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Eur J Anaesthesiol 2018 Dec 17. Epub 2018 Dec 17.

Joanna Kastelik and Michael Fuchs contributed equally to the article.

Background: Local infiltration anaesthesia (LIA) was introduced as an innovative analgesic procedure for enhanced recovery after primary total knee arthroplasty (TKA). However, LIA has never been compared with analgesia based on an adductor canal catheter and a single-shot sciatic nerve block.

Objective: To evaluate two analgesic regimens for TKA comparing mobility, postoperative pain and patient satisfaction. Read More

Am J Emerg Med 2018 Nov 17. Epub 2018 Nov 17.

Emergency Medicine Department, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Low dose ketamine can be used as analgesic in acute pain management in the emergency department (ED).

Objective: Efficacy of IN ketamine in acute pain management in the ED.

Method: This is a double blind randomized clinical trial on patients older than 15 years who needed digital nerve block (DNB). Read More

Clin Neurol Neurosurg 2018 Dec 3;176:73-77. Epub 2018 Dec 3.

Science & Innovation Manager, R&D Department, Cumbria Partnership NHS Foundation Trust, Carlisle, CA1 3SX, UK. Electronic address:

Objective: Greater occipital nerve (GON) block is a treatment option applied for a variety of primary headache disorders. Although a patient's body position is known to have an impact on the effect of local anaesthetics, this has not before been investigated for patients undergoing GON block. Therefore, the clinical effectiveness of either a sitting or supine position was assessed. Read More

Indian J Anaesth 2018 Nov;62(11):876-880

Department of Anesthesia and Pain Relief Services, Tata Motors Hospital, Jamshedpur, Jharkhand, India.

Background And Aims: Monopolar radiofrequency ablation (MRFA) of the genicular nerve is effective in managing chronic knee pain from osteoarthritis (OA); however, the procedure itself is associated with significant pain due to manipulation of electrode to localise tiny genicular nerves. We hypothesised that inserting two electrodes to target the genicular nerves [bipolar radiofrequency ablation (BRFA)] without sensory localisation can decrease the procedural pain with equal analgesic efficacy in treating knee pain.

Methods: Thirty patients with chronic knee pain due to OA were randomised to receive either MRFA ( = 15) or BRFA ( = 15), after having 50% pain relief with diagnostic genicular nerve block. Read More

Rev Esp Anestesiol Reanim 2018 Dec 5. Epub 2018 Dec 5.

Facultad de Medicina, Universitat de Barcelona, Barcelona, España; Hospital Clinic, Universitat de Barcelona, Barcelona, España. Electronic address:

Introduction: To recognise the relationship between the needle tip and the median nerve during peripheral nerve block is of interest to avoid neural damage. However, signs of intraneural injection are not clearly established. The aim of this study was to define the changes observed in the peripheral nerve after the intraneural or perineural administration of 1ml of solution. Read More

Vet Anaesth Analg 2018 Sep 19. Epub 2018 Sep 19.

Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Oslo, Norway.

Objective: To determine the infusion rates that maintain the train-of-four (TOF) ratio within 20-70% in dogs and compare the infusion rates between diabetic and nondiabetic dogs.

Study Design: Prospective clinical study.

Animals: In total, 47 dogs scheduled for phacoemulsification were included with a median (80% central range) bodyweight of 10. Read More

Vet Anaesth Analg 2018 Oct 22. Epub 2018 Oct 22.

Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.

Objective: To develop a modified ultrasound-guided parasacral approach to the sciatic nerve and compare the effects of a volume of 0.2 mL kg of 0.5% levobupivacaine with an equivalent volume of 0. Read More

J Neuroeng Rehabil 2018 Nov 12;15(1):103. Epub 2018 Nov 12.

Toledo Physiotherapy Research Group (GIFTO), Nursing and Physiotherapy School, Castilla La Mancha University, 45071, Toledo, Spain.

Background: High-frequency alternating currents of greater than 1 kHz applied on peripheral nerves has been used in animal studies to produce a motor nerve block. It has been evidenced that frequencies higher than 5 kHz are necessary to produce a complete peripheral nerve block in primates, whose nerve thickness is more similar to humans. The aim of the study was to determine the effect on muscle strength after the application of a high-frequency stimulation at 5 and 10 kHz compared to sham stimulation in healthy volunteers. Read More

Medicine (Baltimore) 2018 Oct;97(43):e12958

Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Center, University of Goettingen, Goettingen.

Background: Continuous blockade of the femoral nerve is widely used for postoperative analgesia after hip surgery. It can be achieved by ultrasound-guided placement of a femoral nerve catheter via either the in plane (IP) or out of plane (OOP) technique. On the basis of postoperative radiographs, we evaluated the paths of femoral nerve catheters with respect to both techniques and its effect on postoperative analgesia. Read More

J Arthroplasty 2018 Oct 13. Epub 2018 Oct 13.

Department of Orthopaedics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.

Background: Peripheral nerve block and local infiltration analgesia (LIA) have an increasing role as part of multimodal analgesia for enhanced recovery after total knee arthroplasty (TKA). We hypothesized that the combination of obturator nerve block (ONB) and tibial nerve block (TNB) would reduce pain and opioid consumption more than ONB or TNB alone when combined with continuous adductor canal block and LIA.

Methods: Ninety patients were recruited into the study and received spinal anesthesia, LIA, and continuous adductor canal block. Read More

Anticancer Res 2018 Nov;38(11):6479-6484

Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland

Background/aim: The relationship of plasma concentrations of the oxidative stress biomarker catalase with pain on numeric rating scale at rest (NRSr) and under wound pressure 24 hours postoperatively (NRSp) in midline laparotomy patients with rectus sheath block (RSB) analgesia are unknown. Our original hypothesis was that RSB analgesia might reduce postoperative pain.

Patients And Methods: Initially, 56 patients were randomized to four groups: control group (n=12), single-dose (n=16), repeated-dose (n=12) and continuous infusion (n=16) RSB analgesia groups. Read More

J Clin Anesth 2018 Nov 2;54:61-65. Epub 2018 Nov 2.

Muğla Sıtkı Koçman University, Department of Anesthesiology and Reanimation, Muğla, Turkey.

Study Objective: Breast cancer is the most common malignancy of women all over the world. In this study, we compared the effects of ultrasound-guided modified pectoral nerve (PECS) block and erector spinae plane (ESP) block on postoperative opioid consumption, pain scores, and intraoperative fentanyl need of patients undergoing unilateral modified radical mastectomy surgery.

Design: Single-blinded, prospective, randomized, efficacy study. Read More

J Anaesthesiol Clin Pharmacol 2018 Jul-Sep;34(3):372-378

Department of Anesthesia, Toronto Western Hospital, Toronto, Ontario, Canada.

Background And Aims: Cadaveric studies have shown that injectate from transmuscular quadratus lumborum block (QLB) can spread to the lumbar plexus. Our aim was to compare analgesic efficacy of transmuscular QLB with lumbar plexus block (LPB) for patients undergoing total hip arthroplasty (THA).

Material And Methods: Thirty patients receiving transmuscular QLB were propensity score matched with 30 patients receiving LPB for age, sex, ASA score, BMI, operative time, preoperative oxycodone, and intraoperative opioid use. Read More

Proc Natl Acad Sci U S A 2018 11 22;115(45):E10720-E10729. Epub 2018 Oct 22.

Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan 40402;

Adequate pain management remains an unmet medical need. We previously revealed an opioid-independent analgesic mechanism mediated by orexin 1 receptor (OX1R)-initiated 2-arachidonoylglycerol (2-AG) signaling in the ventrolateral periaqueductal gray (vlPAG). Here, we found that low-frequency median nerve stimulation (MNS) through acupuncture needles at the PC6 (Neiguan) acupoint (MNS-PC6) induced an antinociceptive effect that engaged this mechanism. Read More

Eur Neurol 2018 22;80(1-2):100-105. Epub 2018 Oct 22.

Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an,

Purpose: The diagnosis of Guillain-Barre syndrome (GBS) in the very early stage may be challenging. Our aim was to report the neurophysiological abnormalities in GBS within 4 days of clinical onset. We expected that GBS will be diagnosed by the assistance of neurophysiological study in the very early stage. Read More

Clin Anat 2018 Oct 20. Epub 2018 Oct 20.

Department of Anesthesiology, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.

Our objective was to define the positions of the nerves around the brachial artery and, secondarily, to assess the risk of intraneural injection during dual guided axillary block. Sixty ultrasound-guided axillary blocks were performed. The locations of the musculocutaneous, median, ulnar, and radial nerves relative to the brachial artery were determined. Read More

BMC Anesthesiol 2018 Oct 19;18(1):143. Epub 2018 Oct 19.

Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical College, 2 Fuxue Road, Wenzhou City, Zhejiang Province, 325000, China.

Background: Proximal brachial plexus blocks can lead to an extended period of motor paralysis and delay the return of motor function. This could influence patient satisfaction, and extend hospitalizations. The aim of the study is to compare a selective distal nerve block of the arm to a proximal axillary block, both ultrasound-guided, in terms of their motor block intensity of the elbow. Read More

J Hand Surg Asian Pac Vol 2018 Sep;23(3):419-423

‡ Department of Orthopaedic Surgery, Aichiken Koseiren Kainan Hospital, Nagoya, Japan.

Early active mobilization after hand surgery is extremely important for preventing scar tissue and adhesion. We examined four patients for whom continuous peripheral nerve blocks (CPNB) were used during and after hand surgery. This method was used for three median nerves and one ulnar nerve. Read More

Am J Vet Res 2018 Oct;79(10):1028-1034

OBJECTIVE To determine whether addition of epinephrine to a lidocaine solution would prolong and potentiate the efficacy of a palmar digital nerve block (PDNB) in horses. ANIMALS 6 adult horses with naturally occurring forefoot lameness. PROCEDURES Initially, a PDNB with a 2% lidocaine solution was performed on the affected foot of each horse. Read More

Surgery 2018 Sep 21. Epub 2018 Sep 21.

Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands; SolviMáx, Center of Expertise for ACNES, Center of Excellence for Abdominal Wall and Groin Pain, The Netherlands.

Background: Chronic abdominal pain due to anterior cutaneous nerve entrapment syndrome may require surgery to provide long-term pain relief in up to 70% of patients. Factors predicting outcome after an anterior neurectomy are unknown. The aim of the study is to identify factors associated with treatment failure to possibly allow for optimizing patient counselling and selection. Read More

JBJS Essent Surg Tech 2018 Mar 14;8(1):e7. Epub 2018 Mar 14.

Sheffield Teaching Hospitals, Sheffield, United Kingdom.

Effective anesthesia of the hand and wrist has many uses inside and outside the operating room. In the emergency department or fracture clinic, a wrist block may be used for closed reductions of dislocations and fractures or for effective inspection and treatment of wounds. In the operating room, surgery may be carried out under a wrist block alone or a wrist block may be used as an adjunct to general anesthesia as the block is an opiate-sparing option to facilitate outpatient surgery and to provide many hours of postoperative analgesia, particularly if administered prior to the commencement of surgery. Read More

N Z Vet J 2019 Jan 15;67(1):46-51. Epub 2018 Oct 15.

d Small Animal Specialist Hospital , Sydney , Australia.

CASE HISTORY Thirteen cats developed ophthalmic complications following dental procedures in Australia and New Zealand between December 2014 and February 2018. All cats had at least one maxillary tooth extracted and some received a transoral maxillary nerve block. CLINICAL FINDINGS Ocular signs were identified at a median of 1. Read More

Gait Posture 2018 Oct 31;66:166-171. Epub 2018 Aug 31.

Department of Orthopedics, Xuanwu Hospital, Capital Medical University, No.45 Changchun Street, Xicheng District, Beijing, China. Electronic address:

Background: The main objective of total knee arthroplasty is to relieve pain, restore normal knee function, and improve gait stability. Significant flexion contractures can severely impair function after surgery. The purpose of this study is to evaluate the efficacy of implementing a continuous proximal sciatic nerve block in conjunction with aggressive physical therapy to treat patients with persistent flexion contractures that were recalcitrant to rehabilitation efforts following primary total knee arthroplasty (TKA). Read More

Toxicology 2018 Sep 1;408:113-124. Epub 2018 Sep 1.

Department of Anatomy and Forensic Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.

Background: Physostigmine and its analogues neostigmine, pyridostigmine and rivastigmine are carbamates nowadays used in many indications, including antidotal effects against antimuscarinic poisonings, reversal of competitive neuromuscular block, myasthenia gravis, Alzheimer's disease and prophylaxis against nerve agent intoxications. Use of these medicinal carbamates, but also of carbamate insecticides, created need for research into the potential and mechanisms of action of several antidotes against carbamate poisonings, including anticholinergics and oximes.

Aim: The goal of this experimental study was to ascertain the life-preserving potential of anticholinergics atropine, hexamethonium and d-tubocurarine, oxime HI-6 and their combinations in rats poisoned with physostigmine or pyridostigmine. Read More

Ann Thorac Surg 2019 Jan 28;107(1):128-134. Epub 2018 Aug 28.

Division of Cardiac Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York. Electronic address:

Background: Optimal pain control continues to be a concern in cardiac surgery. Current strategies for postoperative pain management often yield suboptimal results. The superiority of Exparel (Pacira Pharmaceuticals, Inc, Parsippany, NJ) in providing postoperative pain control and opioid sparing is equivocal. Read More

Toxicol Lett 2018 Nov 27;297:19-23. Epub 2018 Aug 27.

Experimental Anesthesiology Section, Department of Anesthesiology and Intensive Care Medicine, Eberhard-Karls-University, Waldhoernlestrasse 22, 72072 Tuebingen, Germany. Electronic address:

Intoxication with organophosphorus compounds can result in life-threatening organ dysfunction and refractory seizures. Sedation or hypnosis is essential to facilitate mechanical ventilation and control seizure activity. The range of indications for midazolam includes both hypnosis and seizure control. Read More

Neuromodulation 2018 Aug 30. Epub 2018 Aug 30.

Department of Orthopedic Surgery, University of California, San Diego, San Diego, CA, USA.

Objectives: The purpose of this prospective proof of concept study was to investigate the feasibility of using percutaneous peripheral nerve stimulation of the femoral nerve to treat pain in the immediate postoperative period following ambulatory anterior cruciate ligament reconstruction with a patellar autograft.

Materials And Methods: Preoperatively, an electrical lead (SPRINT, SPR Therapeutics, Inc., Cleveland, OH, USA) was percutaneously implanted with ultrasound guidance anterior to the femoral nerve caudad to the inguinal crease. Read More

Cureus 2018 Jun 21;10(6):e2852. Epub 2018 Jun 21.

Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, USA.

Introduction Peripheral nerve blockade (PNB) can be a useful component of a multimodal analgesia approach in managing pain after knee arthroscopy. However, the impact of PNB and short-term recovery in pediatric patients, particularly adolescents, who underwent knee arthroscopy for anterior cruciate ligament (ACL) reconstruction and/or meniscus surgery (repair or resection) has not been well characterized. This prospective study presents observational data on short-term patient outcomes and side effects for 72 hours following discharging home of pediatric patients who underwent arthroscopic ACL and/or meniscus procedures with PNB. Read More

Turk J Anaesthesiol Reanim 2018 Feb 27;46(1):15-20. Epub 2017 Nov 27.

Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, India.

Objective: Compared to ropivacaine, levobupivacaine is more lipophilic and a more potent vasoconstrictor. The study was conducted to compare the effect of 0.5% ropivacaine and 0. Read More

Heart Rhythm 2018 Dec 18;15(12):1808-1815. Epub 2018 Aug 18.

Division of Pediatric Cardiology, Department of Pediatrics UCLA Medical Center, University of California, Los Angeles, Los Angeles, California; Division of Cardiology, Department of Medicine, Ahmanson/UCLA Adult Congenital Heart Disease Center, University of California, Los Angeles, Los Angeles, California.

Background: Patients with congenitally corrected transposition of the great arteries (CCTGA) are at risk of congestive heart failure (CHF). There are limited data on cardiac resynchronization therapy (CRT) techniques and long-term outcomes in this population.

Objective: The purpose of this study was to determine implantation techniques and efficacy of CRT for CCTGA. Read More

J Int Med Res 2018 Oct 20;46(10):4207-4213. Epub 2018 Aug 20.

1 Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

Objective This study aimed to identify the median effective volume of ropivacaine 0.5% for ultrasound-guided adductor canal block (ACB). Methods Thirty-two patients received ultrasound-guided ACB for knee arthroscopic meniscectomy. Read More

Anaesthesia 2018 Oct 18;73(10):1260-1264. Epub 2018 Aug 18.

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

We evaluated the effect of pre-operative serratus anterior plane block on postoperative pain and opioid consumption after thoracoscopic surgery. We randomly allocated 89 participants to block with 30 ml ropivacaine 0.375% (n = 44), or no block without placebo or sham procedure (n = 45). Read More

Neuromodulation 2018 Aug 17. Epub 2018 Aug 17.

Department of Bioengineering, University of Utah, Salt Lake City, UT, USA.

Objectives: Kilohertz high-frequency alternating current (KHFAC) electrical nerve stimulation produces a reversible nerve block in peripheral nerves in human patients with chronic pain pathologies. Although this stimulation methodology has been verified with nonselective extrafascicular electrodes, the effectiveness of producing a selective nerve block with more-selective intrafascicular electrodes has not been well documented. The objective of this study was to examine whether intrafascicular electrodes can block painful stimuli while preserving conduction of other neural activity within the implanted nerve. Read More

Anaesthesia 2018 Oct 16;73(10):1244-1250. Epub 2018 Aug 16.

Department of Anaesthesiology and Pain Medicine, Anaesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.

Although different injection locations for retrolaminar and erector spinae plane blocks have been described, the two procedures have a similar anatomical basis. In this cadaveric study we compared anatomical spread of dye in the thoracic region following these two procedures. Following randomisation, 10 retrolaminar blocks and 10 erector spinae plane blocks were performed on the left or right sides of 10 unembalmed cadavers. Read More

J Anaesthesiol Clin Pharmacol 2018 Apr-Jun;34(2):205-210

Department of Anesthesiology, Nihon University School of Medicine, Tokyo, Japan.

Background And Aims: Ultrasound (US)-guided transversus abdominis plane (TAP) block is used as a part of a multimodal analgesic regimen in the postoperative period. Lateral approach TAP block (LTAP) has been widely used for postoperative analgesia after lower abdominal surgeries. Posterior approach TAP block (PTAP), which is achieved by more posterior blockade of the anterior ramus of the spinal nerve, also provides profound postoperative analgesia after transverse lower abdominal incision. Read More

Vet Anaesth Analg 2018 Nov 19;45(6):839-848. Epub 2018 Jun 19.

Department of Statistics, College of Natural Sciences, Colorado State University, Fort Collins, CO, USA.

Objective: To describe injectate diffusion for two equine mental foramen block techniques.

Study Design: Descriptive anatomic study.

Animals: A total of 12 equine heads and three live horses. Read More

Anesth Analg 2018 Aug 9. Epub 2018 Aug 9.

From the Department of Anesthesiology, University of California, San Diego, California.

We tested the hypothesis that during a continuous popliteal-sciatic nerve block, postoperative analgesia is improved with the catheter insertion point "deep" to the paraneural sheath immediately distal to the bifurcation between the tibial and common peroneal branches, compared with the traditional approach "superficial" to the paraneural sheath proximal to the bifurcation. The needle tip location was determined to be accurately located with a fluid bolus visualized with ultrasound; however, catheters were subsequently inserted without a similar fluid injection and visualization protocol (visualized air injection was permitted and usually implemented, but not required per protocol). The average pain (0-10 scale) the morning after surgery for subjects with a catheter inserted at the proximal subparaneural location (n = 31) was a median (interquartile) of 1. Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2018 Jul;21(7):761-765

Department of Pancreatobiliary Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.

Objective: To explore the appropriate operative strategy in recurrent groin hernia repair.

Methods: Clinical and follow-up data of 82 patients with recurrent groin hernia undergoing operation at Department of Pancreatobiliary Surgery, Xiangya Hospital of Central South University from April 2010 to April 2017 were analyzed retrospectively. The operative approaches included laparoscopic transabdominal preperitoneal (TAPP) hernia repair, Lichtenstein repair and hybrid repair. Read More

Anaesthesia 2018 Oct 25;73(10):1251-1259. Epub 2018 Jul 25.

Department of Anaesthesiology, Nordsjaellands Hospital, University of Copenhagen, Denmark.

We aimed to examine to what extent a lateral infraclavicular brachial plexus block affected the axillary and the suprascapular nerve. We included patients undergoing hand surgery anaesthetised with a lateral infraclavicular brachial plexus block. Our primary outcome was the relative change in surface electromyography during maximum voluntary isometric contraction of the medial deltoid muscle (axillary nerve) and the infraspinatus muscle (suprascapular nerve) from baseline to 30 min after the block procedure. Read More

Paediatr Anaesth 2018 08 23;28(8):703-709. Epub 2018 Jul 23.

Department of Anaesthesiology, University Hospitals of the KU Leuven, Leuven, Belgium.

Background And Aims: Circumcision is a frequently performed procedure in day case pediatric surgery. Dorsal penile nerve block has proven its effectiveness for the management of acute postoperative pain after circumcision. We investigated if the ultrasound-guided placement of a dorsal penile nerve block could reduce opioid requirement as compared to a landmark-based technique. Read More

Therap Adv Gastroenterol 2018 1;11:1756284818786111. Epub 2018 Jul 1.

University Hospital of South Manchester, Manchester, UK.

Background: Posterior tibial nerve stimulation (PTNS) is a novel treatment for patients with faecal incontinence (FI) and may be effective in selected patients; however, its mechanism of action is unknown. We sought to determine the effects of PTNS on anorectal physiological parameters.

Methods: Fifty patients with FI underwent 30 min of PTNS treatment, weekly for 12 weeks. Read More

Neuromodulation 2018 Jul 19. Epub 2018 Jul 19.

SPR Therapeutics, Cleveland, OH, USA.

Introduction: The objective of the present feasibility study was to investigate the use of a new treatment modality-percutaneous peripheral nerve stimulation (PNS)-in controlling the often severe and long-lasting pain following total knee arthroplasty (TKA).

Methods: For patients undergoing a primary, unilateral TKA, both femoral and sciatic open-coil percutaneous leads (SPR Therapeutics, Cleveland, OH) were placed up to seven days prior to surgery using ultrasound guidance. The leads were connected to external stimulators and used both at home and in the hospital for up to six weeks total. Read More

Singapore Med J 2018 Jul 16. Epub 2018 Jul 16.

Department of Rehabilitative Services, Changi General Hospital, Singapore.

Introduction: Adductor canal block (ACB) is hypothesised to provide superior analgesia to femoral nerve block (FNB) for total knee arthroplasty (TKA) while preserving quadriceps strength.

Methods: 30 patients undergoing TKA were randomised to receive either ACB or FNB. Baseline tests of quadriceps strength were performed. Read More

PLoS One 2018 2;13(7):e0199776. Epub 2018 Jul 2.

Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Center, University of Goettingen, Goettingen, Germany.

Background: Out-of-hospital analgosedation in trauma patients is challenging for emergency physicians due to associated complications. We compared peripheral nerve block (PNB) with analgosedation (AS) as an analgetic approach for patients with isolated extremity injury, assuming that prehospital required medical interventions (e.g. Read More

Anesth Essays Res 2018 Apr-Jun;12(2):452-458

Department of Anesthesiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.

Background: Adductor canal blocks (ACBs) have become a popular technique for postoperative pain control in total knee arthroplasty patients. Proximal and distal ACB have been compared previously, but important postoperative outcomes have yet to be assessed.

Aims: The primary objective of this study is to compare postoperative analgesia between proximal and distal ACB. Read More

Scand J Pain 2013 Apr 1;4(2):95-100. Epub 2013 Apr 1.

Department of Anaesthesiology and Surgical Intensive Care Medicine, University Medical Center Mannheim, Medical Faculty Mannheim Heidelberg University, Mannheim, Germany.

Background and objectives Unmyelinated C-fibres comprise the largest group of somatic afferents and have demonstrated a crucial role not only in the perception of high-threshold mechanically, thermally or chemically induced pain, but also in non-harmful low-threshold mechanical stimuli [1,2]. The objective of our study was to characterize differential sensitivity changes of C-fibre related subclasses of high-threshold and low-threshold polymodal nociceptors and low-threshold mechanoreceptors to the local anaesthetic (LA) mepivacaine during nerve block of the purely sensory lateral femoral cutaneous nerve (LFCN) in human. We assumed a diverse response of different classes of afferents to the two different concentrations of the LA mepivacaine (Scandicaine). Read More

Scand J Pain 2012 Jan 1;3(1):46-51. Epub 2012 Jan 1.

Department of Anaesthesiology and Intensive Care, Karolinska Institutet and Karolinska University Hospital, Solna, Sweden.

Pain after total knee arthroplasty (TKA) is difficult to control. A recently developed and increasingly popular method for postoperative analgesia following knee and hip arthroplasty is Local Infiltration Analgesia (LIA) with ropivacaine, ketorolac and epinephrine. This method is considered to have certain advantages, which include administration at the site of traumatized tissue, minimal systemic side effects, faster postoperative mobilization, earlier postoperative discharge from hospital and less opioid consumption. Read More

Reg Anesth Pain Med 2018 Aug;43(6):572-579

Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY.

Background And Objectives: Perineural dexamethasone and intravenous (IV) dexamethasone have been shown to prolong peripheral nerve block duration. The effects of perineural and IV dexamethasone have only been compared at doses of 4 mg or greater. This triple-blind, randomized trial examined the effect of 1 mg IV versus perineural dexamethasone on interscalene block (ISB) analgesia duration. Read More

Mar Drugs 2018 Jun 5;16(6). Epub 2018 Jun 5.

Department of Materials Science and Engineering, College of Materials, Xiamen University, Xiamen 361005, China.

Postherpetic neuralgia (PHN) is nerve pain caused by a reactivation of the varicella zoster virus. Medications are used to reduce PHN but their use is limited by serious side effects. Tetrodotoxin (TTX) is a latent neurotoxin that can block neuropathic pain, but its therapeutic index is only 3⁻5 times with intravenous or intramuscular injection. Read More

Pain Physician 2018 05;21(3):285-294

Department of Neurosurgery, University of Ulm, Ulm, Germany; Department of Neurosurgery, Nova Clinic Biberach, Biberach, Germany.

Background: Among the various causes of vertigo, the so-called cervicogenic vertigo (CV) has been the most controversial. However, perturbations of proprioceptive signals and abnormal activity of the cervical afferents can induce vertigo. Medial branch blocks (MBBs) are a diagnostic tool designed to test whether a patient's neck pain is mediated by one or more of the medial branches of the dorsal rami of the spinal nerve. Read More