Articles: nerve-block.
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Rev Bras Anestesiol · May 2019
Case Reports[Ultrasound guided erector spinae plane block for postoperative analgesia after augmentation mammoplasty: case series].
Augmentation mammoplasty is the third most frequently performed esthetic surgical procedure worldwide. Breast augmentation with prosthetic implants requires the insertion of an implant under breast tissue, which causes severe pain due to tissue extension and surgical trauma to separated tissues. In this case series, we present the successful pain management of six patients with ultrasound-guided Erector Spinae Plane block after augmentation mammoplasty. ⋯ At the postoperative 24th hour, the mean Numerical Rating Scale score was 1. The mean intravenous tramadol consumption was 70.8±15.3mg in the first 24 h. None of the patients had any complications related to erector spinae plane block.
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Randomized Controlled Trial Multicenter Study Comparative Study
Randomized clinical trial of liposomal bupivacaine transverse abdominis plane block versus intrathecal analgesia in colorectal surgery.
Transverse abdominis plane (TAP) block is considered an effective alternative to neuraxial analgesia for abdominal surgery. However, limited evidence supports its use over traditional analgesic modalities in colorectal surgery. This study compared the analgesic efficacy of liposomal bupivacaine TAP block with intrathecal (IT) opioid administration in a multicentre RCT. ⋯ IT opioid administration provided better immediate postoperative pain control than TAP block. Both modalities resulted in low pain scores in patients undergoing elective colorectal surgery and should be considered in multimodal postoperative analgesic plans. Registration number: NCT02356198 ( http://www.clinicaltrials.gov).
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Meta Analysis
Pectoral nerve block in anesthesia for modified radical mastectomy: A meta-analysis based on randomized controlled trials.
Many types of regional nerve blocks have been used during anesthesia for modified radical mastectomy. In recent years, the use of pectoral nerve (PECS) block has gained importance in postoperative analgesia, but there are still controversies regarding its efficacy. There is especially no consensus on the optimal type of PECS block to be used. Herein, we attempt to evaluate the analgesic efficacy of the PECS block after radical mastectomy. ⋯ Even considering the limitations (evaluations of efficacy in different age groups and for chronic pain were not carried out) of this meta-analysis, it can be concluded that the PECS II block is an effective anesthetic regimen in modified radical mastectomy that can effectively reduce the intra- and postoperative consumption of opioids, postoperative PONV, and the need for postoperative rescue analgesia and can alleviate early pain (0-6 hours) after surgery.
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Observational Study
Safety, complications and clinical outcome after ultrasound-guided paravertebral catheter insertion for rib fracture analgesia: a single-centre retrospective observational study.
Rib fractures are associated with significant morbidity and mortality. Ultrasound-guided thoracic paravertebral catheter insertion has been described for the management of pain secondary to rib fractures. We conducted a retrospective observational study of all patients with rib fractures who had a paravertebral catheter inserted for analgesia provision over a 4-year period. ⋯ The proportion of rib fracture patients managed with paravertebral catheters increased from 31/200 (15.5%) in the first year of study to 81/168 (48.2%) in the fourth; over this time-period the observed:predicted mortality ratio fell from 1.04 to 0.66. Proportional hazard regression with and without propensity score matching demonstrated a reduction in mortality associated with paravertebral catheter use, but this became statistically non-significant when time-dependent analysis was used. Paravertebral catheters are a safe and effective technique for rib fracture analgesia; however, our data were insufficient to demonstrate any improvement in mortality.
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Letter Retracted Publication
Successful cases of bilateral erector spinae plane block for treatment of tension headache.