fast-track anesthesia management is to achieve good analgesia while reducing perioperative opioid use. Furthermore, it is important to consider early extubation not only as a competition for time to extubation but also as the culmination of a qualitative improvement in the outcome of treatment for each patient.
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Our meta-analysis aimed to compare the analgesic effectiveness of ultrasound-guided preoperative erector spinae plane block (ESPB) versus paravertebral nerve block (PVB) in breast surgery. ⋯ Both ultrasound-guided preoperative ESPB and PVB showed comparable analgesic effects in patients undergoing breast surgery. However, with a significantly shorter procedure time and higher block success rate, our findings suggest that ESPB may be a simple alternative to PVB in breast surgery.
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Minerva anestesiologica · Jun 2023
Randomized Controlled TrialComparison of ultrasound-guided erector spinae plane block and thoracic paravertebral block for postoperative analgesia after laparoscopic nephrectomy: a randomized controlled non-inferiority clinical trial.
Thoracic paravertebral block offers effective analgesia after laparoscopic nephrectomy but has potential severe complication risks. Erector spinae plane block has been described for analgesia after abdominal surgery. However, there are no prospective randomized trials determining if ultrasound-guided erector spinae plane block is non-inferior to thoracic paravertebral block in terms of analgesia after abdominal surgeries including laparoscopic nephrectomy. ⋯ This study demonstrates that erector spinae plane block provides non-inferior analgesia for pain at rest within 24 postoperative hours in comparison to thoracic paravertebral block for laparoscopic nephrectomy.
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Randomized Controlled Trial
Efficacy of erector spinae plane block for minimally invasive mitral valve surgery: Results of a double-blind, prospective randomized placebo-controlled trial.
To investigate if an erector spinae plane (ESP) block decreases postoperative opioid consumption, pain and postoperative nausea and vomiting in patients undergoing minimally invasive mitral valve surgery (MIMVS). ⋯ Following MIMVS, adding an ESP block to a standard multimodal analgesia regimen did not reduce opioid consumption and pain scores.