Articles: nerve-block.
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Reg Anesth Pain Med · Oct 2021
Non-Fellowship regional anesthesia training and assessment: an international Delphi study on a consensus curriculum.
While there are several published recommendations and guidelines for trainees undertaking subspecialty Fellowships in regional anesthesia, a similar document describing a core regional anesthesia curriculum for non-fellowship trainees is less well defined. We aimed to produce an international consensus for the training and teaching of regional anesthesia that is applicable for the majority of worldwide anesthesiologists. ⋯ This international consensus study provides specific information for designing a non-fellowship regional anesthesia curriculum. Implementation of a standardized curriculum has benefits for patient care through improving quality of training and quality of nerve blocks.
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Epidural anesthesia and thoracic paravertebral blocks have been the mainstay of regional anesthesia for thoracic surgery for many years. Following introduction of ultrasound use during regional anesthesia practices, new blocks named interfascial plane blocks have been introduced into clinical practice. Although interfascial plane blocks fail to provide surgical anesthesia their contribution to providing analgesia is clinically important. In this review we mention the most commonly accepted blocks namely pectoral blocks, serratus anterior plane block, erector spinae plane block and rhomboid blocks.
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Reg Anesth Pain Med · Oct 2021
Observational StudyOpening injection pressure monitoring using an in-line device does not prevent intraneural injection in an isolated nerve model.
Injection pressure monitoring using in-line devices is affordable and easy to implement into a regional anesthesia practice. However, solid evidence regarding their performance is lacking. We aimed to evaluate if opening injection pressure (OIP), measured with a disposable in-line pressure monitor, can prevent intraneural (subepineural) injection using 15 pound per square inch (PSI) as the reference safety threshold. ⋯ Our results suggest that in-line pressure monitoring may not prevent intraneural injection using an injection pressure of 15 PSI as reference threshold. Due to the preliminary nature of our study, further evidence is needed to demonstrate clinical relevance.
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Blocking the suprascapular nerve under the inferior belly of the omohyoid muscle is a novel regional anesthesia technique that has been proposed for shoulder analgesia. We describe the use of and our experience with bilateral indwelling suprascapular catheters for pain management via continuous infusions in a patient undergoing bilateral shoulder surgery. ⋯ Judicious use of preoperatively placed bilateral suprascapular catheters added to a comprehensive multimodal analgesic regimen provided excellent analgesia without respiratory compromise throughout the perioperative course.
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Case Reports
Role of erector spinae plane block in controlling functional abdominal pain: Case reports.
Functional abdominal pain is an intractable medical condition that often reduces quality of life. Celiac plexus block is a representative intervention for managing intractable abdominal pain. However, celiac plexus block can be technically difficult to perform and carries the risk of potential complications. During erector spinae plane block (ESPB), the injectate can enter the paravertebral space and reach the sympathetic chain. If local anesthetics spread to the sympathetic chain that supplies fibers to the splanchnic nerve, abdominal pain theoretically could be reduced. ⋯ We suggest that lower thoracic ESPB could be an option for management of functional abdominal pain.