Articles: nerve-block.
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Case Reports
Hematoma After Continuous Erector Spinae Plane Block With Catheter Placement: A Case Report.
The erector spinae plane block (ESPB) is described as a safe and effective alternative when epidural or paravertebral blocks are contraindicated by anticoagulation therapy. We present a case of subcutaneous hematoma after ESPB catheter placement. The patient received bilateral ESPB catheters for perioperative pain control. ⋯ Physical examination revealed a well circumscribed, fluctuant mass that produced bloody material during incision and drainage. This case report describes hematoma as a potential complication of the ESPB. After the procedure, patients should be closely monitored for complications, including hematoma.
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Randomized Controlled Trial
Anterior Quadratus Lumborum block area comparison in the three different volumes of Ropivacaine: a double-blind, randomized controlled trial in healthy volunteers.
In abdominal surgery, ultrasound-guided anterior quadratus lumborum blocks (QLB) are performed to induce analgesia. However, no study reported suitable volumes of the anterior QLB for the different postoperative analgesia regions. Therefore, this prospective randomized controlled study assessed the dermatomal spread and analgesic effects of the three different volumes of a local anesthetic for anterior QLB. ⋯ No difference was observed in block duration with the various volumes of 0.375% ropivacaine. However, the larger volume for anterior QLB contributed to a larger area of cutaneous sensory blockade. Appropriate volumes in anterior QLB can create suitable postoperative analgesia levels for the different operative sites.
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J. Cardiothorac. Vasc. Anesth. · Nov 2022
ReviewParasternal Intercostal Nerve Blocks in Patients Undergoing Cardiac Surgery: Evidence Update and Technical Considerations.
In the Enhanced Recovery After Surgery era, parasternal intercostal nerve block has been proposed to improve pain control and reduce opioid use in patients undergoing cardiac surgery. However current literature has reported conflicting evidence about the effect of this multimodal pain management, as procedural variations might pose a significant bias on outcomes evaluation. In this setting, the infiltration of the parasternal plane into 2 intercostal spaces, second and fifth, with a local anesthetic spread under or above the costal plane with ultrasound guidance, seem to be standardized in theory, but significant differences might be observed in clinical practice. ⋯ A trend toward reduced intensive care unit stay or duration of mechanical ventilation should be confirmed by adequately powered randomized trials or registry studies. Differences in operative technique might impact outcomes and, therefore, standardization of the procedure plays a pivotal role before reporting specific outcomes. Parasternal plane blocks might significantly improve outcomes of cardiac surgery with full median sternotomy, and should be introduced comprehensively in Enhanced Recovery After Surgery protocols.