Articles: nerve-block.
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Comparative Study
Intrathecal Morphine Versus Nerve Blocks in an Enhanced Recovery Pathway for Pancreatic Surgery.
Intrathecal morphine (ITM) and peripheral nerve blocks are accepted techniques for analgesia after abdominal surgery, but their efficacy has not been evaluated in the context of an enhanced recovery pathway (ERP) in pancreatic surgery. ⋯ ITM was associated with reduced pain scores and opioid requirements compared with peripheral nerve blocks in an ERP for pancreatic surgery.
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Continuous peripheral nerve blocks refer to a local anesthetic solution administered via perineurally placed catheters in an effort to extend the benefits of a single-shot peripheral nerve block. They offer several advantages in the postoperative period including excellent analgesia, reduced opioid consumption and associated side effects, enhanced rehabilitation and improved patient satisfaction. ⋯ Should we routinely use continuous peripheral nerve blocks in our daily practice? This PRO-CON debate aims at answering the question from the experts' perspectives. Fascial compartment and wound catheters are outside the scope of this debate.
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Despite their emerging therapeutic relevance, there are many discrepancies in anatomical description and terminology of the articular nerves supplying the human knee capsule. This cadaveric study aimed to determine their origin, trajectory, relationship and landmarks for therapeutic purpose. ⋯ The pattern of distribution of sensitive nerves supplying the knee joint capsule allows accurate and safe targeting of five constant genicular nerves for therapeutic purpose. This study provides robust anatomical foundations for genicular nerve blockade and radiofrequency ablation.
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Case Reports
Perioperative analgesia during thymectomy via median sternotomy : Ultrasound-guided bilateral parasternal block.
Thymectomy is sometimes carried out via median sternotomy; however, patients undergoing thymectomy via median sternotomy may experience severe postoperative pain. In this study, an ultrasound-guided regional anesthetic technique called a parasternal block, which can be used to relieve postoperative surgical pain after thymectomy via median sternotomy by blocking the medial nerve branch of the anterior cutaneous branch is presented. ⋯ While these are preliminary findings, further confirmatory clinical trials will be conducted. In summary, ultrasound-guided bilateral parasternal block appears to be a safe, simple, effective and minimally invasive technique for surgery via median sternotomy.