Articles: nerve-block.
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BACKGROUND Regional nerve blocks ideally provide safe and effective post-operative pain control, decrease opiate requirements, and enhance recovery from intense pain following major thoracic, abdominal, and musculoskeletal surgeries. The erector spinae plane block, a recently described novel treatment for chronic neuropathic pain and acute pain after thoracic surgery, can be performed with in plane infiltration and placement of a continuous infusion catheter deep to the erector spinae muscle at the tip of the transverse process, resulting in diffusion of local anesthetic between vertebrae and the paravertebral space with sensory blockade of spinal nerves as well as sympathetic branches. ⋯ The use of the erector spinae block in this context provided effective post-operative analgesia. CONCLUSIONS Additional evidence from clinical trials will be helpful to evaluate the role of this relatively new block for peri-operative analgesia.
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Randomized Controlled Trial
Effects of ultrasound-guided paravertebral block on MMP-9 and postoperative pain in patients undergoing VATS lobectomy: a randomized, controlled clinical trial.
Local anesthesia can reduce the response to surgical stress and decrease the consumption of opioids, which may reduce immunosuppression and potentially delay postoperative tumor recurrence. We compared paravertebral block (PVB) combined with general anesthesia (GA) and general anesthesia regarding their effects on postoperative pain and matrix metalloproteinase-9 (MMP-9) after video-assisted thoracoscopic surgery (VATS) lobectomy. ⋯ The paravertebral block/general anesthesia can provide statistically better pain relief and attenuate MMP-9 response to surgery and after VATS lobectomy. This technique may be beneficial for patients to recover rapidly after lung surgery and reduce postoperative tumor recurrence.
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Abdominal surgery is common and is associated with severe postoperative pain. The transverse abdominal plane (TAP) block is considered an effective means for pain control in such cases. The quadratus lumborum (QL) block is another option for the management of postoperative pain. The aim of this study was to conduct a meta-analysis and thereby evaluate the efficacy and safety of QL blocks and TAP blocks for pain management after abdominal surgery. ⋯ The QL block provides better pain management with less opioid consumption than the TAP block after abdominal surgery. In addition, there are no differences between the TAP block and QL block with respect to PONV.
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Anesthesia and analgesia · Mar 2020
Randomized Controlled Trial Comparative StudyUltrasound-Assisted Versus Landmark-Guided Spinal Anesthesia in Patients With Abnormal Spinal Anatomy: A Randomized Controlled Trial.
Spinal ultrasound improves first-pass success for patients with abnormal spinal anatomy undergoing spinal block, although there was no difference in total procedure time.
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Gen Thorac Cardiovasc Surg · Mar 2020
Randomized Controlled Trial Comparative StudyIntercostal block vs. epidural analgesia in thoracoscopic lung cancer surgery: a randomized trial.
To explore the best strategy for combatting pain after thoracoscopic lobectomy for cancer. ⋯ Although our limited sample size compromised our ability to draw definitive conclusions, intercostal nerve block followed by high-dose oral celecoxib seems to be an option for patients undergoing thoracoscopic lobectomy for lung cancer.