Articles: nerve-block.
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Erector spinae plane (ESP) continuous catheters are used for the management of postsurgical pain. The use of these catheters for acute nonsurgical abdominal pain is not well defined. ⋯ Bilateral ESP continuous catheters successfully controlled her pain, and she was weaned off of all analgesics during the week following catheter placement. This case demonstrates that ESP continuous catheters can be considered for patients with acute nonsurgical abdominal pain especially when thoracic epidural analgesia is contraindicated.
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Curr Pain Headache Rep · Nov 2021
Review Case ReportsA Review of Techniques of Intercostal Nerve Blocks.
Intercostal nerve blocks are indicated for multiple chronic pain and acute pain conditions including rib fractures, herpes zoster, post-thoracotomy pain syndrome, and intercostal neuralgia. Intercostal neuralgia is a type of neuropathic pain that is in the distribution of intercostal nerves. The purpose of this review is to evaluate the different techniques used to perform intercostal nerve blocks and review their efficacy and safety including blind technique using anatomical landmarks, and fluoroscopically guided and ultrasound-guided intercostal nerve blocks. ⋯ Literature search was performed with the keywords including intercostal neuralgia, treatment, intercostal nerve blocks, and radiofrequency ablation on PubMed and Google Scholar. Three studies and one case report were identified. Literature review revealed that ultrasound-guided techniques and fluoroscopically guided techniques are superior to landmark-based technique in terms of efficacy. There was no difference in efficacy and complication rates between ultrasound and fluoroscopic guidance. Ultrasound-guided techniques and fluoroscopically guided techniques can both be performed safely and effectively for various chronic pain conditions. Ultrasound guidance has its advantages of direct visualization of nerves, vessels, muscles, and the lung. It is potentially a superior technique in terms of improving accuracy and decreasing complications. Further large population randomized control studies should be conducted to compare the efficacy of intercostal nerve blocks performed under ultrasound and fluoroscopy.
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Thoracolumbar interfascial plane (TLIP) block as a novel plane block technique was proposed in 2015 and can be performed in patients undergoing lumbar spine surgery. However, no meta-analysis demonstrates the effects of TLIP block on postoperative pain undergoing lumbar spine surgery. ⋯ The TLIP block is an effective strategy to improve postoperative pain at rest/movement and to reduce PCA consumption in patients undergoing lumbar spine surgery, which exerts significant analgesia. In the future, it is worth being applied in lumbar spine surgery extensively.
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J Trauma Acute Care Surg · Nov 2021
Randomized Controlled TrialA randomized clinical trial of single dose liposomal bupivacaine versus indwelling analgesic catheter in patients undergoing surgical stabilization of rib fractures.
Locoregional analgesia (LRA) remains underused in patients with chest wall injuries. Surgical stabilization of rib fractures (SSRF) offers an opportunity to deliver surgeon-directed LRA under direct visualization at the site of surgical intervention. We hypothesized that a single-dose liposomal bupivacaine (LB) intercostal nerve block provides comparable analgesia to an indwelling, peripheral nerve plane analgesic catheter with continuous bupivacaine infusion (IC), each placed during SSRF. ⋯ Therapeutic, level II.