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Front Med (Lausanne) 2022 26;9:862309. Epub 2022 Apr 26.

Pediatric Hematology/Oncology, Medical University of South Carolina, Charleston, SC, United States.

Purpose: Bone marrow harvesting is associated with significant postoperative pain that may have potential negative consequences for the patient and health care system. In the current absence of uniform guidelines, there exists considerable variability amongst providers with respect to perioperative analgesia, especially opioid administration. In this initiative, we explored the potential for preoperative bilateral quadratus lumborum blocks in combination with a standardized perioperative analgesic protocol to manage pain with the goal of reducing perioperative narcotic usage and thereby improving opioid stewardship. Read More

Europace 2022 May 6. Epub 2022 May 6.

Department of Electrophysiology, Alfried Krupp Hospital, Essen, Germany.

Aims: Catheter ablation for atrial fibrillation (AF) using thermal energy can cause collateral damage. Pulsed field ablation (PFA) is a novel non-thermal energy source. Few small clinical studies have been published. Read More

Nephrol Dial Transplant 2022 May 5. Epub 2022 May 5.

Urology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Background: chronic pain is often difficult to manage in ADPKD patients and sometimes even leads to nephrectomy. We analyzed long-term efficacy of our innovative multidisciplinary protocol to treat chronic refractory pain, and that aims to preserve kidney function by applying among other sequential nerve blocks.

Methods: patients were eligible if pain was present ≥ 3 months with a score on a visual analogue scale (VAS) of ≥ 50 out of 100, was negatively affecting quality of life, and if there had been insufficient response to previous therapies, including opioid treatment. Read More

Front Hum Neurosci 2022 11;16:860965. Epub 2022 Apr 11.

Applied Neuroscience Laboratory, Universidade Federal de Pernambuco, Recife, Brazil.

Background: We investigated whether transcranial magnetic stimulation (rTMS) over the primary somatosensory cortex (S1) and sensory stimulation (SS) could promote upper limb recovery in participants with subacute stroke.

Methods: Participants were randomized into four groups: rTMS/Sham SS, Sham rTMS/SS, rTMS/SS, and control group (Sham rTMS/Sham SS). Participants underwent ten sessions of sham or active rTMS over S1 (10 Hz, 1,500 pulses, 120% of resting motor threshold, 20 min), followed by sham or active SS. Read More

J Grad Med Educ 2022 Apr 14;14(2):229-232. Epub 2022 Apr 14.

is Assistant Professor, Department of Obstetrics and Gynecology.

Background: Pudendal nerve block is an important alternative to neuraxial anesthesia, yet studies demonstrate that 3% to 50% of pudendal nerve blocks are ineffective. Lack of clinician training is the most common cause, and there are no simulation models currently described.

Objective: To develop and test a novel, low-cost, low-fidelity simulation model for training residents in the placement of a pudendal nerve block. Read More

BMC Anesthesiol 2022 04 18;22(1):109. Epub 2022 Apr 18.

Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, HatYai, 90110, Songkhla, Thailand.

Background: Direct stimulation of the afferent nerve endings in the venous endothelium is one explanation of propofol injection pain. Previous studies found that ondansetron can also block sodium channels. This effect is similar to that of lidocaine. Read More

Front Oncol 2022 31;12:858030. Epub 2022 Mar 31.

Department of Anesthesiology, Bethune International Peace Hospital, Shijiazhuang, China.

Background: Breast cancer has overtaken lung cancer as the most commonly diagnosed malignancy and is the leading cause of cancer-related death in women. Surgery is the only possible cure for breast cancer, and the incidence of acute postoperative pain (APP) is high in breast surgery. Previous reports suggested that ultrasound-guided deep serratus anterior plane block (dSAPB) provided effective blockade to relieve pain after modified radical mastectomy for breast cancer. Read More

BMC Anesthesiol 2022 04 15;22(1):107. Epub 2022 Apr 15.

Department of Anesthesiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Background: Modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) was first described as a peripheral nerve block by Tulgar in 2019. This technique provides an analgesic effective range from Th7-11 with a single puncture per side. Although the efficacy and effective duration of M-TAPA have been reported, further examination is required. Read More

Oral Oncol 2022 May 11;128:105833. Epub 2022 Apr 11.

Department of Intensive and Perioperative Care, Skåne University Hospital, Entrégatan 7, 222 42 Lund, Sweden; Department of Clinical Sciences, Lund University, Box 117, 221 00 Lund, Sweden. Electronic address:

Background And Objectives: Curative treatment for locally advanced head and neck tumours often includes reconstructive surgery using a microvascular free flap. Effective recuperation is essential but may be impeded by postoperative donor site pain. The aim of this study was to evaluate the effects of a continuous popliteal block on postoperative pain after fibular graft harvesting. Read More

J Neuroophthalmol 2022 Mar 24. Epub 2022 Mar 24.

Neurology Department (JAM, IdL, LS-C, MS, JDdT), University Hospital "La Paz", Madrid, Spain; and La Paz Institute for Health Research (IdiPAZ) (MS, JDdT), Madrid, Spain.

Background: To study the effect of greater occipital nerve (GON) block on migraine-associated photophobia levels. Photophobia is one of the most bothersome symptoms reported by migraine patients. Studies investigating the impact of migraine treatment on this symptom are scarce. Read More

Perioper Med (Lond) 2022 Apr 14;11(1):15. Epub 2022 Apr 14.

Department of Anesthesiology, The First Central Hospital of Baoding, Northern Great wall Street 320#, Baoding, 071000, Hebei, China.

Background: Hip fracture and surgery are associated with moderate to severe pain, which hampers early mobilization and extends the hospital stay. Femoral nerve block and fascia iliaca compartment block could provide effective postoperative pain relief. Unfortunately, they could weaken the strength of the quadriceps muscle and increase the risk of falls. Read More

Trials 2022 Apr 12;23(1):295. Epub 2022 Apr 12.

Department of Anesthesiology, Guangdong Provincial People's Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, 510080, People's Republic of China.

Background: Ultrasound-guided intertruncal approach (IA) has been proposed to be an alternative and promising approach to the supraclavicular block (SCB), in which double injection (DI) of local anesthetics (LA) is sequentially administered between intertruncal planes. We would like to apply a refined injection technique, named triple injection (TI) technique, based on the 3 separate compartments visualized by ultrasound. The aim of this study is to compare the percentage of patients with complete sensory blockade at 20 min of DI vs TI technique, when they are applied in patients undergoing upper limb arteriovenous access surgery. Read More

J Clin Med 2022 Mar 25;11(7). Epub 2022 Mar 25.

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

Former studies investigated the application of high-frequency alternating currents (HFAC) in humans for blocking the peripheral nervous system. The present trial aims to assess the effect of HFAC on the motor response, somatosensory thresholds, and peripheral nerve conduction when applied percutaneously using frequencies of 10 kHz and 20 kHz in healthy volunteers. A parallel, placebo-controlled, double-blind, randomized clinical trial was conducted. Read More

J Pain Res 2022 29;15:827-835. Epub 2022 Mar 29.

Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, People's Republic of China.

Purpose: The transversalis fascia (TF) encases the quadratus lumborum and psoas major (PM) muscles, respectively, after they split caudalward approximately at the level of the iliac crest. The branches of the lumbar plexus variably exit medially and laterally from the TF-encased PM muscle. We hypothesized that the local anesthetic (LA) injections around the anterolateral edge of PM at the supra-iliac level and into the retro-psoas compartment at the L5/S1 level, which termed as the circum-psoas blocks, could block the lumbar plexus branches. Read More

Cureus 2022 Feb 18;14(2):e22365. Epub 2022 Feb 18.

Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara Oncology Training and Research Hospital, Ankara, TUR.

Aim: During transurethral resection of bladder tumor (TUR-BT), adductor muscle spasms in varying degrees can be seen due to stimulation of obturator nerve if the tumor is in the inferolateral localization. This can cause some serious complications such as bladder perforation. We aim to show the effectiveness of obturator nerve block (ONB) to avoid the adductor muscle spasm in general anesthesia applied with laryngeal mask (LMA) without using muscle relaxant according to the spinal anesthesia method. Read More

Anesthesiology 2022 05;136(5):763-778

Respiratory Intensive Care Unit and Laboratory of Medical Investigation 09, INCOR, Heart Institute, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.

Background: Strong spontaneous inspiratory efforts can be difficult to control and prohibit protective mechanical ventilation. Instead of using deep sedation and neuromuscular blockade, the authors hypothesized that perineural administration of lidocaine around the phrenic nerve would reduce tidal volume (VT) and peak transpulmonary pressure in spontaneously breathing patients with acute respiratory distress syndrome.

Methods: An established animal model of acute respiratory distress syndrome with six female pigs was used in a proof-of-concept study. Read More

Anesth Analg 2022 Mar 28. Epub 2022 Mar 28.

From the Department of Anesthesiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

Background: Although interscalene nerve block is the standard for shoulder analgesia, the risk of hemidiaphragmatic paralysis restricts its use in patients with compromised pulmonary function. We hypothesized that a novel subparaneural upper trunk block would provide noninferior postoperative analgesia but superior diaphragmatic sparing effect compared to interscalene block.

Methods: This randomized controlled trial comprised 96 patients who underwent arthroscopic shoulder surgery under either subparaneural upper trunk block (5 mL of 0. Read More

Heliyon 2022 Mar 16;8(3):e09119. Epub 2022 Mar 16.

Department of Plastic Surgery, Emergency County Hospital, Str. Clinicilor 3-5, Cluj-Napoca, 400006, Romania.

Aim: Evaluating patient comfort during full awake local anesthesia in carpal tunnel release surgery, without tourniquet use, by using epinephrine to obtain a completely dry surgical field.

Methods: We included into the study 41 patients who underwent carpal tunnel syndrome surgery under full awake combined anesthesia, using a 9-point questionnaire. Pain and anxiety in all patients were evaluated through a Wang-Baker 0-5 scale. Read More

J Clin Anesth 2022 Aug 22;79:110770. Epub 2022 Mar 22.

Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, China. Electronic address:

Study Objective: Although combined thoracic paravertebral blockade (TPVB)-general anesthesia (GA) could improve pain control compared to GA alone after thoracoscopic lung cancer surgery, it has not been established whether this improvement in pain control could reduce associated adverse outcomes. Thus, this study aimed to explore the association between TPVB usage and adverse outcomes after thoracoscopic lung cancer surgery.

Design: Retrospective cohort study from a prospective database. Read More

Clin Neurophysiol Pract 2022 2;7:71-77. Epub 2022 Mar 2.

Department of Neurology, Graduate School of Medicine, Chiba University Chiba, Japan.

Objective: Fatigue is a major disabling problem in patients with neuromuscular disorders. Both nerve demyelination and increased axonal branching associated with collateral sprouting reduce the safety factor for impulse transmission and could cause activity-dependent hyperpolarization and conduction block during voluntary contraction, and thus fatigue. This study aimed to investigate whether activity-dependent conduction block is associated with fatigue in demyelinating neuropathies and lower motor neuron disorders. Read More

J Clin Anesth 2022 Aug 18;79:110754. Epub 2022 Mar 18.

Department of Anesthesiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, PR China. Electronic address:

Background: Median nerve block can provide excellent analgesia during open surgery for trigger thumb in children. However, no data on the 90% minimum effective volume (MEV) and concentration (MEC) of ropivacaine for ultrasound-guided median nerve block in pediatric patients have been reported.

Design: A prospective two-phase study with an up-and-down sequential allocation trial using a biased coin design. Read More

J Int Med Res 2022 Mar;50(3):3000605221085073

Department of Orthopaedic and Trauma Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia.

Objective: The pericapsular nerve group (PENG) block is a regional block that possibly provides better analgesia than that of the femoral nerve block (FNB) for hip fracture surgery. A randomized comparative trial performed in our institution showed that the PENG block may provide improved pain reduction compared with the FNB while preserving quadriceps strength.

Methods: In this single-center, double-blinded, randomized comparative trial, patients who underwent hip fracture surgery were randomized to receive either a FNB or PENG block for analgesia. Read More

Pediatr Emerg Care 2022 Jan 10. Epub 2022 Jan 10.

Division of Emergency Medicine, Department of Pediatrics, University of Massachusetts Memorial Medical Center, University of Massachusetts, Worchester, MA.

Objectives: Femur fractures are painful, and use of systemic opioids and other sedatives can be dangerous in pediatric patients. The fascia iliaca compartment nerve block and femoral nerve block are regional anesthesia techniques to provide analgesia by anesthetizing the femoral nerve. They are widely used in adult patients and are associated with good effect and reduced opioid use. Read More

Can Vet J 2022 Mar;63(3):269-274

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, Colorado 80523, USA (Simpson, Van Metre, Applegate, Johnson, Brooks, Mama); Department of Veterinary Pathobiology, Oklahoma State University Center for Veterinary Health Sciences, 114 McElroy Hall, Stillwater, Oklahoma 74078, USA (Taylor).

Purpose: To determine whether a single 4-point regional nerve block using 2% lidocaine administered distal to the fetlock of sheep with a single distal limb lameness will result in analgesia of the digits.

Animals: Eighteen adult ewes with a single limb lameness originating from distal to the metacarpo/metatarsophalangeal joint were enrolled in the study.

Procedures: Digital lameness was confirmed and scored based on clinical examination. Read More

Anesthesiology 2022 Jun;136(6):970-982

Department of Anesthesiology, University of California San Diego, San Diego, California; Outcomes Research Consortium, Cleveland, Ohio.

Background: The common technique using a basal infusion for an ambulatory continuous peripheral nerve blocks frequently results in exhaustion of the local anesthetic reservoir before resolution of surgical pain. This study was designed to improve and prolong analgesia by delaying initiation using an integrated timer and delivering a lower hourly volume of local anesthetic as automated boluses. The hypothesis was that compared with a traditional continuous infusion, ropivacaine administered with automated boluses at a lower dose and 5-h delay would (1) provide at least noninferior analgesia (difference in average pain no greater than 1. Read More

Neurol Int 2022 Feb 7;14(1):199-206. Epub 2022 Feb 7.

Department of Neurology, Faculty of Medicine, Ain Shams University, 12th Abbassiya Street, Cairo 08080, Egypt.

Background: Calcitonin-gene-related peptide (CGRP) and CGRP receptors are expressed in trigeminal nerve cells, and treatments targeting CGRP are effective in migraines. For headaches that do not respond to pharmacological treatment, minimally invasive techniques such as greater-occipital-nerve block (GONB) can help relieve the pain and reduce the frequency of headaches. Our study assessed the efficacy of ultrasound-guided greater-occipital-nerve block (USgGONB) in chronic migraines (CM) and its relationship to serum CGRP levels. Read More

Reg Anesth Pain Med 2022 05 21;47(5):309-312. Epub 2022 Feb 21.

Department of Anesthesiology, University of Minnesota, Minneapolis, Minnesota, USA.

Background: Single-injection interscalene brachial plexus blocks are used for analgesia for rotator cuff repair (RCR) but have limited duration. The value of adding liposomal bupivacaine (LB) to prolong single-injection interscalene blocks is unclear. The purpose of this trial is to evaluate the addition of LB to regular bupivacaine interscalene blocks for patients undergoing arthroscopic RCR. Read More

Surg Endosc 2022 Feb 17. Epub 2022 Feb 17.

Department of Surgery, Kaiser Permanente San Francisco Medical Center, 2238 Geary Blvd, San Francisco, CA, 94115, USA.

Background: The aim of this study is to determine whether regional abdominal wall nerve block is a superior to epidural anesthesia (EA) after hepatectomy.

Methods: Patients undergoing open hepatectomy in the NSQIP targeted file (2014-2016) were identified. Those with INR > 1. Read More

A A Pract 2022 Feb 14;16(2):e01567. Epub 2022 Feb 14.

From the Departments of Anesthesiology.

A 56-year-old woman presented with flexion dysfunction of the fifth digit 6 weeks after surgical repair of a flexor digitorum profundus laceration. She was scheduled for surgical adhesiolysis and restoration of the functionality of the finger. Intraoperative monitoring of the range of motion by active flexion was deemed important to prevent incomplete release of the tendon and residual dysfunction. Read More

Anesth Pain Med (Seoul) 2022 Jan 19;17(1):75-86. Epub 2022 Jan 19.

Department of Anesthesiology and Pain Medicine, Dankook University Hospital, Cheonan, Korea.

Background: Postoperative pain occurring after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is difficult to control because of extensive surgical injuries and long incisions. We assessed whether the addition of a four-quadrant transabdominal plane (4Q-TAP) block could help in analgesic control.

Methods: Seventy-two patients scheduled to undergo elective CRS with HIPEC and intravenous patient-controlled analgesia (IV PCA) were enrolled. Read More