Articles: nerve-block.
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Review Meta Analysis
Efficacy of Phrenic Nerve Block and Suprascapular Nerve Block in Amelioration of Ipsilateral Shoulder Pain after Thoracic Surgery: A Systematic Review and Network Meta-Analysis.
Background and Objectives: Ipsilateral shoulder pain (ISP) is a common complication after thoracic surgery. Severe ISP can cause ineffective breathing and impair shoulder mobilization. Both phrenic nerve block (PNB) and suprascapular nerve block (SNB) are anesthetic interventions; however, it remains unclear which intervention is most effective. ⋯ Conclusion: This study suggests that PNB ranks first for prevention and reduction of ISP severity during the first 24 h after thoracic surgery. SNB was considered the worst intervention for ISP management. No evidence indicated that PNB was associated with a significant impairment of postoperative ventilatory status.
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Randomized Controlled Trial Comparative Study
Nociception Control of Bilateral Single-Shot Erector Spinae Plane Block Compared to No Block in Open Heart Surgery-A Post Hoc Analysis of the NESP Randomized Controlled Clinical Trial.
Background and Objectives: The erector spinae plane block (ESPB) is an analgesic adjunct demonstrated to reduce intraoperative opioid consumption within a Nociception Level (NOL) index-directed anesthetic protocol. We aimed to examine the ESPB effect on the quality of intraoperative nociception control evaluated with the NOL index. Materials and Methods: This is a post hoc analysis of the NESP (Nociception Level Index-Directed Erector Spinae Plane Block in Open Heart Surgery) randomized controlled trial. ⋯ The NOL index was significantly lower in the ESPB-to-Control group at T2 (12.95 ± 1.49 vs. 35.97 ± 1.47), T3 (13.28 ± 1.49 vs. 24.44 ± 1.47), and T4 (15.52 ± 1.49 vs. 34.39 ± 1.47) (p < 0.001) but not at T1 and T5. Compared to controls, significantly fewer ESPB patients reached a NOL index > 25 at T2 (4.7% vs. 79%), T3 (0% vs. 37.2%), and T4 (7.1% vs. 79%) (p < 0.001). Conclusions: The addition of bilateral single-shot ESPB to general anesthesia during cardiac surgery improved the quality of intraoperative nociception control according to a NOL index-based evaluation.
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Background and Objectives: This study aims to investigate whether erector spinae plane (ESP) block can be an alternative to general anesthesia as a primary anesthesia method in percutaneous balloon kyphoplasty surgery. In addition, postoperative intensive care needs were compared in terms of length of intensive care unit stay and length of hospital stay. Materials and Methods: Medical records of patients who underwent percutaneous balloon kyphoplasty operation at Kastamonu Training and Research Hospital between January 2020 and November 2022 were reviewed retrospectively. ⋯ A statistically significant difference was found in Group GA and Group ESP, which was higher in Group GA for the length of stay in the intensive care unit (p = 0.02) and length of hospitalization (p = 0.04). Conclusions: ESP block may be an alternative method to general anesthesia as the primary anesthetic option for single or multilevel percutaneous balloon kyphoplasty surgery. With the ESP block, the length of stay in the intensive care unit and the length of stay in the hospital can be reduced, especially in high-risk patients.
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This article represents the response to the inquiries adopted by Dr. Raghuraman M Sethuraman, M. D., regarding our recently published study which compared the erector spinae plane block (ESPB) versus paravertebral block (PVB) regarding postoperative analgesic consumption following breast surgeries (Elewa et al, BMC Anesthesiol 22: 1-9, 2022). We would like to introduce our appreciation and gratitude to the author for his interest in our work, despite being inaccurate in some of his comments.