Articles: nerve-block.
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Thoracic fascial blocks have been included in multimodal analgesia for breast surgery. Fewer studies demonstrate its use as a regional anesthesia technique. The serratus anterior plane (SAP) block provides anesthesia to the lateral thoracic wall and the axilla, the surgical area of some breast surgeries, with a single injection. This article reports the use of the SAP block as an anesthetic technique for breast lumpectomy with axillary dissection ensuring good surgical conditions and patient safety.
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Review Case Reports
Opioid-sparing multimodal analgesia with bilateral bi-level erector spinae plane blocks in scoliosis surgery: a case report of two patients.
Postoperative pain following scoliosis correction surgery is severe and usually requires prolonged intravenous opioid therapy. Regional anesthesia options are limited and include intrathecal opioid and epidural analgesia; however, they remain little used because of side effects and inconsistent efficacy. We describe a novel multimodal anesthetic regimen incorporating bilateral bi-level erector spinae plane (ESP) blocks together with a combination of several evidence-based intraoperative opioid-sparing analgesic strategies. ⋯ Bilateral bi-level ESP blocks are a simple method of providing pre-emptive regional analgesia in extensive multi-level spine surgery. Integration of ESP blocks into a multimodal regimen that employs other opioid-sparing strategies may have additive, and potentially synergistic, benefits in improving postoperative analgesia and reducing opioid requirements.
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This systematic review and network meta-analysis (NMA) compared postoperative analgesic efficacy of transversus abdominis plane (TAP) blocks with that of wound infiltration for Cesarean delivery (CD) without long-acting neuraxial opioid administration. ⋯ In the absence of long-acting neuraxial opioid after CD, single-dose TAP blocks and WC are effective opioid-sparing strategies.
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Objective: Recently, there has been an increasing interest in combined adductor canal block (ACB) with periarticular anesthetic injection (PAI) as a technique to control postoperative pain in total knee arthroplasty (TKA). This study evaluated the analgesic efficacy and safety of the combined therapy for early postoperative pain treatment after TKA. Methods: From the inception to July 2018, two independent investigators used the following electronic databases to search existing literature: PubMed, Embase, Medline, and Web of Science. ⋯ Similarly, there were no significant differences between groups in opioid-related adverse effects, and LOS. Conclusions: There is evidence that combined therapy is more effective than single therapy within 48 h following primary TKA. Applying combined therapy appears to be an effective and safe method for pain control.
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Journal of anesthesia · Dec 2020
Course of the thoracic nerves around the umbilicus within the posterior layer of the rectus sheath: a cadaver study.
Rectus sheath block is used to anesthetize thoracic nerves around the umbilicus. However, the appropriate point for anesthetic injection during rectus sheath block has not been determined anatomically. ⋯ The position where the lateral edge of the rectus abdominis muscle and the medial border of the transversus abdominis muscle cross approximates the position where thoracic nerves T10 passes through the posterior layer of the rectus sheath. Our results identify effective landmarks to guide the performance of rectus sheath block.