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Pain Res Manag 2020 13;2020:9103421. Epub 2020 Jun 13.

Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.

Background: Recently, ultrasound- (US-) guided selective nerve root block (SNRB) has been reported to have similar effects compared to fluoroscopy- (FL-) guided cervical epidural steroid injection (CESI). There is no published study comparing the therapeutic efficacy and safety of interlaminar- (IL-) CESI and transforaminal- (TF-) CESI with US-guided SNRB. Our retrospective study aimed to compare the mid-term effects and advantages of the US-guided SNRB, FL-guided IL-CESI, and TF-CESI for radicular pain in the lower cervical spine through assessment of pain relief and functional improvement. Read More

Ulus Travma Acil Cerrahi Derg 2020 Jun;26(4):620-627

Department of Anesthesiology and Reanimation, Gülhane Training and Research Hospital, Ankara-Turkey.

Background: The configuration of a nerve block catheter may affect the local anesthetic spread in epidural analgesia and continuous peripheral nerve blocks. This prospective and randomized study aims to compare the multi-orifice nerve block catheter with an end-hole catheter in ultrasound-guided continuous infraclavicular brachial plexus block (BPB) in terms of providing postoperative analgesia for the orthopedic upper limb surgery below the shoulder. The primary outcome measure was mean pain scores. Read More

J Med Imaging Radiat Oncol 2020 Jun 25. Epub 2020 Jun 25.

Department of Medical Imaging, Flinders Medical Centre, Adelaide, South Australia, Australia.

The spinal epidural and posterior ligamentous complex spaces are important anatomic regions which are the target of various radiologic procedures in the cervical, thoracic and lumbar spine for the purpose of analgesia and anaesthesia. Given the frequency with which procedures are performed in and around the epidural space, a sound understanding of the associated anatomy is paramount to ensure the safety and efficacy of procedural intervention. Read More

Pain Res Manag 2020 1;2020:1537875. Epub 2020 Jun 1.

Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine, Seongnam, Republic of Korea.

Objective: Nowadays, trans-sacral epiduroscopic laser decompression (SELD) using slender epiduroscopy and laser is one of the preferred options for minimally invasive treatment in lumbar disc diseases. However, SELD is still in the initial stages of the global field of spine surgery, and the clinical outcomes in patients with lumbar disc herniation are not established yet. Therefore, the authors investigated patients undergoing SELD to report the clinical results. Read More

J Hip Preserv Surg 2019 Dec 7;6(4):353-363. Epub 2019 Nov 7.

Department of Orthopaedic Surgery, University Hospitals Sports Medicine Institute, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Hanna House 5043, Cleveland, OH 44106, USA.

The purpose of this article was to review current literature on peri-operative pain management in hip arthroscopy. A systematic review of the literature on pain control in hip arthroscopy published January 2008 to December 2018 was performed. Inclusion criteria consisted of English language or articles with English translations, subjects undergoing hip arthroscopy with documented peri-operative pain control protocols in studies reporting Level I to IV evidence. Read More

Rev Bras Anestesiol 2020 May 13. Epub 2020 May 13.

Ospedali Riuniti Ancona, Department of Emergency, Anesthesia and Intensive care of Transplantation and Major Surgery, Ancona, Italy.

Background And Objectives: The lumbar plexus block (LPB) is a key technique for lower limb surgery. All approaches to the LPB involve a number of complications. We hypothesized that Chayen's approach, which involves a more caudal and more lateral needle entry point than the major techniques described in the literature, would be associated with a lower rate of epidural spread. Read More

Asian Spine J 2020 Jun 12. Epub 2020 Jun 12.

Department of Anaesthesiology, Pain Medicine & Critical Care, All India Institute of Medical Sciences, New Delhi, India.

Transforaminal epidural steroid injection is often administered to patients with radiculopathy under fluoroscopic guidance, although it has disadvantages of radiation hazards and requirement of a special area to perform the block. To avoid these disadvantages, ultrasound-guided transforaminal injection (USTFI) has recently been described and is continually developed. This review article describes the indexed articles published on USTFI and ultrasound-guided selective nerve block (SNRB) to evaluate current evidence on best approach to perform the block. Read More

J Pediatr Urol 2020 May 20. Epub 2020 May 20.

Prof.Dr. Cemil Tascioglu City Hospital, Department of Pediatric Surgery, Kaptan Paşa, SSK Okmeydanı Hst. No:25, 34384, Şişli, İstanbul, Turkey. Electronic address:

Background: The surgery of hypospadias is very painful in the postoperative period and requires long-term analgesia. A dorsal penile nerve block (DPNB) and caudal epidural block (CEB) are commonly used regional anesthesia techniques for postoperative pain control.

Objectives: The primary aim of the prospective, observational study was to use the duration until the first postoperative analgesic requirement after two different block techniques to compare the analgesic effect. Read More

Korean J Anesthesiol 2020 Jun 5. Epub 2020 Jun 5.

Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Background: Neuroleukemiosis is a rare complication of leukemia. The diagnosis may be delayed owing to non-specific symptoms and the need for special diagnostic modalities.

Case: A 70-year-old man in his sixth year of remission from acute myeloid leukemia was referred to the pain clinic for shooting and radiating pain in the left posterior leg. Read More

Indian J Anaesth 2020 Apr 28;64(4):280-285. Epub 2020 Mar 28.

Division of Thoracic Surgery, Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India.

Background And Aims: Post-thoracotomy pain can be severe and disabling. The aim of this study was to examine the efficacy of intercostal nerve block when used as adjunct to thoracic epidural analgesia in patients undergoing posterolateral thoracotomy.

Methods: This was a parallel-group randomised patient and assessor-blinded study carried out at a tertiary-referral cancer center. Read More

J Int Med Res 2020 Jun;48(6):300060520922691

Southwest Medical University, Luzhou, Sichuan Province, China.

Background: A novel technique of continuous transversus abdominis plane block (TAPB) has been reported to be beneficial to patients undergoing abdominal surgery because it can significantly relieve postoperative pain. The aim of our study is to compare this novel technique with a traditional technique of continuous epidural analgesia (EA).

Methods: We conducted our meta-analysis in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Read More

Int J Spine Surg 2020 Apr 30;14(2):222-225. Epub 2020 Apr 30.

Department of Cell Biology and Anatomy, New York Medical College, Valhalla, New York.

Background: This is a brief technical report about a novel regional anesthesia technique in which local anesthetic was deposited around the thoracolumbar dorsal rami nerves via 4 multiorifice pain catheters to obtain analgesia for posterior spinal fusion surgery on scoliosis patients. Scoliosis is the most common deformity of the spine. Currently, most surgeons prefer a dual rod, segmental spinal fixation system that allows multiple anchor points for attachment to the deformed spine. Read More

Zhen Ci Yan Jiu 2020 Apr;45(4):325-9

Department of Anesthesiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province.

Objective: To investigate the effect of electroacupuncture (EA) analgesia at the latent stage of labor on epidural analgesia, labor outcome and neonatal score so as to provide the reference to the clinical labor analgesia.

Methods: According to the random number table, 104 primipara of vaginal delivery were divided into three groups, named an EA group (37 cases), a sham-EA group (36 cases) and an epidural block group (31 cases). In the EA group, when the cervix opened up by 1 cm, Han's acupoint nerve stimulation apparatus was attached to bilateral Hegu (LI4) and bilateral Sanyinjiao (SP6) to achieve EA analgesia till the active stage (the cervix up 3 cm). Read More

Saudi J Anaesth 2020 Apr-Jun;14(2):231-234. Epub 2020 Mar 5.

Department of Anaesthesiology, Intensive Care and Emergency Medicine, Porto Centro Hospitalar, Porto, Portugal.

The epidural block is an anesthetic procedure that can have possible complications upon insertion or removal. Epidural catheter retention is a rare complication; its etiology may come from lateral migration with kinking of the catheter or from involvement with bone, ligamentous, muscular, vascular structures, or nerve roots. Up until today, there is not a standard approach to this complication; however, there are some recommendations for the management of retained epidural catheters. Read More

Br J Anaesth 2020 06 15;124(6):739-747. Epub 2020 Apr 15.

Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark; Copenhagen Centre for Translational Research, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Background: Current treatment of postdural puncture headache includes epidural blood patch (EBP), which is invasive and may result in rare but severe complications. Sphenopalatine ganglion block is suggested as a simple, minimally invasive treatment for postdural puncture headache. We aimed to investigate the analgesic effect of a transnasal sphenopalatine ganglion block with local anaesthetic vs saline. Read More

Cureus 2020 Apr 10;12(4):e7626. Epub 2020 Apr 10.

Anesthesiology, Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, USA.

Thoracic paravertebral blocks (TPVBs) provide an effective pain relief modality in conditions where thoracic epidurals are contraindicated. Historically, TPVBs were placed relying solely on the landmark-based technique, but the availability of ultrasound imaging makes it a valuable and practical tool during the placement of these blocks. TPVBs also provide numerous advantages over thoracic epidurals, namely, minimal hypotension, absence of urinary retention, lack of motor weakness, and remote risk of an epidural hematoma. Read More

Acta Anaesthesiol Scand 2020 Apr 9. Epub 2020 Apr 9.

Department of Anaesthesiology, Zealand University Hospital, Roskilde, Denmark.

Background: Management of moderate-to-severe post-operative pain after elective caesarean section (ECS) is internationally primarily based on either epidural catheters or opioids. However, both techniques are associated with some undesirable adverse events. Bilateral transmuscular quadratus lumborum (TQL) block has proven to reduce opioid consumption significantly in the first 24 post-operative hours following ECS and prolong time to first opioid (TFO) (Hansen CKD, Steingrimsdottir M, Laier GE, et al. Read More

Case Rep Anesthesiol 2020 12;2020:1830136. Epub 2020 Mar 12.

Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Tribhuvan University, Kathmandu, 44600, Nepal.

Fractures in and around the hip are common presentations in the emergency department. It is commonly seen in the elderly as a result of osteoporotic changes. However, younger age groups are also affected, especially as a result of high velocity trauma. Read More

J Arthroplasty 2020 Jun 14;35(6S):S241-S245. Epub 2020 Feb 14.

Department of Orthopedic Surgery, Henry Ford Hospital, Detroit, MI.

Background: The purpose of this randomized controlled trial is to identify if a fascia iliaca block reduces postoperative pain and narcotic consumption and improves early functional outcomes in primary total hip arthroplasty (THA) performed through the mini-posterior approach.

Methods: Patients were recruited from September 2017 to September 2019. Eligible patients received a primary THA using a mini-posterior approach with epidural anesthesia. Read More

Pain Physician 2020 03;23(2):E211-E218

Xi'an Jiatong University Xi'an, Shannxi China.

Background: Percutaneous endoscopic lumbar discectomy (PELD) can only relieve mechanical compression but cannot directly reduce the inflammatory reaction of the adjacent nerve root, which contributes to persistent pain and physical disabilities postoperatively. Numerous studies have explored the application of epidural steroids after an open lumbar discectomy in relieving pain by reducing local inflammatory reactions and further peridural scar formation.

Objectives: To explore that whether "cocktail treatment" in which a gelatin sponge was impregnated with ropivacaine, dexamethasone, and vitamin B12 promoted early postoperative recovery after PELD. Read More

J Arthroplasty 2020 Jun 13;35(6S):S178-S181. Epub 2020 Feb 13.

CritiCare Multispecialty Hospital, Mumbai, Maharashtra, India.

Background: Total knee arthroplasty (TKA) is associated with moderate-to-severe postoperative pain. Satisfactory perioperative analgesia is essential for a good and predictable surgical outcome. Effective postoperative pain control is a major challenge to the treating surgeon and his team. Read More

J Cardiothorac Vasc Anesth 2020 Jul 25;34(7):1870-1876. Epub 2020 Jan 25.

Department of Surgery, Indiana University School of Medicine, Indianapolis, IN.

Objective: Video-assisted thoracoscopic surgery (VATS) has improved patient outcomes; however, postoperative pain remains potentially severe. The objective of this study was to compare adjunct analgesic modalities for VATS, including paravertebral nerve blockade (PVB) and thoracic epidural anesthesia (TEA).

Design: Prospective, randomized trial. Read More

Int J Neurosci 2020 Mar 11:1-5. Epub 2020 Mar 11.

Department of Pain, Linyi Central Hospital, Linyi, China.

To compare the therapeutic effects of continuous epidural block combined with drugs and oral drugs alone on postherpetic neuralgia (PHN). Ninety-six PHN patients meeting the standard were selected and divided into group A and group B. Patients in group A had epidural block combined with oral administration of gabapentin and oxycodone-acetaminophen, and patients in group B received oral gabapentin and oxycodone-acetaminophen. Read More

World Neurosurg 2020 May 27;137:421-424. Epub 2020 Feb 27.

Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.

Background: An epidural nerve block injection is the most common modality of treatment for control of low backache associated with radiating pain. Epidural catheter injections are also widely used by pain physicians to control cancer pain. Epidural catheters could be associated with procedure-related complications, such as epidural hematoma, epidural abscess, and post-dural puncture headache, and rare complications, such as shearing or breakage of the catheter tip. Read More

Reg Anesth Pain Med 2020 05 23;45(5):373-376. Epub 2020 Feb 23.

Serviço de Anestesiologia - Departamento de Anestesiologia Cuidados Intensivos e Emergencia, Centro Hospitalar e Universitário do Porto, Porto, Portugal.

Background And Objectives: The gold standard for the treatment of postdural puncture headache (PDPH) is the epidural blood patch (EBP). Regional techniques-sphenopalatine ganglion block (SPGB), greater occipital nerve block (GONB) and trigger point infiltration (TPI)-can also be used for the treatment of PDPH. Our objective was to evaluate the efficacy of these peripheral nerve blocks (PNBs) in the treatment of PDPH. Read More

J Am Coll Surg 2020 Jul 17;231(1):150-154. Epub 2020 Feb 17.

Department of Surgery, University of California San Francisco, Fresno, CA.

Background: Rib fractures are common among trauma patients and analgesia remains the cornerstone of treatment. Intercostal nerve blocks provide analgesia but are limited by the duration of the anesthetic. This study compares outcomes of epidural analgesia with intercostal nerve block using liposomal bupivacaine for the treatment of traumatic rib fractures. Read More

Clin J Pain 2020 Jun;36(6):449-457

Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.

Objectives: Epidural injections and selective nerve blocks are widely used for pain relief, but steroid usage is controversial due to safety concerns. We carried out this retrospective cohort study to estimate the incidence rates of neurological complications associated with epidural and selective nerve blocks, in relation to steroid use patterns.

Materials And Methods: Using a national insurance claims database, we identified patients who received at least one epidural injection or nerve block from 2009 to 2013. Read More

Anaesthesia 2020 Feb 16. Epub 2020 Feb 16.

Department of Anaesthesia, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada.

Serratus anterior plane and pectoral nerves blocks are recently described alternatives to established regional anaesthesia techniques in cardiac surgery, thoracic surgery and trauma. We performed a systematic review to establish the current state of evidence for the analgesic role of these fascial plane blocks in these clinical settings. We identified relevant studies by searching multiple databases and trial registries from inception to June 2019. Read More

Curr Opin Anaesthesiol 2020 Jun;33(3):305-310

Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, UK.

Purpose Of Review: Preeclampsia remains an important cause of maternal and neonatal morbidity and mortality. Recent interest in angiogenic biomarkers as a prognostic indicator is reviewed, together with analgesic, anaesthetic and critical-care management of the preeclamptic patient.

Recent Findings: There has been recent interest in the angiogenic biomarkers placental growth factor and soluble fms-like tyrosine kinase-1 in establishing the diagnosis of preeclampsia and guiding its management. Read More

JA Clin Rep 2019 Jul 11;5(1):44. Epub 2019 Jul 11.

Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.

Background: Blind epidural catheter placement can lead to inadvertent misplacement. We present a case of intercostal misplacement of a thoracic epidural catheter.

Case Presentation: A 67-year-old male underwent left lung cancer surgery via thoracotomy with epidural analgesia via the Th 5-6 intervertebral space, although with some difficulty. Read More

Open Vet J 2019 10 16;9(3):230-237. Epub 2019 Aug 16.

Departament de Medicina y Cirugia Animal, Facultad de Veterinaria, Instituto de Ciencias Biomedicas, Universidad CEU Cardenal Herrera, Valencia, Spain.

Background: The caudal thoracic paravertebral (CTPV) block is a regional anesthesia technique currently used in human medicine to provide analgesia in abdominal surgical procedures.

Aim: The objectives of this study are to describe an ultrasound-guided technique to place catheters in CTPV space in canine cadavers and evaluate the distribution of a 50:50 contrast-dye solution administered through them.

Methods: Eight thawed adult beagle cadavers (9. Read More

Vet Anaesth Analg 2020 Mar 30;47(2):229-237. Epub 2019 Oct 30.

Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Anestesiología y Algiologia, Buenos Aires, Argentina.

Objective: To investigate the distribution and nerve staining of two volumes of lidocaine-dye solution after ultrasound-guided erector spinae plane (ESP) injections in canine cadavers.

Study Design: Experimental cadaveric study.

Animals: A total of nine canine cadavers. Read More

Br J Surg 2020 Jan;107(2):e17-e25

Centre for Surgical Research, University of Bristol, Bristol, UK.

Background: Emergency surgery encompasses more than 50 per cent of the surgical workload; however, research efforts are disproportionally low. The mode of anaesthesia used during emergency surgery may affect outcomes, but the extent of research and the impact of the different modes of anaesthesia used are unclear.

Methods: MEDLINE and Embase were searched using scoping review methodology with a rapid systematic search strategy, identifying any study comparing locoregional (local, nerve block, subarachnoid, epidural) anaesthesia with general anaesthesia. Read More

Turk J Phys Med Rehabil 2019 Jun 22;65(4):406-410. Epub 2019 Nov 22.

Department of Physical Medicine and Rehabilitation, Pain Medicine Section, Medicine Faculty of Marmara University, İstanbul, Turkey.

Post-injection sciatic neuropathy (PISN) from an inadvertent intramuscular injection in the gluteal region is a type of iatrogenic sciatic nerve injury. Patients with neuropathic pain following PISN frequently experience disability leading to restrictions in daily activities and pain, which may be resistant to conventional treatments and physiotherapy in some cases. To date, minimal invasive procedures for neuropathic pain have been performed with various medications at the site of lesion. Read More

Reg Anesth Pain Med 2020 03 25;45(3):249-250. Epub 2019 Dec 25.

Shanghai Children's Hospital, Shanghai, China

BMC Anesthesiol 2019 12 17;19(1):230. Epub 2019 Dec 17.

Department of Orthopedics, Chengdu Aerospace Hospital, Chengdu, 610100, China.

Background: There is no consensus on the optimal anesthesia method for intertrochanteric fracture surgeries in elderly patients. Our study aimed to compare the hemodynamics and perioperative outcomes of general anesthesia with endotracheal intubation, combined spinal-epidural anesthesia, and general anesthesia with laryngeal mask airway (LMA) and nerve block for intertrochanteric fracture surgeries in elderly patients.

Methods: This is a retrospective study of 75 patients aged > 60 years scheduled for intertrochanteric fracture surgeries with general anesthesia with intubation (n = 25), combined spinal-epidural anesthesia (n = 25), and general anesthesia with LMA and nerve block (n = 25). Read More

Curr Opin Anaesthesiol 2020 Feb;33(1):64-70

Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital.

Purpose Of Review: Regional anesthesia blocks may benefit patients undergoing cardiovascular surgery. This review coincides with the evolution of ultrasound-guided fascial plane blocks, societal concerns regarding opioid misuse and changing expectations regarding surgical recovery.

Recent Findings: Paravertebral block and thoracic epidural analgesia have comparable postoperative analgesic profiles following thoracotomy; however, the former has a more favorable complication profile. Read More

Rev Med Liege 2019 Dec;74(12):662-666

Service d'Anesthésie, Centre Hospitalier du Bois de l'Abbaye, Seraing, Belgique.

For about twenty years, peripheral nervous blocks have become the gold standard in postoperative analgesia for knee and foot surgery. The development of echography adapted to anesthesia gave anesthesiologists the opportunity to perform distal, mostly sensitive nerve blocks. Proximal nervous blocks associated analgesia used to be better than general (intravenous or oral) analgesia. Read More

Cureus 2019 Nov 26;11(11):e6237. Epub 2019 Nov 26.

Anesthesiology, McGovern Medical School University of Texas Health Science Center, Houston, USA.

Postdural puncture headache (PDPH) is a common complication of neuraxial anesthesia. The gold standard treatment for PDPH is an epidural blood patch (EBP). However, the risks of EBP, and patient willingness to undergo another attempted neuraxial procedure, can prevent patients from receiving this treatment. Read More

Best Pract Res Clin Anaesthesiol 2019 Dec 26;33(4):407-413. Epub 2019 Jul 26.

Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave., New Orleans, LA 70112, USA. Electronic address:

The facsia iliaca block (FIB) is a relatively new regional technique where local anesthetic is delivered within the fascia iliaca region. Indications for a FIB include surgical anesthesia to the lower extremity after knee, femoral shaft, hip surgery, management of cancer pain or pain secondary to inflammatory conditions of the lumbar plexus, as well as treatment of acute pain in the setting of trauma, fracture, or burns. The FIB may be performed using either a loss of resistance technique or an ultrasound (US)-guided technique; however, the use of US has become commonplace and resulted in improved femoral nerve and obturator nerve motor blocks. Read More

Pain Physician 2019 11;22(6):521-536

Massachusetts General Hospital and Harvard Medical School, Boston, MA.

Background: The cost of US health care continues to increase, with treatments related to low back and neck pain and other musculoskeletal disorders accounting for the third highest amount of various disease categories. Interventional techniques for managing pain apart from conservative modalities and surgical interventions, have generally been thought to be growing rapidly. However, a recent analysis of utilization of interventional techniques from 2000 to 2016 has shown a modest decline from 2009 to 2016, compared to 2000 to 2009. Read More

J Pediatr Urol 2020 Feb 30;16(1):99-106. Epub 2019 Oct 30.

Okmeydanı Training and Research Hospital, Department of Pediatric Surgery, Istanbul, Turkey. Electronic address:

Background: Circumcision can be performed under sedo-analgesia, general anesthesia, or regional anesthesia. It may cause serious postoperative pain and patients often require additional analgesia. Dorsal penile nerve block (DPNB) and caudal epidural block are commonly used regional anesthesia methods to provide effective postoperative pain control in circumcision. Read More

J Laparoendosc Adv Surg Tech A 2020 Jan 19;30(1):81-86. Epub 2019 Nov 19.

Department of Anesthesiology and Reanimation, Yüksek İhtisas University School of Medicine, Ankara, Turkey.

The aim of this study was to compare the effectiveness of epidural block (EDB) and paravertebral block (PVB) for minimally invasive pectus repair with the conventional method in terms of pain control during and after pectus operations, patient comfort, and length of stay in hospital. A retrospective review was made of patients who underwent minimally invasive pectus repair. The patients were allocated into three groups as follows: PVB group (Pre-emptive ultrasound-guided bilateral thoracic single injection PVB,  = 15); EDB group (Pre-emptive landmark-guided single injection thoracic EDB,  = 8); and Control group (Neither PVB nor EPB,  = 9). Read More

Acta Clin Croat 2019 Jun;58(Suppl 1):101-107

1Clinic for Anesthesiology, Reanimatology and Intensive Care Medicine, Clinical Hospital Dubrava; 2School of Dental Medicine, University of Zagreb, Croatia.

A significant component of all surgical procedures and postoperative treatment is pain management.Due to the physiological and psychological advantages of pain relief, it is one of the foremost indicators of quality of care. Today, there are various modalities of pain reduction, aimed to reduce patient discomfort andminimize side effects, which can be divided by therapeutic agents used (opioid or non-opioid), route of administration (intravenous, regional, oral, etc. Read More

Acta Clin Croat 2019 Jun;58(Suppl 1):96-100

Clinical department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia.

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. Read More

J Emerg Med 2019 Dec 7;57(6):844-847. Epub 2019 Nov 7.

Department of Emergency Medicine, Saint Joseph Mercy Ann Arbor Hospital, Ypsilanti, Michigan.

Background: Thoracic injuries present many challenges for management in the acute and inpatient settings, including achieving appropriate pain control. Traditional modalities, such as opioids and spinal epidural anesthesia, are associated with multiple complications. Ultrasound-guided regional nerve blocks are becoming more prevalent, and they have been shown to be an effective modality of pain control for other traumatic injuries. Read More

A A Pract 2020 Jan;14(1):6-8

Institute of Anesthesia and Intensive Care, University of Padova, Padova, Italy.

Spontaneous intracranial hypotension (SIH) has been increasingly characterized in recent years. A definitive diagnostic algorithm remains controversial because several symptoms are often found to be nonspecific. When neuroimaging fails to identify a cerebrospinal fluid leak and symptoms are atypical, an epidural blood patch (EBP) may be performed but not without risks. Read More

Spinal Cord Ser Cases 2019 5;5:92. Epub 2019 Nov 5.

2Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK.

Introduction: Ganglion impar block (GIB) is a well-recognised treatment for chronic coccydynia. Several side effects have previously been described with this procedure, including transient motor dysfunction, bowel, bladder, and sexual dysfunction, neuritis, rectal perforation, impingement of the sciatic nerve, cauda equina syndrome, and infection.

Case Presentation: We describe the first report of imaging-documented conus infarction after an unguided-GIB performed in theatre using particulate steroids for a 17-year-old patient with coccydynia. Read More

PLoS One 2019 28;14(10):e0224487. Epub 2019 Oct 28.

Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea.

The paravertebral spread that occurs after erector spinae plane block may be volume-dependent. This cadaveric study was undertaken to compare the extent of paravertebral spread with erector spinae plane block using different dye volumes. After randomization, twelve erector spinae plane blocks were performed bilaterally with either 10 ml or 30 ml of dye at the level of T5 in seven unembalmed cadavers except for two cases of unexpected pleural puncture using the 10 ml injection. Read More