Articles: nerve-block.
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Anesthesia and analgesia · Aug 2021
Comparative StudyFiber-Needle Swept-Source Optical Coherence Tomography for the Real-Time Visualization of the Transversus Abdominis Plane Block Procedure in a Swine Model.
Fascia blocks (eg, the transversus abdominis plane [TAP] block) target the intermuscular fascia layers. Ultrasound techniques have allowed peripheral blocks to be performed with accuracy and safety, however, with limitations. Optical coherence tomography (OCT) is based on low-coherence interferometry. In this study, we examined the ability of OCT to identify the TAP. ⋯ This study introduced a novel needle imaging probe method to identify the transversus abdominis fascia plane in real-time. Quantitative calculation of the attenuation coefficients can further aid objective identification by providing direct confirmation of the tip position, increasing the first-pass success rate, and decreasing the need for needle repositioning. Combining OCT and ultrasound may improve the accuracy of anesthetics placement.
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J Coll Physicians Surg Pak · Aug 2021
Treatment of Renal Colic by Nerve Blockade with Lidocaine Versus Intravenous Dexketoprofen.
To compare non-steroidal anti-inflammatory drugs (NSAIDs) with spinal nerve blockade of related dermatomes using lidocaine for pain palliation of patients admitted to the Emergency Department (ED) with an episode of renal colic. ⋯ Spinal nerve blocks with 2% lidocaine resulted in greater short-term pain relief than intravenous dexketoprofen in ED patients with renal colic. Key Words: Renal colic, NSAID, lidocaine, Nerve blockade.
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Reg Anesth Pain Med · Aug 2021
Anatomy of the thoracic paravertebral space: 3D micro-CT findings and their clinical implications for nerve blockade.
A precise anatomical understanding of the thoracic paravertebral space (TPVS) is essential to understanding how an injection outside this space can result in paravertebral spread. Therefore, we aimed to clarify the three-dimensional (3D) structures of the TPVS and adjacent tissues using micro-CT, and investigate the potential routes for nerve blockade in this area. ⋯ A non-destructive, multi-sectional approach using 3D micro-CT more comprehensively demonstrated the real topography of the intricate TPVS than previous cadaver studies. The posterior boundary and connectivity of the TPVS provides an anatomical rationale for the notion that paravertebral spread can be achieved with an injection outside this space.
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Severe headache is a hallmark clinical feature of spontaneous subarachnoid hemorrhage (SAH), affecting nearly 90% of patients during index hospitalization, regardless of the SAH severity or presence of a culprit aneurysm. Up to 1 in 4 survivors of SAH experience chronic headaches, which may be severe and last for years. Data guiding the optimal management of post-SAH headache are lacking. Opioids, often in escalating doses, remain the guideline-recommended mainstay of acute therapy, but pain relief remains suboptimal. ⋯ PPF blockade might constitute a promising opioid-sparing therapeutic strategy for the management of post-SAH headache that merits further prospective controlled randomized studies.