Articles: nerve-block.
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Randomized Controlled Trial
Regional anaesthesia on the finger: Traditional dorsal digital nerve block versus subcutaneous volar nerve block, a randomized controlled trial.
To identify the most comfortable digital nerve block by comparing painfulness and efficiency of two commonly used digital nerve blocks: the volar subcutaneous nerve block and the traditional dorsal nerve block. ⋯ In patients requiring digital anaesthesia in the Emergency Department, the anaesthetic technique affects both the discomfort of the injection and extent of anaesthesia. The traditional dorsal digital nerve block is preferred for dorsal injuries. The subcutaneous volar nerve block is preferred for volar injuries.
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To analyze the safety and efficacy of image-guided genicular nerve cooled radiofrequency ablation (C-RFA) for the treatment of pain in non-surgical candidates with moderate to severe knee osteoarthritis (OA) and to compare three- vs four-needle technique. ⋯ The four-needle treatment approach offers an advantage in the overall efficacy in treating stiffness and pain in patients with moderate-to-severe OA refractory to conservative treatments leading to decreased opiate usage without complications.
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Case Reports
Successful Ultrasound-Guided Erector Spinae Plane Block for Herpes Zoster in the Emergency Department: A Case Report.
The varicella zoster virus, which lies dormant in the dorsal root ganglion, can be reactivated as herpes zoster in times of acute stress or immunosuppression. The herpes zoster lesions can be very painful, both at the time of eruption and after healing, as postherpetic neuralgia. During the acute outbreak time period, many patients visit the emergency department (ED) for pain control, often requiring opioids. ⋯ Here, we demonstrate two cases for which an erector spinae plane (ESP) nerve block with ropivicaine was used as an alternative to opioids, resulting in immediate and safe analgesia in the ED. Both patients had lesions across the back that were significantly impairing their daily lives; one with distribution in the thoracic region, one in the lumbar region. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: ESP blocks can offer quick, easy, and effective analgesia in the ED and can be used in place of parenteral or oral analgesia. It also can be used to reduce opioid prescriptions issued from the ED. Further studies can be done to confirm the efficacy of ESP blocks against opioids through prospective trials.