Articles: nerve-block.
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Case Reports
Continuous Bilateral Erector of Spine Plane Block at T8 for Extensive Lumbar Spine Fusion Surgery: Case Report.
Supplementary strategies, in combination with conventional analgesia, for pain control after lumbar fusion surgery remain limited. ⋯ A 79-year-old woman experienced excruciating pain on post-operative day 1 after undergoing L2 to S1 spine fusion. Bilateral continuous erector spinae plane (ESP) blocks were performed at T8 and, after a bolus of ropivacaine 0.2% (20 mL) per side, a continuous infusion (5 mL/hour) of ropivacaine 0.2% per side was maintained for 48 hours, which provided effective analgesia. During this period, two boluses (15 mL) per day of ropivacaine 0.2% were administered bilaterally to maintain optimal analgesia. ESP catheterizations at T8, placed remotely from surgical site, may be considered in extensive lumbar spinal fusion cases.
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Meta Analysis
The efficacy of fascia iliaca compartment block for pain control after hip arthroplasty: A meta-analysis.
To assess the effect of fascia iliaca compartment block (FICB) on pain control and morphine consumption in patients with total hip arthroplasty (THA). ⋯ FICB has a beneficial role in reducing pain intensity and morphine consumption after THA. Moreover, FICB has morphine-sparing effects when compared with a control group. More high-quality RCTs are needed to identify the optimal technique and volume of injectate for FICB.
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Journal of ultrasound · Jun 2019
Comparative StudyUltrasound-guided selective nerve root block versus fluoroscopy-guided interlaminar epidural block for the treatment of radicular pain in the lower cervical spine: a retrospective comparative study.
Recent studies have compared the therapeutic efficacy and safety of the procedure using ultrasound and fluoroscopy. However, there are no published studies comparing the therapeutic efficacy and safety of fluoroscopy (FL)-guided cervical interlaminar epidural steroid injection (CIESI) with that of ultrasound (US)-guided selective nerve root block (SNRB). This study aimed to compare the mid-term effects and advantages of US-guided SNRB with FL-guided CIESI for radicular pain in the lower cervical spine through assessment of pain relief and functional improvement. ⋯ Our results suggest that, compared with FL-guided CIESI, US-guided SNRB requires a shorter administration duration while providing similar pain relief and functional improvements.
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Surgical procedure causes tissue damage which activates systemic inflammatory response and leads to changes in endocrine and metabolic system. Anaesthesia and pain can further disrupt immune performance. Regional anaesthesia causes afferent nerve blockade and in this way mediates immune protection. ⋯ It was shown that transversus abdominis plane block and epidural analgesia have the same effect on postoperative pain, but transversus abdominis plane block was better regarding hemodynamic stability and hospital stay. Multimodal approach combining regional and systemic analgesia is currently the most appropriate perioperative pain management strategy. More studies should be done to give recommendations.
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Ultrasound-guided nerve blocks (UGNBs) allow emergency physicians an opportunity to provide optimal pain management for acute traumatic conditions. Over the past decade, a growing body of literature has detailed the novel ways clinicians have incorporated UGNBs for analgesia and an alternative to procedural sedation. ⋯ Even with the presumed level of increased safety, we recommend that any clinician who performs ultrasound-guided nerve blocks be aware of complications that could arise during and after the procedure. Peripheral nerve injury (PNI) post block, local anesthetic systemic toxicity (LAST) and the role of single peripheral nerve blocks in patients with a risk for compartment syndrome are common safety issues discussed when performing ultrasound-guided nerve blocks.