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Reg Anesth Pain Med 2021 May 14. Epub 2021 May 14.

Clinical Research Department, CMC Ambroise Paré, Neuilly-sur-Seine, France.

Objective: This study aims to assess the effect of a preoperative parasternal plane block (PSB) on opioid consumption required to maintain hemodynamic stability during sternotomy for coronary artery bypass graft surgery.

Methods: This double-blind, randomized, placebo-controlled trial prospectively enrolled 35 patients scheduled for coronary artery bypass graft surgery under general anesthesia with propofol and remifentanil. Patients were randomized to receive preoperative PSB using either ropivacaine (PSB group) or saline solution (placebo group) (1:1 ratio). Read More

Eur J Neurosci 2021 May 13. Epub 2021 May 13.

Department of Integrative Physiology, National Institute for Physiological Sciences, Okazaki, Japan.

The interaction between the somatosensory and motor systems is important for control of movement in humans. Cortical activity related to somatosensory response and sensory perception is modulated by the influence of movement executing mechanisms. This phenomenon has been observed as inhibition in the short-latency components of somatosensory evoked potentials and magnetic fields (SEPs/SEFs). Read More

Turk Neurosurg 2020 Oct 30. Epub 2020 Oct 30.

Tianjin Medical University General Hospital, Department of Orthopaedic Surgery, Tianjin, China.

Aim: In clinical practice, some patients with radicular pain do not present with typical dermatomal patterns, and selective spinal nerve block (SSNB) has been proposed to identify the involved nerve. In this study, we aimed to assess the role of our modified SSNB procedure to predict the results of the subsequent Percutaneous endoscopic transforaminal lumbar surgeries (PETLS).

Material And Methods: We retrospectively analyzed data of patients who underwent our modified SSNBs before PETLS from February 2013 to March 2018 Clinical outcome data were collected 3 days after PETLS and at follow-up visits. Read More

Reg Anesth Pain Med 2021 May 5. Epub 2021 May 5.

Department of Anesthesia, Clinique Medipole Garonne, Toulouse, Occitanie, France.

Background And Objectives: Although regional analgesia is considered an important component of optimal pain management, use of peripheral nerve blocks for total hip arthroplasty remains controversial. Since the obturator nerve innervates the anteromedial part of the joint capsule, we hypothesized that an obturator nerve block would decrease the opioid consumption after total hip arthroplasty.

Methods: In this single center, prospective, triple blinded study, we randomly allocated 60 patients undergoing total hip arthroplasty under opioid-sparing total intravenous general anesthesia to a preoperative obturator nerve block or a sham block (placebo group) using 20 mL of ropivacaine 0. Read More

Braz J Anesthesiol 2021 Apr 27. Epub 2021 Apr 27.

Dr. Soetomo General Hospital, Department of Anaesthesiology & Intensive Therapy, Surabaya, Indonesia.

The subscapularis plane block is an effective approach to anesthetize axillary and upper subscapular nerves. There have been no reports regarding brachial plexus paralysis as a potential complication to date. Described here is a case of median nerve palsy following ultrasound-guided subscapularis plane block for awake frozen shoulder manipulation that was performed on a 52-year-old female diagnosed with adhesive capsulitis. Read More

Agri 2021 Apr;33(2):119-121

Department of Anaesthesiology and Reanimation, Başkent University Faculty of Medicine, Konya, Turkey.

Infraclavicular block provides adequate anesthesia to the arm, forearm, and antecubital region. There are many different approaches to infraclavicular brachial plexus block. Corocoid approach which is mostly preferred is not appropriate in some cases that needle orientation disappear. Read More

Cureus 2021 Mar 26;13(3):e14129. Epub 2021 Mar 26.

Anesthesiology and Reanimation, Ondokuz Mayis University, Samsun, TUR.

Introduction In this study, our objective was to compare the lateral sagittal infraclavicular block (LS-ICB) with the costoclavicular infraclavicular block (CC-ICB) for ultrasound (US)-guided infraclavicular brachial plexus block in terms of block dynamics as well as patient and surgeon satisfaction levels. Methods A total of 100 patients, falling under the American Society of Anaesthesiologists (ASA) I-III categories, who were aged 18-65 years and scheduled for elective forearm and hand surgery were enrolled in the study. The patients were randomly allocated to receive a US-guided LS-ICB or US‑guided CC-ICB. Read More

Int Urol Nephrol 2021 Apr 27. Epub 2021 Apr 27.

Department of Urology, Mayo Clinic Hospital, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.

Purpose: The transversus abdominis plane (TAP) block has been effective in providing adequate pain control, limiting opioid use, and improving perioperative outcomes in patients undergoing major abdominal surgeries. Little is known regarding the efficacy of preoperative (pre-incisional) versus postoperative TAP block in patients who undergo cystectomy.

Methods: This is a retrospective study that reviewed all patients who underwent cystectomy between January 2011 and January 2020 at a single institution. Read More

Acta Chir Belg 2021 Apr 24:1-14. Epub 2021 Apr 24.

Department of Surgery, Bursa Medicana Hospital, Bursa, Turkey.

Objectives: There are few published data on the optimized use of botulinum toxin A (BTA) for the treatment of chronic anal fissure (CAF). The aim of this study was to investigate the effect of injection of 100 IU botulinum toxin A into the internal anal sphincter at the side opposite of the fissure, using an anal retractor, sedation, and perianal transcutaneous pudendal nerve block.

Methods: The prospectively maintained data of 132 patients who underwent BTA injection for CAF were retrospectively analyzed. Read More

Braz J Anesthesiol 2021 Apr 22. Epub 2021 Apr 22.

Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, P.R. China. Electronic address:

Objective: To investigate the effects of Erector Spinae Plane Block (ESPB) and Retrolaminar Block (RLB) on intra- and postoperative analgesia in patients with Multiple Rib Fractures (MRFs).

Methods: A total of 80 MRFs patients were randomly divided into the ESPB (Group E) and RLB (Group R) groups. After general anesthesia, ESPB and RLB were performed under ultrasound guidance, respectively, together with 20 mL of 0. Read More

Sci Rep 2021 Apr 19;11(1):8432. Epub 2021 Apr 19.

Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo, 181-8611, Japan.

We developed a novel technology using the photoacoustic effect that improve needle tip visibility. We evaluated whether this technology improves needle tip visibility when performing a deep peripheral nerve block in a cadaver model. A photoacoustic needle was developed using a conventional echogenic needle with an intraluminal optical fiber. Read More

J Urol 2021 Apr 19:101097JU0000000000001777. Epub 2021 Apr 19.

Rush University Medical Center, Chicago, Illinois.

Purpose: The primary aim of our study was to evaluate relief of chronic scrotal content pain after a series of spermatic cord blocks with a combination of local anesthetic and a steroid. Secondary aims were to assess factors associated with a positive response and complications.

Materials And Methods: We performed a retrospective chart review of patients who underwent spermatic cord block series for chronic scrotal content pain at our practice between 2012 and 2019. Read More

J Neurol Surg A Cent Eur Neurosurg 2021 Apr 12. Epub 2021 Apr 12.

Department of Neurology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Veneto, Italy.

Our case report underscores the importance of electroneuromyography (ENMG) combined with peripheral nerve high-resolution ultrasound (HRUS) in the evaluation of neurofibromatosis type 1 (NF1). A 49-year-old woman affected by NF1 came to our attention because of new-onset left arm weakness and atrophy. Debulking of a cervicothoracic C7-T1 neurofibroma had been performed 8 years earlier. Read More

Acad Radiol 2021 Apr 8. Epub 2021 Apr 8.

Department of Radiology, Mayo Clinic, 5779 E Mayo Blvd, Phoenix, AZ, 85054. Electronic address:

Rationale And Objectives: Celiac plexus and retrocrural splanchnic nerve (CP/RSN) blocks are widely used for cancer-related abdominal pain, but there is limited literature on their efficacy for non-cancer related pain. Our aim was to determine the indications and effectiveness of CT-guided CP/RSN blocks performed on patients with abdominal pain from non-cancer related sources.

Materials And Methods: CT-guided CP/RSN blocks for non-cancer related abdominal pain from 2011-2020 were retrospectively reviewed for patient demographics, procedure details, duration of pain relief, and complications. Read More

Braz J Anesthesiol 2021 Apr 3. Epub 2021 Apr 3.

Ospedale Regionale di Bellinzona a Valli, Bellinzona, Switzerland.

Background And Objectives: Anesthesiologists and hospitals are increasingly confronted with costs associated with the complications of Peripheral Nerve Blocks (PNB) procedures. The objective of our study was to identify the incidence of the main adverse events associated with regional anesthesia, particularly during anesthetic PNB, and to evaluate the associated healthcare and social costs.

Methods: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic search on EMBASE and PubMed with the following search strategy: ("regional anesthesia" OR "nerve block") AND ("complications" OR "nerve lesion" OR "nerve damage" OR "nerve injury"). Read More

Indian J Anaesth 2021 Mar 20;65(Suppl 1):S27-S33. Epub 2021 Mar 20.

Paediatric Surgery, Postgraduate Institute of Medical Education and Research(PGIMER), Chandigarh, India, Chandigarh, India.

Background And Aims: α agonists have been utilised in regional blocks, but very little data is available for their use in transversus abdominis plane (TAP) block in paediatric laparoscopic (LAP) surgeries. This study investigated the analgesic effect of ropivacaine alone versus its combination with dexmedetomidine for TAP block in children undergoing LAP surgery.

Methods: A randomised, double-blind trial was conducted in 50 American Society of Anesthesiologists (ASA) 1 and 2 children of 2-8 years undergoing LAP abdominal surgery. Read More

J Stroke Cerebrovasc Dis 2021 Jun 1;30(6):105759. Epub 2021 Apr 1.

Department of Health Services Research, University of Liverpool, Waterhouse Building Block B, 2nd floor, 1-5 Brownlow Street, Liverpool L69 3GL, United Kingdom. Electronic address:

Aim: The purpose was to explore the reported symptoms of post-stroke visual impairment from a large multi-centre prospective epidemiology study.

Methods: Visual assessment, including a case history, visual acuity, ocular alignment, ocular motility, visual fields, visual inattention and visual perception, was attempted for all stroke admissions to three acute stroke units.

Results: Of 1500 stroke admissions, 1204 received a visual assessment, of which 867 had one or more visual impairments. Read More

Int J Environ Res Public Health 2021 03 31;18(7). Epub 2021 Mar 31.

Department of Anaesthesiology, Intensive Care and Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 40-055 Katowice, Poland.

Erector spinae plane block was recently introduced as an alternative to postoperative analgesia in surgical procedures including thoracoscopies and mastectomies. There are no clinical trials regarding erector spinae plane block in percutaneous nephrolithotomy. The aim of our study was to test the efficacy and safety of erector spinae plane block after percutaneous nephrolithotomy. Read More

Ann Diagn Pathol 2021 Mar 22;52:151732. Epub 2021 Mar 22.

Department of Pathology and Laboratory Medicines, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.

Median Arcuate Ligament Syndrome (MALS) is a rare entity characterized by severe post-prandial epigastric pain, nausea, vomiting, and/or weight loss. Symptoms have been attributed to vascular compression (celiac artery compression syndrome, CACS), but it remains controversial whether they could be secondary to neural compression. Literature review identified rare description of pathologic findings in surgery journals. Read More

Front Surg 2021 11;8:582980. Epub 2021 Mar 11.

Complex Operative Unit of Breast Surgery, Breast Unit, Oncologic Surgery Department, AOUI, Ospedale Civile Maggiore, Verona, Italy.

The advent of the COVID-19 pandemic has led to the sudden disruption of routine medical care, and the subsequent reorganization of hospital structures and therapeutic algorithms, aiming at protecting patients and health professionals. This was inevitably bound to affect our Breast Unit, dilating both pre- and post-operative times. The aim of this study was to evaluate the effect on patients' flow of organizational and logistic changes () based on lean thinking implemented after the COVID-19 outbreak. Read More

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

BMC Anesthesiol 2021 Mar 31;21(1):98. Epub 2021 Mar 31.

Department of Anesthesiology, Renmin Hospital of Wuhan University, No. 99 Zhang Road, Wuhan, 430060, Hubei Province, China.

Background: Ultrasound-guided parasternal intercostal nerve block is rarely used for postoperative analgesia, and its value remains unclear. This study aimed to evaluate the effectiveness of ultrasound-guided parasternal intercostal nerve block for postoperative analgesia in patients undergoing median sternotomy for mediastinal mass resection.

Methods: This randomized, double-blind, placebo-controlled trial performed in Renmin Hospital, Wuhan University, enrolled 41 participants aged 18-65 years. Read More

J Clin Anesth 2021 Mar 19;71:110254. Epub 2021 Mar 19.

UPMC Children's Hospital of Pittsburgh, Department of Anesthesiology and Perioperative Medicine, 4401 Penn Avenue, Pittsburgh, PA 15224, USA.

Study Objective: The primary goal of this study was to determine if the addition of clonidine to ropivacaine prolonged periumbilical numbness compared to ropivacaine alone in pediatric patients receiving ultrasound guided rectus sheath nerve blocks for laparoscopic appendectomy. The secondary goals were to evaluate differences in perioperative pain scores, analgesic consumption, sedation, anxiolysis, and hemodynamic effects from clonidine.

Design: This was a single center, randomized, double-blinded prospective study. Read More

Anaesth Crit Care Pain Med 2021 Apr 18;40(2):100831. Epub 2021 Mar 18.

Department of Burn & Plastic Surgery, All India Institute of Medical Sciences (AIIMS), Patna, India.

Background And Aims: Radial artery is a common site of cannulation in acute care setting. There are conflicting reports as to which nerve, radial or median or both supplies the radial artery. We did this prospective study in patients undergoing minor procedures under peripheral nerve blocks to ascertain which nerve block, radial or median increases the cross sectional area and blood flow in the radial artery. Read More

Anesthesiology 2021 05;134(5):722-733

Background: Pain management is important for ensuring early mobilization after hip arthroplasty; however, the optimal components remain controversial. Recently, the quadratus lumborum block has been proposed as an analgesic option. The current study tested the hypothesis that the posterior quadratus lumborum block combined with multimodal analgesia decreases morphine consumption after hip arthroplasty. Read More

Pain Physician 2021 Mar;24(2):185-192

Northern General Hospital, Sheffield Teaching Hospitals, Sheffield, UK.

Background: Diagnostic injections (blocks) are a valuable tool in the management of chronic noncancer pain. By precise blockade of specific neural structures and observation of pain responses, pain mechanisms can be accurately defined. With such information, therapeutic procedures targeting neural structures are possible. Read More

Clin J Pain 2021 May;37(5):359-365

Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt.

Objectives: Postoperative pain following mastectomy is often severe and pain management is necessary. We evaluated the analgesic efficacy of continuous pectoral nerve block (PEC) in comparison with that of the continuous thoracic paravertebral block (TPVB) and the intravenous opioid analgesia in patients scheduled for modified radical mastectomy (MRM).

Materials And Methods: A total of 90 female patients aged 20 to 70 years, American Society of Anesthesiologists (ASA) I to III, undergoing unilateral MRM were randomly allocated into 3 groups. Read More

Vet Anaesth Analg 2021 May 3;48(3):398-406. Epub 2021 Feb 3.

Vetsuisse Faculty, Department of Clinical Veterinary Medicine, Bern, Switzerland.

Objective: To determine the intraoperative and early postoperative opioid requirement after ultrasound-guided sciatic and/or femoral nerve block or epidural anaesthesia in dogs undergoing tibial plateau levelling osteotomy (TPLO).

Study Design: Prospective, masked, pilot, randomized, clinical trial.

Animals: A total of 40 client-owned dogs undergoing TPLO. Read More

Expert Rev Neurother 2021 Mar 29:1-7. Epub 2021 Mar 29.

Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila - L'Aquila, Italy.

Introduction: Cervicogenic headache (CGH) is a secondary headache disorder caused by cervical spine or neck soft tissue lesions. Despite few available evidence-based pharmacological treatments are available, greater occipital nerve blocks (GONBs) are considered as therapeutic option.

Area Covered: In June 2020, we conducted a systematic review on Pubmed and Scopus, to summarize effectiveness and safety of GONBs in treating CGH. Read More

PLoS One 2021 10;16(3):e0248131. Epub 2021 Mar 10.

Clinical Unit of Anesthesiology and Perioperative Intensive-Care Medicine, Department for Small Animals and Horses, Vetmeduni Vienna, Vienna, Austria.

Transversus abdominis plane (TAP) block is a regional anesthetic technique used to desensitize the abdominal wall in several species. This study aimed to describe the anatomical characteristics of the abdominal wall and to identify a feasible approach for an US-guided TAP injection that would result in adequate staining of the relevant nerves in the abdominal wall in pig cadavers. Fresh cadavers from five Landrace pigs (age, 12 weeks; body weight, 35. Read More