Articles: nerve-block.
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Minerva anestesiologica · Oct 2019
Letter Case ReportsDexamethasone as a local anesthetic adjuvant in bilateral ultrasound guided erector spinae plane block can provide a long-lasting analgesia in laparotomic abdominal surgery.
Abstract
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Rev Esp Anestesiol Reanim · Oct 2019
Observational StudyAnatomical description of anaesthetic spread after deep erector spinae block at L-4.
Thoracic erector spinae plane (ESP) block is now used for postoperative analgesia. However, although reports of lumbar ESP have been published, the anesthetic spread and mechanism of action of this technique remains unclear. We describe the lumbar ESP block technique and evaluate the spread of 20ml of solution administered at the level of the transverse process of L4 in a cadaver model. ⋯ Lumbar ESP at L4 always acts on the posterior branches of the spinal nerves, but seldom spreads to the paravertebral space to block the spinal nerve.
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Korean J Anesthesiol · Oct 2019
Optimal location of local anesthetic injection into the interspace between the popliteal artery and posterior capsule of the knee (iPACK) for posterior knee pain after total knee arthroplasty: an anatomical and clinical study.
This study aimed to determine the optimal location of local anesthetic injection in the interspace between the popliteal artery and posterior capsule of the knee (iPACK), using the anatomical pattern of the articular branch of tibial nerve (ABTN). We hypothesized that injection at the level of ABTN forming a popliteal plexus would mainly spread throughout the popliteal fossa without contacting the tibial or peroneal nerves. ⋯ We described a modified iPACK technique injection at the level of the ABTN forming the popliteal plexus, and it may constitute an optional anesthetic regimen to promote early ambulation following TKA.
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Paediatric anaesthesia · Oct 2019
Ultrasound-Guided Dorsal Penile Nerve Block vs Neurostimulator-Guided Pudendal Nerve Block in Children Undergoing Hypospadias Surgery: A Prospective, Randomized, Double-Blinded Trial.
Hypospadias is a common congenital malformation in pediatric patients. Surgical repair of this malformation is a painful procedure and has long-term effects. Pudendal and penile nerve blocks are commonly preferred techniques for maintaining postoperative analgesia. However, the conventional landmark-based penile block technique involves numerous potential complications and provides a shorter analgesic period compared to the pudendal block. A promising ultrasound-guided dorsal penile nerve block was recently described. We aimed to compare the analgesic effectiveness of ultrasound-guided penile nerve block with that of neurostimulator-guided pudendal nerve block. ⋯ Ultrasound-guided dorsal penile nerve block provided a longer analgesic period and reduced opioid consumption compared to neurostimulator-guided pudendal nerve block.
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Journal of anesthesia · Oct 2019
A laser mount probe holder facilitates fixation of the optimized ultrasound image and needle alignment in-plane to the ultrasound beam during ultrasound-guided peripheral nerve block.
Laser guidance facilitates needle alignment in-plane to the ultrasound beam. Once the ultrasound image is optimized, there is no further need to maneuver the probe. ⋯ The needle brightness was quantitatively measured using an image analysis software. We found that the laser mount probe holder is useful, not only to visualize the needle tip in the ultrasound plane, but also to fix the best ultrasound image.