323 results match your criteria Local and Regional Anesthesia


Opioid-Free Segmental Thoracic Spinal Anesthesia with Intrathecal Sedation for Breast and Axillary Surgery: Report of Four Cases.

Local Reg Anesth 2022 9;15:23-29. Epub 2022 May 9.

Department of Anaesthesiology, IRCSS-INRCA, Ancona, Italy.

Purpose: Few studies have described segmental thoracic spinal anesthesia (STSA) as primary anesthesiologic method in breast and axillary surgery, documenting the association of intrathecal local anesthetics and opioids. This case series reports an opioid-free scheme of STSA in four elderly patients undergoing major breast and axillary oncological surgery.

Patients And Methods: STSA was performed in three female patients undergoing unilateral mastectomy ± axillary lymph node dissection (ALND) or sentinel lymph node biopsy for invasive ductal carcinoma and in one male patient undergoing ALND for melanoma metastases. Read More

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Analgesia in the Neurosurgical Intensive Care Unit.

Front Neurol 2021 25;12:819613. Epub 2022 Jan 25.

Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.

Acute pain in neurosurgical patients is an important issue. Opioids are the most used for pain treatment in the neurosurgical ICU. Potential side effects of opioid use such as oversedation, respiratory depression, hypercapnia, worsening intracranial pressure, nausea, and vomiting may be problems and could interfere with neurologic assessment. Read More

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January 2022

Bupivacaine for Root Canal Treatment - Practitioner Behaviors and Patient Perspectives: Survey Studies.

Local Reg Anesth 2022 3;15:11-21. Epub 2022 Feb 3.

Department of Endodontics, New York University College of Dentistry, New York, NY, USA.

Introduction And Objectives: Local anesthesia is essential in dentistry in providing intraoperative analgesia and anesthesia. However, knowledge related to its use for management of post-operative pain is limited. Perioperative pain management is especially important for root canal treatment (ie, endodontic therapy), performed by endodontists. Read More

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February 2022

Erector Spinae Block with Opioid Free Anesthesia in Cirrhotic Patients Undergoing Hepatic Resection: A Randomized Controlled Trial.

Local Reg Anesth 2022 25;15:1-10. Epub 2022 Jan 25.

Department of Anesthesia and Intensive Care, National Liver Institute, Menoufia University, Sheeben Elkom City, Egypt.

Background: Hepatic resection is a major abdominal surgery with challenging pain management. We aimed to investigate the effect of erector spinae plane block (ESPB) with opioid free anesthesia (OFA) in cirrhotic patients scheduled for liver resection on perioperative pain management in terms of hemodynamic stability. Secondarily, we assessed time to first request for analgesia and perioperative fentanyl consumption, nausea and vomiting within 24 hours after surgery. Read More

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January 2022

Potential Therapeutic Application of Local Anesthetics in Cancer Treatment.

Recent Pat Anticancer Drug Discov 2022 Jan 19. Epub 2022 Jan 19.

Department of Anesthesiology, Stony Brook University Health Science Center, Stony Brook, NY, USA.

Local anesthetics are voltage-gated sodium channel blockers primarily administered locally or to the innervating nerves for anesthetic or analgesic purposes. In vitrol studies have found direct effects of local anesthetics on cancer cell, such as impacts on cancer cell proliferation, apoptosis, migration, invasion, and chemosensitivity, which involved multiple mechanisms. So far, in vivo evidence in the effect of local anesthetics on cancer cell lines is relatively lacking. Read More

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January 2022

Interscalene Block for Analgesia in Orthopedic Treatment of Shoulder Trauma: Single-Dose Liposomal Bupivacaine versus Perineural Catheter.

Local Reg Anesth 2021 7;14:167-178. Epub 2021 Dec 7.

Department of Anesthesiology, McGovern Medical School at UTHealth, Houston, TX, USA.

Background: Interscalene brachial plexus block is frequently utilized to provide perioperative analgesia to patients undergoing shoulder surgery to optimize recovery, minimize opioid consumption, and decrease overall hospital length of stay. The use of an indwelling perineural interscalene catheter provides extended analgesia and is efficacious in managing severe postoperative pain following major shoulder surgery. Currently, the only alternative to perineural catheters for extended analgesia with interscalene block involves the perineural infiltration of liposomal bupivacaine. Read More

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December 2021

Relationship Between Gender, Age, BMI and Side of Body on the Size and Position of Nerves of the Brachial Plexus in Axilla: Pilot Study.

Local Reg Anesth 2021 20;14:161-166. Epub 2021 Nov 20.

Department of Anaesthesia, Leeds Teaching Hospitals Trust, Leeds, West Yorkshire, UK.

Background And Objectives: Studies demonstrate variations in the size and position of the nerves in the brachial plexus. The objective of this pilot study was to determine the effect of age, gender, BMI and side of body on the size and position of these nerves and to determine the feasibility of a further study.

Methods: Twenty healthy volunteers were recruited. Read More

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November 2021

Spinal or Intravenous Dexmedetomidine for Spinal Anesthesia with Chloroprocaine in Ambulatory Knee Arthroscopies: A Double-Blind Randomized Trial.

Local Reg Anesth 2021 20;14:153-160. Epub 2021 Nov 20.

Department of Anesthesia, GZA Hospitals, Wilrijk, Belgium.

Purpose: Chloroprocaine provides spinal anesthesia for day-case surgery lasting up to 40 minutes. Intravenous and spinal dexmedetomidine can prolong spinal anesthesia, but no data are available for the combination with chloroprocaine. This double-blind randomized controlled trial compares chloroprocaine with spinal or intravenous dexmedetomidine regarding block characteristics, micturition, and discharge times. Read More

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November 2021

Local and Regional Anesthesia in Zoological Companion Animal Practice.

Vet Clin North Am Exot Anim Pract 2022 Jan;25(1):321-336

College of Veterinary Medicine, Midwestern University, 5715 W Utopia Road, Glendale, AZ 85308, USA.

Local anesthetics provide analgesia and can be incorporated into multimodal anesthetic protocols. They work by blocking the voltage-dependent sodium ion channels along neurons that mediate nociception. Systemically, these drugs can be cardiotoxic in a dose-dependent manner. Read More

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January 2022

Evaluation of the Analgesic Efficacy of Bilateral Ultrasound-Guided Transversus Thoracic Muscle Plane Block on Post-Sternotomy Pain: A Randomized Controlled Trial.

Local Reg Anesth 2021 12;14:145-152. Epub 2021 Nov 12.

Department of Anesthesiology, Ain Shams University, Cairo, Egypt.

Purpose: Transverse thoracic block is a new perioperative analgesic method for post-sternotomy discomfort. This study discusses the efficacy of an ultrasound-guided transversus thoracic muscle plane block (TTPB) in patients undergoing heart surgery, including sternotomy.

Patients And Methods: In this prospective trial, 60 patients were randomly assigned to two groups: transversus (T) or general anesthesia (GA). Read More

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November 2021

Short Communication: Lumbar Plexus Block versus Suprainguinal Fascia Iliaca Block to Provide Analgesia Following Hip and Femur Surgery in Pediatric-Aged Patients - An Analysis of a Case Series.

Local Reg Anesth 2021 19;14:139-144. Epub 2021 Oct 19.

Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.

Introduction: For surgical procedures involving the hip and femur, various regional anesthetic techniques may be used to provide analgesia. Although there has been an increase in the use of lumbar plexus block (LPB), the technique may be time consuming and associated with complications. Suprainguinal fascia iliaca compartment block (FICB) is a potentially easier and safer alternative. Read More

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October 2021

Anastomoses (Superficial Cervical Ansa) Between the Cervical Plexus and Peripheral Facial Nerve Branches: Implications for Regional Anesthesia in Carotid Endarterectomies - Anatomical Study.

Local Reg Anesth 2021 13;14:133-138. Epub 2021 Oct 13.

Bielefeld University Medical Center OWL, Working Group 3: Anatomy and Cell Biology, Bielefeld, DE-33501, Germany.

Purpose: Sensory innervation in the carotid triangle involves the cervical plexus, cranial nerves, and the sympathetic trunk. This innervation also applies to skin incision, including various anatomical structures with potentially different innervation, such as the skin (dermatomes), the platysma (myotomes), and the superficial layer of the cervical fascia (fasciotomes), as well as retromandibular retractor insertion (co-innervation: V, VII). The aim of this anatomical study was to develop an injection technique for carotid endarterectomies to additionally block anastomoses between the transverse cervical nerve (TCN), the cervical branch VII (CB VII), and the marginal mandibular branch VII (MMB VII). Read More

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October 2021

Efficacy and Safety of Cryoneurolysis for Treatment of Chronic Head Pain Secondary to Occipital Neuralgia: A Pilot Study.

Local Reg Anesth 2021 17;14:125-132. Epub 2021 Sep 17.

Mid America PolyClinic, Overland Park, KS, USA.

Purpose: Treatment of chronic pain associated with occipital neuralgia (ON) is complex, and no consensus statement or guidelines have been published for ON management. This pilot study evaluated the efficacy and safety of cryoneurolysis for management of ON-associated chronic pain.

Patients And Methods: The study was a prospective, multicenter, nonrandomized cohort study assessing the degree and duration of clinical effect of cryoneurolysis therapy for reducing pain in patients diagnosed with unilateral or bilateral ON. Read More

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September 2021

Comment on: "Comparison of local and regional anesthesia modalities in breast surgery: A systematic review and network meta-analysis".

J Clin Anesth 2021 12 10;75:110514. Epub 2021 Sep 10.

Department of Anesthesiology, China Medical University Hospital, Taiwan. Electronic address:

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December 2021

Corrigendum to: 'Comparison of local and regional anesthesia modalities in breast surgery: A systematic review and network meta-analysis' [Journal of Clinical Anesthesia Volume 72 (2021)/Article 110274].

J Clin Anesth 2021 Dec 6;75:110491. Epub 2021 Sep 6.

Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Honorary Senior Clinical Lecturer, King's College London, London, United Kingdom.

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December 2021

Serious Complications After Epidural Catheter Placement: Two Case Reports.

Local Reg Anesth 2021 24;14:117-124. Epub 2021 Jul 24.

University Medical Center Rostock, Department of Neurology, Rostock, Germany.

Thoracic epidural analgesia (TEA) is a standard procedure in multimodal analgesia applied in major thoracic and abdominal surgeries. Two cases are presented with serious complications related to TEA. In both cases, earlier reaction of the treating physicians to patient-reported sensory symptoms could have prevented the complicated course. Read More

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Comparison of Ultrasound-Guided Modified BRILMA Block with Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy - A Randomized Controlled Trial.

Local Reg Anesth 2021 2;14:109-116. Epub 2021 Jul 2.

Department of Anesthesiology, SRM Medical College Hospital and Research Centre, Kattankulathur, Chennai, 603203, India.

Background And Aims: Subcostal Transversus Abdominis Plane (TAP) block is the standard practice for postoperative analgesia following laparoscopic cholecystectomy. This study aimed to compare the efficacy of modified BRILMA Block (blocking the BRanches of Intercostal nerves at the Level of Mid-Axillary line) with Subcostal TAP block for pain relief following laparoscopic cholecystectomy.

Methods: Sixty cases scheduled for laparoscopic cholecystectomy were randomly divided into two groups: modified BRILMA block (Group B) and Subcostal TAP block (Group T). Read More

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Analysis of Epidural Waveform to Determine Correct Epidural Catheter Placement After CSE Labor Analgesia.

Local Reg Anesth 2021 17;14:103-108. Epub 2021 Jun 17.

Department of Anesthesiology, Policlinico Casilino, Roma, Italy.

Background: The epidural pressure is pulsatile and synchronized with arterial pulsations. Monitoring the epidural waveform has been suggested as a technique to reliably confirm the appropriate localization of the epidural catheter.

Objective: The aim of this study was to evaluate the sensitivity and specificity of the Computer Controlled Drug Delivery System with continuous pressure and waveform sensing technology (CCDDS) (CompuFlo CathCheck™) as an instrument to assess the correct placement of the catheter in the epidural space in parturients who have received combined spinal-epidural technique (CSE) for labor analgesia. Read More

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Combination of the T7 Unilateral Erector Spinae Plane Block and T10 Bilateral Retrolaminar Blocks in a Patient with Multiple Rib Fractures on the Right and T10-12 Vertebral Compression Fractures: A Case Report.

Local Reg Anesth 2021 15;14:99-102. Epub 2021 Jun 15.

Department of Anesthesia, Advocate Illinois Masonic Medical Center, Chicago, IL, 60657, USA.

Multiple vertebral compression and rib fractures in elderly patients with pre-existing chronic obstructive pulmonary disease is a common scenario associated with significant morbidity and mortality. Severe pain prevents normal ventilation and leads to atelectasis, consolidation, and pneumonia. Subsequently, these patients frequently develop respiratory failure and require intubation and critical care. Read More

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Perioperative Blocks for Decreasing Postoperative Narcotics in Breast Reconstruction.

Anesth Pain Med 2020 Oct 23;10(5):e105686. Epub 2020 Oct 23.

Division of Plastic and Reconstructive Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

Context: High rates of mortality and chemical dependence occur following the overuse of narcotic medications, and the prescription of these medications has become a central discussion in health care. Efforts to curtail opioid prescribing include Enhanced Recovery After Surgery (ERAS) guidelines, which describe local anesthesia techniques to decrease or eliminate the need for opioids when used in a comprehensive protocol. Here, we review effective perioperative blocks for the decreased use of opioid medications post-breast reconstruction surgery. Read More

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October 2020

Ultrasound-Guided Local Anesthetic Infiltration Between the Popliteal Artery and the Capsule of the Posterior Knee (IPACK) Block for Primary Total Knee Arthroplasty: A Systematic Review of Randomized Controlled Trials.

Local Reg Anesth 2021 12;14:85-98. Epub 2021 May 12.

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Rochester, MN, USA.

Posterior knee pain after total knee arthroplasty (TKA) is common despite multimodal analgesia and regional anesthesia use. This review included randomized controlled trials (RCTs) comparing analgesic outcomes after inclusion of local anesthetic infiltration between the popliteal artery and capsule of the knee (iPACK) block versus pathways without iPACK. Electronic databases (MEDLINE, Cochrane Library, Web of Science, Scopus) were searched from inception to 10/11/2020. Read More

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Effects of Ultrasound-Guided Bilateral Cervical Plexus Block Combined with General Anesthesia in Patients Undergoing Total Parathyroidectomy and Partial Gland Autotransplantation Surgery.

Local Reg Anesth 2021 23;14:75-83. Epub 2021 Apr 23.

Department of Orthopaedics, The 960th Hospital of the People's Liberation Army Joint Logistical Support Force, Jinan, Shandong, People's Republic of China.

Background: The aim of this study is to evaluate the effect of ultrasound-guided bilateral cervical plexus block on general anesthesia, postoperative analgesia, and surgical outcomes in patients undergoing total parathyroidectomy with autotransplantation.

Patients And Methods: Forty-eight ASA III-IV patients with hyperparathyroidism secondary to renal failure were included: 24 patients received ultrasound-guided bilateral superficial and deep cervical plexus block combined with general anesthesia (group A), and 24 patients received general anesthesia alone (group B). Postoperative patient-controlled intravenous analgesia was provided with sufentanil 2 μg/kg. Read More

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Transmuscular Quadratus Lumborum Block versus Suprainguinal Fascia Iliaca Block for Hip Arthroplasty: A Randomized, Controlled Pilot Study.

Local Reg Anesth 2021 20;14:67-74. Epub 2021 Apr 20.

Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.

Background: This study aimed to investigate the analgesic efficacy and motor block profile of single-shot transmuscular quadratus lumborum block (QLB) in comparison with those of suprainguinal fascia iliaca block (FIB) in patients undergoing hip arthroplasty.

Methods: This randomized, double-blinded, controlled trial included adult patients undergoing hip arthroplasty under spinal anesthesia. Patients were allocated to one of two groups according to the regional block received: FIB group (n=19) or QLB group (n=17). Read More

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Quadratus Lumborum Blocks in Nephrectomy: A Narrative Review.

Local Reg Anesth 2021 19;14:57-65. Epub 2021 Apr 19.

Department of Anesthesiology and Perioperative Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.

The quadratus lumborum block is a novel truncal block where local anaesthetic is injected adjacent to the quadratus lumborum muscle. It is used for caesarean sections, hip arthroplasty, gynecologic surgery, colectomy, and recently nephrectomy. To date, there are no reviews that outline the efficacy and performance of the quadratus lumborum blocks in patients receiving laparoscopic nephrectomy. Read More

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Comparison of local and regional anesthesia modalities in breast surgery: A systematic review and network meta-analysis.

J Clin Anesth 2021 Sep 16;72:110274. Epub 2021 Apr 16.

Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; King's College London, London, United Kingdom.

Study Objective: Moderate to severe postoperative pain occurs in up to 60% of women following breast operations. Our aim was to perform a network meta-analysis and systematic review to compare the efficacy and side effects of different analgesic strategies in breast surgery.

Design: Systematic review and network meta-analysis. Read More

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September 2021

The Current Practice of Spinal Anesthesia in Anesthetists at a Comprehensive Specialized Hospital: A Single Center Observational Study.

Local Reg Anesth 2021 31;14:51-56. Epub 2021 Mar 31.

Department of Anesthesia, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

Background: Spinal anesthesia block is the most widely practiced anesthesia technique due to its safety margin. It is an invasive procedure that could be associated with a variety of complications like total spinal, cardiovascular collapse, meningitis, paralysis, and even death. The aim of this study to assess the current practice of spinal anesthesia. Read More

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Levobupivacaine Consumption in Automated Intermittent Bolus in Ultrasound Guided Subparaneural Sciatic Nerve Catheters: A Prospective Double-Blind Randomized Trial.

Local Reg Anesth 2021 25;14:43-50. Epub 2021 Mar 25.

Department of Anesthesia and Perioperative Medicine, Ghent University Hospital, Ghent, Belgium.

Purpose: Continuous sciatic nerve blocks have proven benefits for postoperative analgesia after foot surgery. However, the optimal mode of administration remains a point of debate. Ultrasound guided subparaneural injection accelerates onset time and increases duration after a single shot sciatic nerve block. Read More

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Hypotension Associated with MTS is Aggravated by Early Activation of TEA During Open Esophagectomy.

Local Reg Anesth 2021 2;14:33-42. Epub 2021 Mar 2.

Department of Surgical Gastroenterology, Rigshospitalet, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Objective: A mesenteric traction syndrome (MTS) is elicited by prostacyclin (PGI)-induced vasodilation and identified by facial flushing, tachycardia, and hypotension during abdominal surgery. We evaluated whether thoracic epidural anesthesia (TEA) influences the incidence of MTS.

Design: Randomized, blinded controlled trial. Read More

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Assessment of Morphological and Morphometrical Variations of Sacral Hiatus in Dry Human Sacrum in Ethiopia.

Local Reg Anesth 2021 24;14:25-32. Epub 2021 Feb 24.

Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia.

Background: The sacral hiatus is an opening present at the lower end of the sacral canal. The anatomy of the sacral hiatus and its variations are clinically important during administration of caudal epidural block (CEB) in obstetrics and gynecology, orthopedic, urology and general surgical practices. The success and reliability of CEB depends upon the sound knowledge of anatomical variations of the sacral hiatus. Read More

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February 2021