Articles: nerve-block.
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Randomized Controlled Trial
Continuous interscalene versus phrenic nerve-sparing high-thoracic erector spinae plane block for total shoulder arthroplasty: a randomized controlled trial.
The high-thoracic erector spinae plane block (HT-ESPB) has been reported as an effective analgesic modality for the shoulder region without phrenic nerve palsy. The goal of this study was to compare the HT-ESPB as a phrenic nerve-sparing alternative to an interscalene block for total shoulder arthroplasty. ⋯ gov (NCT03807505); registered 17 January 2019.
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Strong spontaneous inspiratory efforts can be difficult to control and prohibit protective mechanical ventilation. Instead of using deep sedation and neuromuscular blockade, the authors hypothesized that perineural administration of lidocaine around the phrenic nerve would reduce tidal volume (VT) and peak transpulmonary pressure in spontaneously breathing patients with acute respiratory distress syndrome. ⋯ Phrenic nerve block is feasible, lasts around 12 h, and reduces VT and driving pressure without changing respiratory rate in patients under assisted ventilation.
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Chronic neck pain is often multifactorial and is a leading cause of pain and disability. Cervical facet joint pain is a common cause of neck pain and, in addition to more conservative modalities, can be treated with radiofrequency ablation (RFA) of the respective medial branch nerves. Cervicogenic headaches are a frequent complaint in pain clinics in the United States and can be targeted via a similar procedural approach. ⋯ Based on this systematic review, efficacy of cervical facet RFA in treatment of chronic neck pain has Level II evidence.