5,675 results match your criteria Regional Anesthesia for Postoperative Pain Control


The impact of loco-regional anaesthesia on postoperative opioid use in elderly hip fracture patients: an observational study.

Eur J Trauma Emerg Surg 2021 May 7. Epub 2021 May 7.

Department of Anesthesiology, Luzerner Kantonsspital, Luzern, Switzerland.

Purpose: Hip fractures are a common health problem among the elderly with an increasing incidence. They are associated with high mortality and morbidity. Optimal pain management remains challenging and inadequate pain control is known for negatively affecting outcomes. Read More

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Continuous erector spinae plane block versus thoracic epidural analgesia in video-assisted thoracic surgery: a study protocol for a prospective randomized open label non-inferiority trial.

Trials 2021 May 4;22(1):321. Epub 2021 May 4.

Department of Anesthesiology and Pain Medicine, Catharina Hospital, Michelangelolaan 2, Eindhoven, 5623 EJ, The Netherlands.

Background: Thoracic epidural analgesia is considered the gold standard for pain relief in video-assisted thoracoscopic surgery. This neuraxial technique blocks pain sensation by injecting a local anesthetic agent in the epidural space near the spinal cord to block spinal nerve roots. Recently, the erector spinae plane block has been introduced as a practical alternative to the thoracic epidural. Read More

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Anterior quadratus lumborum block for ambulatory laparoscopic cholecystectomy: a randomized controlled trial.

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

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The analgesic efficacy of iPACK after knee surgery: A systematic review and meta-analysis with trial sequential analysis.

J Clin Anesth 2021 Apr 28;72:110305. Epub 2021 Apr 28.

Consultant, Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Honourary Senior Lecturer, King's College London, London, United Kingdom.

Study Objective: The novel infiltration between the popliteal artery and the capsule of the posterior knee (iPACK) has been described to relieve posterior knee pain after knee surgery. The study objective is to determine whether iPACK provides analgesia after knee surgery when compared with a control group.

Design: Systematic review, meta-analysis and trial sequential analysis. Read More

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Pain management using a novel hybrid technique of perineural stimulation combined with regional anaesthesia through a stimulating perineural catheter for below knee amputation.

Anaesth Rep 2021 Jan-Jun;9(1):69-72. Epub 2021 Apr 21.

Department of Anesthesiology, Perioperative Medicine and Pain Medicine Stanford University Stanford CA USA.

Pain after amputation can be difficult to manage due to its complex aetiology. A multimodal approach to analgesia, including regional anaesthetic techniques, is advised. However, optimal pain management cannot always be achieved, and high doses of opioid analgesics may contribute to adverse effects. Read More

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Safety and Duration of Low-Dose Adjuvant Dexamethasone in Regional Anesthesia for Upper Extremity Surgery: A Prospective, Randomized, Controlled Blinded Study.

Hand (N Y) 2021 Apr 21:15589447211008558. Epub 2021 Apr 21.

Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA.

Background: Orthopedic procedures concerning the upper extremity commonly use a brachial plexus nerve block to achieve postoperative analgesia. The addition of dexamethasone to peripheral nerve blocks has been shown to significantly prolong its effect. We hypothesize that 1 mg doses of dexamethasone will prolong brachial plexus nerve block with similar efficacy to 4 mg and better than ropivacaine alone. Read More

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A randomised trial of bilateral erector spinae plane block vs. no block for thoracolumbar decompressive spinal surgery.

Anaesthesia 2021 Apr 20. Epub 2021 Apr 20.

Division of Anaesthesiology and Peri-operative Medicine, Mater Misericordiae University Hospital, Dublin, Ireland.

Major spinal surgery causes significant postoperative pain. We tested the efficacy and safety of bilateral erector spinae block on quality of recovery and pain after thoracolumbar decompression. We randomly allocated 60 adults to standard care or erector spinae block. Read More

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Pain distraction during awake low anterior resection and Cuddle Delivery initiative for inpatient: frugal procedural options to support surgery in the COVID-19 era.

Eur Rev Med Pharmacol Sci 2021 04;25(7):3116-3121

Department of General Surgery, Valduce Hospital, Como, Italy.

Objective: Since minimally invasive surgery and general anesthesia are both aerosol-generating procedures, their use became controversial during the outbreak of coronavirus disease 2019 (COVID-19). Moreover, social distancing resulted in serious psychological consequences for inpatients. This case report investigates pain distraction during awake laparotomy, as well as new possibilities for emotional postoperative support to inpatients. Read More

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Evaluation of early postoperative intravenous opioid rescue as a novel quality measure in patients who receive thoracic epidural analgesia: a retrospective cohort analysis and prospective performance improvement intervention.

BMC Anesthesiol 2021 Apr 19;21(1):120. Epub 2021 Apr 19.

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA.

Background: In this study, we explored the utility of intravenous opioid rescue analgesia in the post anesthesia care unit (PACU-OpResc) as a single marker of thoracic epidural analgesia (TEA) failure and evaluated the resource implications and quality improvement applications of this measure.

Methods: We performed a retrospective analysis of all TEA placements over a three-year period at a single academic medical center in Boston, Massachusetts. The study exposure was PACU-OpResc. Read More

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Comparison of local and regional anesthesia modalities in breast surgery: A systematic review and network meta-analysis.

J Clin Anesth 2021 Apr 16;72:110274. Epub 2021 Apr 16.

Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; King's College London, London, United Kingdom.

Study Objective: Moderate to severe postoperative pain occurs in up to 60% of women following breast operations. Our aim was to perform a network meta-analysis and systematic review to compare the efficacy and side effects of different analgesic strategies in breast surgery.

Design: Systematic review and network meta-analysis. Read More

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Perioperative Management of the Patient With Obstructive Sleep Apnea: A Narrative Review.

Anesth Analg 2021 05;132(5):1231-1243

From the Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria.

The prevalence of obstructive sleep apnea (OSA) has reached 1 billion people worldwide, implying significant risk for the perioperative setting as patients are vulnerable to cardiopulmonary complications, critical care requirement, and unexpected death. This review summarizes main aspects and considerations for the perioperative management of OSA, a condition of public health concern. Critical determinants of perioperative risk include OSA-related changes in upper airway anatomy with augmented collapsibility, diminished capability of upper airway dilator muscles to respond to airway obstruction, disparities in hypoxemia and hypercarbia arousal thresholds, and instability of ventilatory control. Read More

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Analgesic efficacy of paraspinal interfascial plane blocks performed with the use of neurophysiology monitoring for posterior cervical laminectomy surgery: a case series.

J Spine Surg 2021 Mar;7(1):109-113

Division of Regional Anesthesia & Acute Pain Management, Department of Anesthesiology, Westchester Medical Center/New York Medical College, Valhalla, NY, USA.

Posterior cervical spine surgery often requires large posterior midline incision which can result in poorly controlled postoperative pain, arises from iatrogenic mechanical damage, intraoperative retraction and resection to structures such as bone, ligaments, muscles, intervertebral disks, and zygapophysial joints. Local anesthetics may be utilized for infiltration of the surgical wound; however, their analgesic efficacy has not been studied in this surgical approach. Here we report a case series. Read More

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Femoral nerve block versus fascia iliaca block for pain control in knee and hip arthroplasties: A meta-analysis.

Medicine (Baltimore) 2021 Apr;100(14):e25450

Department of Anesthesiology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology.

Background: This meta-analysis aimed to compare the efficiency of fascia iliaca compartment block (FICB) and femoral nerve block (FNB) for pain management in knee and hip surgeries.

Methods: We searched four electronic databases (Pubmed, Embase, Cochrane library database, Web of Science) from inception to January 2019. Only randomized controlled trials (RCTs) were included. Read More

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Ultrasound-guided erector spinae plane block versus thoracic paravertebral block on postoperative analgesia after laparoscopic nephroureterectomy: study protocol of a randomized, double-blinded, non-inferiority design trial.

Trials 2021 Apr 6;22(1):249. Epub 2021 Apr 6.

Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No. 8, Xishiku Street, Beijing, 100034, China.

Introduction: Erector spinae plane block (ESPB) is a novel inter-fascial plane block, which is applied more and more in postoperative pain control, especially in chest surgery. Regional block is advocated in order to decrease opioid consumption and improve analgesia in urological surgery. Therefore, we aimed to explore whether ESPB would have similar analgesia compared with thoracic paravertebral block (TPVB) in laparoscopic nephroureterectomy. Read More

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Reasons for discontinuation of acute postoperative pain ketamine infusions: A retrospective case-control study.

Pain Pract 2021 Apr 3. Epub 2021 Apr 3.

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, Florida, USA.

Purpose: The purpose of the study was to investigate factors associated with early discontinuation of low-dose ketamine infusions due to adverse drug events (ADEs).

Methods: A retrospective, matched case-control study of surgical patients who received low-dose ketamine infusions for postoperative pain over 6 years was conducted. Forty-seven study patients, who required early discontinuation of their infusion due to ADEs, were included and matched 1:1 with 47 controls, who did not experience ADEs, for a total of 94 patients. Read More

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Erector Spinae Plane Block for Perioperative Analgesia after Percutaneous Nephrolithotomy.

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

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Ultrasound-Guided Regional Anesthesia-Current Strategies for Enhanced Recovery after Cardiac Surgery.

Medicina (Kaunas) 2021 Mar 25;57(4). Epub 2021 Mar 25.

1st Department of Cardiovascular Anesthesiology and Intensive Care, "Prof. C. C. Iliescu" Emergency Institute for Cardiovascular Diseases, 258 Fundeni Road, 022328 Bucharest, Romania.

With the advent of fast-track pathways after cardiac surgery, there has been a renewed interest in regional anesthesia due to its opioid-sparing effect. This paradigm shift, looking to improve resource allocation efficiency and hasten postoperative extubation and mobilization, has been pursued by nearly every specialty area in surgery. Safety concerns regarding the use of classical neuraxial techniques in anticoagulated patients have tempered the application of regional anesthesia in cardiac surgery. Read More

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Quadratus Lumborum and Transversus Abdominis Plane Blocks and Their Impact on Acute and Chronic Pain in Patients after Cesarean Section: A Randomized Controlled Study.

Int J Environ Res Public Health 2021 03 28;18(7). Epub 2021 Mar 28.

Second Department of Anesthesia and Intensive Care, Medical University of Lublin, 20-059 Lublin, Poland.

Background: Severe postoperative pain is a significant problem after cesarean sections.

Methods: This study was a randomized, controlled trial of 105 patients conducted in two hospitals. All patients were anesthetized spinally for elective cesarean section. Read More

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Quadratus lumborum block (transmuscular approach) versus transversus abdominis plane block (unilateral subcostal approach) for perioperative analgesia in patients undergoing open nephrectomy: a randomized, double-blinded, controlled trial.

Braz J Anesthesiol 2021 Mar 21. Epub 2021 Mar 21.

Cairo University, Kasr Al Aini Hospital, Cairo, Egypt.

Study Objective: Patients undergoing open nephrectomy surgery experience severe perioperative pain, which is primarily due to incision of several muscles. Abdominal wall blocks are known to reduce pain without causing epidural-associated hypotension. We conducted this study to compare unilateral ultrasound-guided transmuscular quadratus lumborum block and posterior transversus abdominis block in combination with general anesthesia alone in terms of intraoperative and postoperative analgesics and hemodynamics and postoperative complications. Read More

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The efficacy and safety of interscalene blockade versus local infiltration analgesia in primary total shoulder arthroplasty?: A protocol for systematic review and meta-analysis of randomized controlled trials.

Medicine (Baltimore) 2021 Mar;100(12):e25201

Department of Anesthesiology.

Background: None of review has been conducted to compare the efficacy of interscalene blockade (ISB) with that of local infiltration analgesia (LIA) in patients undergoing total shoulder arthroplasty (TSA). We thus conduct a high-quality meta-analysis of randomized controlled trials (RCTs) to investigate which analgesic provides better pain relief.

Methods: A comprehensive search of the published literature in PUBMED, Scopus, EMBASE, and Cochrane Library databases will be performed. Read More

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Pain Management in Labor.

Am Fam Physician 2021 03;103(6):355-364

Lawrence Family Medicine Residency Program, Lawrence, MA, USA.

A patient's sense of empowerment and control is most predictive of maternal satisfaction with childbirth. Analgesia during labor greatly affects this experience. Individual patient priorities for labor pain management should be explored as part of routine prenatal care. Read More

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Comparison of Ultrasound-Guided Type-II Pectoral Nerve Block and Rhomboid Intercostal Block for Pain Management Following Breast Cancer Surgery: A Randomized, Controlled Trial.

Pain Pract 2021 Mar 12. Epub 2021 Mar 12.

Department of Anesthesiology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey.

Purpose: Although breast-conserving surgery-axillary dissection (BCS-AD) is a minimally invasive surgery, patients may suffer from moderate-to-severe pain. Several regional techniques can be used for pain control. The type II pectoral nerve block (PECS II) and the rhomboid intercostal block (RIB) are interfascial plane blocks that have been reported to provide effective analgesia after breast surgery. Read More

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The Effect of Femoral Nerve Block and Adductor Canal Block Methods on Patient Satisfaction in Unilateral Knee Arthroplasty: Randomized Non-Inferiority Trial.

Geriatr Orthop Surg Rehabil 2021 23;12:2151459321996632. Epub 2021 Feb 23.

Department of Anesthesiology, Training and Research Hospital, Nigde, Turkey.

Introduction: Femoral Nerve Block (FNB) and Adductor Canal Block (ACB) methods, which are regional analgesic techniques, are successfully used in postoperative pain control after total knee arthroplasty. This study aimed to compare adductor canal block method that was preoperatively used and femoral nerve block method in total knee arthroplasty (TKA) patients who underwent spinal anesthesia in terms of factors effecting patient satisfaction and determine whether these methods were equally effective or not.

Methods: A total of 80 patients between the ages of 60 and 75 who were in the American Society of Anesthesia (ASA) physical status of I-III were prospectively included in this randomized study. Read More

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February 2021

Reduced Pain and Opioid Use in the Early Postoperative Period in Patients Undergoing a Frontotemporal Craniotomy under Regional vs General Anesthesia.

World Neurosurg 2021 Mar 5. Epub 2021 Mar 5.

Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida, USA.

Introduction: This study compares the postsurgical course of frontotemporal craniotomies conducted "awake" under regional anesthesia (RA) versus "asleep" under general anesthesia (GA) to investigate postoperative recovery, pain, opioid use, and anesthesia-related side effects.

Methods: We retrospectively reviewed craniotomies for supratentorial, intra-axial tumors with frontotemporal exposure. Chronic opioid use and emergent cases were excluded. Read More

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Triple Monitoring May Avoid Intraneural Injection during Interscalene Brachial Plexus Block for Arthroscopic Shoulder Surgery: A Prospective Preliminary Study.

J Clin Med 2021 Feb 16;10(4). Epub 2021 Feb 16.

Unit of Anaesthesia, Intensive Care and Pain Management, Department of Medicine, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo 21, 00128 Rome, Italy.

Nerve injury is a feared complication of peripheral nerve blockade. The aim of this study was to test the effectiveness of a triple monitoring (TM), i.e. Read More

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February 2021

Avoid suboptimal perioperative analgesia during major surgery by enhancing thoracic epidural catheter placement and hemodynamic performance.

Reg Anesth Pain Med 2021 Mar 2. Epub 2021 Mar 2.

Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.

Thoracic epidural analgesia (TEA) is an established gold standard for postoperative pain control especially following laparotomy and thoracotomy. The safety and efficacy of TEA is well known when the attention to patient selection is upheld. Recently, the use of fascial plane blocks (FPBs) has evolved as an alternative to TEA most likely because these blocks avoid problems such as neurological comorbidity, coagulation disorders, epidural catheter failure and hypotension due to sympathetic denervation. Read More

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Epidural Analgesia in Ventral Hernia Repair: An Analysis of 30-day Outcomes.

Psychopharmacol Bull 2020 Oct;50(4 Suppl 1):33-47

Jones, MD, Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Brovman, MD, Wagenaar, MD, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Whang, MD, Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Langone Health, New York, New York. Ang, MD, Department of Surgery, Brigham and Women's Hospital, Boston, MA. Kaye, MD, PhD, Departments of Anesthesiology and Pharmacology, Toxicology and Neurosciences, Louisiana State University School of Medicine, Shreveport, LA. Urman, MD, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, Center for Perioperative Research, Brigham and Women's Hospital, Boston, MA.

Background: Ventral hernia repair (VHR) is a common procedure associated with significant postoperative morbidity and prolonged hospital length of stay (LOS). The use of epidural analgesia in VHR has not been widely evaluated.

Purpose: To compare the outcomes of general anesthesia plus epidural analgesia (GA + EA) versus general anesthesia alone (GA) in patients undergoing ventral hernia repair. Read More

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October 2020

Does thoracic epidural anaesthesia constitute over-instrumentation in video- and robotic-assisted thoracoscopic lung parenchyma resections?

Authors:
Torsten Loop

Curr Opin Anaesthesiol 2021 Apr;34(2):199-203

Department of Anaesthesiology and Intensive Care Medicine, University Hospital Freiburg, Medical Faculty, Albert-Ludwigs-University Freiburg, Freiburg, Germany.

Purpose Of Review: Effective and sustained perioperative analgesia in thoracic surgery and pulmonary resection is beneficial to patients by reducing both postoperative pulmonary complications and the incidence of chronic pain. In this review, the indication of thoracic epidural anaesthesia in video- (VATS) and robotic-assisted (RATS) thoracoscopy shall be critically objectified and presented in a differentiated way.

Recent Findings: Pain following VATS and RATS has a negative influence on lung function by inhibiting deep respiration, suppressing coughing and secretion and favours the development of atelectasis, pneumonia and other postoperative pulmonary complications. Read More

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Paravertebral anaesthesia with or without sedation versus general anaesthesia for women undergoing breast cancer surgery.

Cochrane Database Syst Rev 2021 Feb 25;2:CD012968. Epub 2021 Feb 25.

Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.

Background: Breast cancer is one of the most common cancers among women. Surgical removal of the cancer is the mainstay of treatment; however, tumour handling during surgery can cause microscopic dissemination of tumour cells and disease recurrence. The body's hormonal response to surgery (stress response) and general anaesthesia may suppress immunity, promoting tumour dissemination. Read More

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February 2021

Continuous erector spinae plane block versus intercostal nerve block in patients undergoing video-assisted thoracoscopic surgery: a pilot randomized controlled trial.

Pilot Feasibility Stud 2021 Feb 24;7(1):56. Epub 2021 Feb 24.

Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.

Background: The optimal analgesia method in video-assisted thoracoscopic surgery (VATS) remains controversial. Intercostal nerve blockade (ICNB) is limited by its duration of action. The erector spinae plane (ESP) block has the potential to provide satisfactory analgesia for VATS; however, the effectiveness of continuous ESP versus surgeon-performed ICNB has not been investigated. Read More

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February 2021