Articles: nerve-block.
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Avoidance of general anesthesia and endotracheal intubation has been shown to reduce respiratory complications in patients with severe lung disease. We describe the case of a 75-year-old patient with chronic obstructive pulmonary disease (COPD) who underwent cochlear implantation managed with nerve block and sedation. A superficial cervical plexus block (SCPB) was performed with 1% mepivacaine before surgery. ⋯ The patient experienced only slight pain during surgery. A SCPB had a good analgesic effect on the posterior auricle. Cochlear implantation in patients with COPD can be performed using a SCPB and sedation.
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Randomized Controlled Trial Comparative Study
Reduction of leakage from insertion site during continuous femoral nerve block with catheter-through-needle versus catheter-over-needle technique for postoperative analgesia after total knee arthroplasty: a randomized controlled trial.
Continuous femoral nerve block (CFNB) is a common procedure used for postoperative analgesia in total knee arthroplasty. Continuous nerve block using a conventional needle (catheter-through-needle/CTN) is complicated by leakage of the anesthetic from the catheter insertion site. A different type of needle (catheter-over-needle/ CON) is now available, which is believed to reduce leakage as the diameter of the catheter is larger than that of the needle. The purpose of this study was to compare the incidence of leakage from the catheter insertion site during CFNB while using CTN and CON for postoperative analgesia after total knee arthroplasty (TKA). ⋯ Use of CON reduces the incidence of leakage from the catheter insertion site during CFNB in the use of postoperative analgesia for total knee arthroplasty. Future research is needed to determine additional benefits of using CON related to decreased leakage.
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Ear pain is mediated by cranial nerves V, IX, and X, as well as branches of C2 and C3, including the occipital nerve. Occipital neuralgia may play a role in the development or worsening of tinnitus and otalgia. The authors reviewed and report 33 cases of ultrasound-guided occipital nerve blocks in patients with tinnitus and otalgia, with postprocedure follow-up intervals of up to 2 years. We found that greater occipital nerve blocks may be a valuable treatment method for these patients.
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Hip arthroscopy is often associated with postoperative pain, requiring opioid analgesia. We describe our use of the pericapsular nerve group (PENG) block as a rescue analgesia for hip arthroscopy. ⋯ All patients exhibited good pain control without clinically significant quadriceps weakness and were able to go home the same day. This case report illustrates the possibility of using the PENG block as an alternative to more conventional regional nerve blocks, such as a fascia iliaca block, femoral nerve block, or lumbar plexus block.
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Randomized Controlled Trial
Day-One Pain Reductions after Hip and Knee Replacement when Buprenorphine-Clonidine-Dexamethasone is added to Bupivacaine Nerve/Plexus Blocks: A Randomized Clinical Trial.
To compare pain outcome reports of patients undergoing hip or knee replacement who received single-injection nerve/plexus blocks with plain bupivacaine (BPV) with those of patients who received injections of buprenorphine-clonidine-dexamethasone (BCD) admixed with BPV. ⋯ Preoperative BPV-BCD blocks in the L2-L4 and L4-S3 nerve distributions for hip and knee replacements led to less pain on postoperative day one and increased knee and hip range of motion, compared with plain BPV blocks.