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J Palliat Care 2021 May 11:8258597211016564. Epub 2021 May 11.

Palliative Care Unit, Takarazuka Municipal Hospital, Takarazuka, Japan.

Introduction: The brachial plexus nerves originate from the cervical (C5-C8) and first thoracic (T1) spinal nerves, and innervate muscles and skin of the chest, shoulder, arm and hand. Brachial plexus injuries can occur as a result of shoulder trauma and inflammation. Malignant tumors can also cause neoplastic brachial plexopathy (NBP), and refractory neuropathic pain is the most common symptom of NBP. Read More

J Vasc Interv Radiol 2021 May 8. Epub 2021 May 8.

Department of Radiodiagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt.

Purpose: To investigate whether hepatic hilar and celiac plexus nerve blocks provide safe and effective analgesia to patients undergoing doxorubicin-eluting embolics embolization for hepatocellular carcinoma MATERIALS AND METHODS: In this prospective, randomized trial, 92 patients undergoing drug-eluting embolics transarterial chemoembolization (TACE) for hepatocellular carcinoma were enrolled. The control group received standard intraprocedural local anesthetic, intraarterial lidocaine, and intravenous analgesia; the study group (HHCB) underwent hepatic hilar and celiac plexus nerve blockade in addition. Intraarterial lidocaine, intravenous and postprocedural oral narcotics and antiemetics requirements, pain, patient satisfaction, adverse events, and hospital stay were compared. Read More

Croat Med J 2021 Apr;62(2):137-145

Ann-Chatrin Leonardsen, Østfold Hospital Trust, Postal box code 300, 1714 Grålum, Norway,

Aim: To explore the effects of an anterior quadratus lumborum block (QLB) on opioid consumption, pain, nausea, and vomiting (PONV) after ambulatory laparoscopic cholecystectomy.

Methods: This randomized controlled study recruited 70 patients scheduled for ambulatory laparoscopic cholecystectomy from January 2018 to March 2019. The participants were randomly allocated to one of the following groups: 1) anterior QLB (n=25) with preoperative ropivacaine 3. Read More

J Maxillofac Oral Surg 2021 Jun 31;20(2):234-239. Epub 2020 Jul 31.

Department of Oral and Maxillofacial Surgery, D.A.V. (C) Dental College and Hospital, Yamunanagar, India.

Objective: To compare the onset, duration and depth of anesthesia, postoperative pain, duration of analgesia and adverse reaction between 0.5% ropivacaine and 2% Lignocaine hydrochloride with adrenaline (1:80,000) in 40 patients having bilaterally impacted mandibular third molars.

Patients And Methods: A prospective, randomized, single blind study was carried out among 40 patients requiring surgical removal of bilaterally impacted mandibular third molars having similar "difficulty index. Read More

Braz J Anesthesiol 2021 Apr 26. Epub 2021 Apr 26.

The Affiliated Hospital of Qingdao University, Department of Anesthesiology, Qingdao, China.

Background: This study aimed to evaluate the impact of Infiltration between the Popliteal Artery and Capsule of the posterior Knee (IPACK) combined with an adductor canal block under the guidance of ultrasound on early motor function after Total Knee Arthroplasty (TKA).

Methods: A sample of 60 cases who were scheduled for elective unilateral TKA were divided into two groups using random number table method: a group with IPACK combined with an adductor canal block (I group, n = 30), and a group with femoral nerve block combined with superior popliteal sciatic nerve block (FS group, n = 30). Before anesthesia induction was completed, the patients in I group received an ultrasound-guided adductor canal block with 15 mL of 0. Read More

Can J Surg 2021 04 28;64(3):E265-E272. Epub 2021 Apr 28.

From the Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man. (Turgeon, Bohm); and the Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Man. (Aragola, Arenson, Tenenbein, Jacobsohn).

Background: Femoral nerve block (NB) and periarticular injection (PI) are 2 common options for pain control after total knee arthroplasty (TKA). We performed a prospective triple-blinded randomized trial comparing continuous femoral NB to PI, with follow-up to 1 year.

Methods: Patients younger than 70 years of age who were scheduled to undergo elective primary TKA under spinal anesthesia between 2009 and 2010 were randomly allocated to receive either continuous femoral NB or PI. 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

J Pediatr Surg 2021 Mar 17. Epub 2021 Mar 17.

Department of Surgery, Division of Pediatric Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States; Department of Surgery, Baylor College of Medicine, Houston, TX, United States.

Background: Recent studies have shown intercostal cryoablation(IC) during the Nuss procedure decreases hospital length of stay(LOS) and opioid administration. However, few studies have also evaluated the risk of postoperative complications related to IC.

Methods: We performed a single center retrospective analysis of all patients who underwent Nuss procedure by one surgeon from 2/2016 to 2/2020, comparing intraoperative IC to other pain management modalities(non-IC). Read More

Contemp Clin Dent 2020 Oct-Dec;11(4):367-370. Epub 2020 Dec 20.

Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, Mysuru, Karnataka, India.

Background And Objectives: Persistent pain during the removal of mandibular third molars is often due to accessory nerve supply causing inadequate local anesthesia. This study aims to assess the requirement of routine distolingual infiltration anesthesia in addition to traditional inferior alveolar, lingual, and long buccal nerve block in mandibular third molar extractions.

Methodology: Sixty patients requiring mandibular third molar extraction were randomly divided into two equal groups; Group A (Classic inferior alveolar, lingual, and buccal nerve block) and Group B (with an additional 0. Read More

Hua Xi Kou Qiang Yi Xue Za Zhi 2021 Apr;39(2):170-174

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.

Objectives: The present study aimed to explore the innervation of the anterior hard palatine and its relationship with individual development stage. Specifically, the effects of anesthesia on patients of different ages were observed, and neurodevelopment in the maxillofacial region was invesitgated. References that are helpful in selecting local anesthesia were provided. Read More

Anesth Prog 2021 03;68(1):29-32

Department of Endodontics, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina.

Local anesthesia techniques are widely used in dentistry because of their numerous advantages, including safety. Several articles have been published on local and systemic complications stemming from the use of local anesthesia, one of which is accidental intravascular injection, usually reported during inferior alveolar nerve blocks. A 58-year-old man presented to the dental office for extraction of the lower left first molar. Read More

Anesth Prog 2021 03;68(1):50-51

Department of Dental Anesthesiology, Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

Rom J Morphol Embryol 2020 Jul-Sep;61(3):783-791

Department of Oral Rehabilitation, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania;

Background: The mandibular foramen (MF) is the anatomic landmark where the interior alveolar nerve enters the mandibular ramus, and the area of choice where anesthesia of this nerve is performed. The position of the MF can vary, and accurately establishing its location and topographic variations is of great importance for the successful anesthesia of the inferior alveolar nerve.

Materials And Methods: We carried out two morphometric ex vivo studies concerning the topography of the MF, on dry human mandibles coming from dentate and completely edentulous human subjects of known age and gender and an in vivo morphometric study, through cone-beam computed tomography (CBCT) scans, concerning the topography of the MF in human subjects having Kennedy Class I mandibular edentulism. Read More

Georgian Med News 2021 Feb(311):36-40

National Pirogov Memorial Medical University, Vinnytsya, Ukraine.

Acute postoperative pain is still an urgent problem in surgery. Today there are many drugs for pain relief, but at the same time, the adequacy of postoperative analgesia for the subjective assessments of patients does not exceed 50%. Therefore, taking into account the pathophysiology of acute pain syndrome, it is necessary to inject an anesthetic directly near the operating field, which can be achieved by long-term conduction anesthesia. Read More

Neurosciences (Riyadh) 2021 Apr;26(2):192-198

From the pain Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.

Objectives: To compare the clinical outcomes of repetitive paravertebral block (PVB) combining oral medication in the treatment of zoster-related pain (ZP) with different courses.

Methods: Sixty-seven patients with ZP were divided into 3 groups based on their course of herpes zoster (HZ). Group I: 24 patients with acute herpetic neuralgia (within one month of disease onset); group II: 22 patients with subacute herpetic neuralgia (disease onset from 1 to 3 months); group III: 21 patients with postherpetic neuralgia (more than 3 months since disease onset). Read More

Nat Rev Neurol 2021 May 29;17(5):308-324. Epub 2021 Mar 29.

Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Cluster headache is a debilitating primary headache disorder that affects approximately 0.1% of the population worldwide. Cluster headache attacks involve severe unilateral pain in the trigeminal distribution together with ipsilateral cranial autonomic features and a sense of agitation. Read More

Head Face Med 2021 Mar 27;17(1):11. Epub 2021 Mar 27.

State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, 145# Western Changle Road, Xi'an, 710032, P.R. China.

Background: Temporomandibular joint (TMJ) 'closed lock' is a clinical condition causing TMJ pain and limited mouth opening (painful locking). Recent studies suggest an increasing prevalence of degenerative joint disease associated with the onset of TMJ closed lock in adolescents and young adults. Early interventions are recommended, but the curative effect of standard therapies remains controversial. Read More

Evid Based Dent 2021 01;22(1):26-27

StR Restorative, Dundee Dental School, Dundee, UK.

Background Pain management in endodontic treatment is often managed with local anaesthetic, occasionally supplemented with oral medication. Currently, there is little evidence to suggest the best combination of local anaesthetic and oral medication to provide optimal pain control in symptomatic irreversible pulpits. A network meta-analysis was carried out to identify the best agent/technique for pulpal anaesthesia in both the maxilla and mandible in irreversible pulpits. Read More

BMJ Case Rep 2021 Mar 18;14(3). Epub 2021 Mar 18.

Department of Oral and Maxillofacial Surgery, Western Sussex Hospital Foundation Trust, St Richards Hospital and Worthing Hospital, Chichester and Worthing, UK

Trigeminal neuralgia is a chronic pain condition affecting one or more distributions of the trigeminal nerve. Patients with this condition experience short, sharp, shooting pain attacks, which can progress to longer, more frequent durations. The pain is often difficult to control. Read More

Clin Orthop Relat Res 2021 Mar 16. Epub 2021 Mar 16.

J. T. YaDeau, E. M. Soffin, A. Tseng, H. Zhong, M. A. Gordon, B. H. Lee, K. Kumar, R. L. Kahn, M. A. Kirksey, A. A. Schweitzer, Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, NY, USA.

Background: Patients often have moderate to severe pain after rotator cuff surgery, despite receiving analgesics and nerve blocks. There are many suggested ways to improve pain after rotator cuff surgery, but the effects of adopting a pathway that includes formal patient education, a long-acting nerve block, and extensive multimodal analgesia are unclear.

Questions/purposes: (1) Does adoption of a clinical pathway incorporating patient education, a long-acting nerve block, and preemptive multimodal analgesia reduce the worst pain during the first 48 hours after surgery compared with current standard institutional practices? (2) Does adoption of the pathway reduce opioid use? (3) Does adoption of the pathway reduce side effects and improve patient-oriented outcomes?

Methods: From September 2018 to January 2020, 281 patients scheduled for arthroscopic ambulatory rotator cuff surgery were identified for this paired sequential prospective cohort study. Read More

J Oral Biol Craniofac Res 2021 Apr-Jun;11(2):263-268. Epub 2021 Feb 9.

Dept of Oral and Maxillofacial Surgery, Nair Hospital Dental College, Mumbai, Maharashtra, India.

Aim: To evaluate and compare the anaesthetic efficacy of 0.75% ropivacaine and 0.5% ropivacaine with 2% lignocaine with 1:200000 Adrenaline (LWA) for surgical extraction of bilateral mandibular 3rd molars using Direct inferior alveolar nerve block (IANB). Read More

Ann Maxillofac Surg 2020 Jul-Dec;10(2):444-449. Epub 2020 Jun 18.

Department of Oral and Maxillofacial Surgery, College of Dental Sciences and Research Centre, Manipur, Ahmedabad, Gujarat, India.

Introduction: The retromolar fossa is a small triangular area posterolateral to 3rd molar region in the mandible. The retromolar fossa often contains the retromolar foramen (RMF) as an anatomical variant. When the RMF is present, the foramen is connected with the mandibular canal (MC) through another canal known as the retromolar canal (RMC). Read More

Ann Maxillofac Surg 2020 Jul-Dec;10(2):361-364. Epub 2020 Dec 23.

Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.

Introduction: An inferior alveolar nerve block is dental anesthesia produced by the local injection of lidocaine plus epinephrine; however, its administration could cause cardiovascular side effects. We aimed to assess the changes in blood pressure and pulse rate following the injection of 2% lidocaine with epinephrine 1:80000 for an inferior alveolar nerve block.

Materials And Methods: Seventy-one patients without any systemic disease were enrolled in this study. Read More

Front Vet Sci 2021 22;8:619244. Epub 2021 Feb 22.

College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States.

Regional nerve blocks have been shown to decrease general anesthetic drug requirements and improve pain management in patients undergoing surgery. Regional nerve blocks are used routinely in patients undergoing oral surgery, such as dental extractions. There is little published information regarding the efficacy of feline maxillary and infraorbital nerve blocks. Read More

Clin Oral Investig 2021 Mar 8. Epub 2021 Mar 8.

Clinical Dentistry, UWA Dental School, University of Western Australia, Perth, Australia.

Objectives: This study aimed to determine the success rate of retromolar canal (RMC) infiltration following the failure of inferior alveolar nerve block (IANB) injections for the anesthesia of mandibular first molars with acute irreversible pulpitis.

Materials And Methods: An IANB injection was administered for 50 patients with acute irreversible pulpitis. Lip numbness was set as the sign of anesthesia and further evaluated and confirmed with pulp sensibility tests after 10-15 min. Read More

J Contemp Dent Pract 2020 Oct 1;21(10):1146-1149. Epub 2020 Oct 1.

Department of Prosthodontics and Crown and Bridge, Sardar Patel Postgraduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India.

Aim And Objective: To compare the efficacy of 2% lignocaine and 4% articaine in the extraction of mandibular molars.

Materials And Methods: This study was conducted on 120 patients requiring surgical removal of tooth. Patients were categorized into 2 groups with 60 samples each. Read More

Indian J Otolaryngol Head Neck Surg 2021 Mar 24;73(1):78-84. Epub 2020 Aug 24.

Department of Surgery, NSCB Government Medical College, Madhya Pradesh, Jabalpur, 482003 India.

Temporo-mandibular joint (TMJ) ankylosis is characterized by a decreased mouth opening which affects mastication, speech, and facial aesthetic. Interpositional arthroplasty using autologous tissue is accepted treatment for TMJ Ankylosis; however, harvesting autologous tissue is associated with additional morbidity. In this article we report our results of silicon interpositional arthroplasty for TMJ ankylosis. Read More

Curr Pain Headache Rep 2021 Feb 25;25(3):13. Epub 2021 Feb 25.

Department of Anesthesiology, Louisiana State University Shreveport, Shreveport, LA, USA.

Purpose Of Review: This is a comprehensive review of the superior hypogastric block for the management of chronic pelvic pain. It reviews the background, including etiology, epidemiology, and current treatment available for chronic pelvic pain. It then presents the superior hypogastric block and reviews the seminal and most recent evidence about its use in chronic pelvic pain. Read More

J Arthroplasty 2021 03 8;36(3):837-844. Epub 2020 Oct 8.

Granovsky Gluskin Division of Orthopaedics, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Background: The introduction of bundled funding for total knee arthroplasty (TKA) has motivated hospitals to improve quality of care while minimizing costs. The aim of our quality improvement project is to reduce the acute hospitalization length of stay to less than 2 days and decrease the percentage of TKA patients discharged to inpatient rehabilitation using an enhanced recovery after surgery bundle.

Methods: This study used a before-and-after design. Read More

Breast Cancer (Auckl) 2020 21;14:1178223420967365. Epub 2020 Oct 21.

Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO, USA.

Purpose: We have shown previously that a preoperative paravertebral nerve block is associated with improved postoperative recovery in microvascular breast reconstruction. The purpose of this study was to compare the outcomes of a complete enhanced recovery after surgery (ERAS) protocol with complete regional anesthesia coverage to our traditional care with paravertebral block.

Patients And Methods: This was a retrospective cohort study of 83 patients who underwent autologous breast reconstruction by T. Read More