Local and Regional Anesthesia最新文献

筛选
英文 中文
Serious Complications After Epidural Catheter Placement: Two Case Reports. 硬膜外置管后严重并发症2例报告。
IF 2.9
Local and Regional Anesthesia Pub Date : 2021-07-24 eCollection Date: 2021-01-01 DOI: 10.2147/LRA.S324362
Ronald Seidel, Marc Tietke, Oliver Heese, Uwe Walter
{"title":"Serious Complications After Epidural Catheter Placement: Two Case Reports.","authors":"Ronald Seidel,&nbsp;Marc Tietke,&nbsp;Oliver Heese,&nbsp;Uwe Walter","doi":"10.2147/LRA.S324362","DOIUrl":"https://doi.org/10.2147/LRA.S324362","url":null,"abstract":"<p><p>Thoracic epidural analgesia (TEA) is a standard procedure in multimodal analgesia applied in major thoracic and abdominal surgeries. Two cases are presented with serious complications related to TEA. In both cases, earlier reaction of the treating physicians to patient-reported sensory symptoms could have prevented the complicated course. The first case was a 73-year-old patient with bronchial carcinoma who underwent right lower lobe resection. In this case, dabigatran 150 mg/d (indication: permanent atrial fibrillation) had been discontinued 72 hours before surgery, and enoxaparin 80 mg (every 12 hours) had been started 11 hours after surgery. An epidural hematoma developed postoperatively. Magnetic resonance imaging (MRI) was performed only after paraplegia had developed the next day. Unfortunately, delayed hematoma evacuation could not prevent persistent paraplegia in this case, which was complicated by hospital-acquired pneumonia with sepsis and acute renal failure. The second case was a 39-year-old patient with ulcerative colitis and an initially undetected malposition of the epidural catheter. Immediately after test bolus injection, the patient reported paresthesia and overall discomfort, which however could not be safely attributed to either the test dose or the already started general anesthesia. The patient could only be extubated after stopping the epidural infusion. Accidental re-start of epidural infusion led to coma, conjugate eye deviation, and respiratory arrest, necessitating re-intubation. Computed tomography (CT) ruled out intracerebral pathology and showed a catheter position centrally in the spinal canal. Fortunately, no neurological deficits were detected after catheter removal.</p>","PeriodicalId":18203,"journal":{"name":"Local and Regional Anesthesia","volume":"14 ","pages":"117-124"},"PeriodicalIF":2.9,"publicationDate":"2021-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/d4/lra-14-117.PMC8318213.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39266197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Comparison of Ultrasound-Guided Modified BRILMA Block with Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy - A Randomized Controlled Trial. 超声引导改良BRILMA阻滞与肋下经腹平面阻滞用于腹腔镜胆囊切除术术后镇痛的比较——一项随机对照试验。
IF 2.9
Local and Regional Anesthesia Pub Date : 2021-07-02 eCollection Date: 2021-01-01 DOI: 10.2147/LRA.S316320
Ravi Saravanan, Rajagopalan Venkatraman, Urkavalan Karthika
{"title":"Comparison of Ultrasound-Guided Modified BRILMA Block with Subcostal Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy - A Randomized Controlled Trial.","authors":"Ravi Saravanan,&nbsp;Rajagopalan Venkatraman,&nbsp;Urkavalan Karthika","doi":"10.2147/LRA.S316320","DOIUrl":"https://doi.org/10.2147/LRA.S316320","url":null,"abstract":"<p><strong>Background and aims: </strong>Subcostal Transversus Abdominis Plane (TAP) block is the standard practice for postoperative analgesia following laparoscopic cholecystectomy. This study aimed to compare the efficacy of modified BRILMA Block (blocking the BRanches of Intercostal nerves at the Level of Mid-Axillary line) with Subcostal TAP block for pain relief following laparoscopic cholecystectomy.</p><p><strong>Methods: </strong>Sixty cases scheduled for laparoscopic cholecystectomy were randomly divided into two groups: modified BRILMA block (Group B) and Subcostal TAP block (Group T). General anesthesia was standardized for both groups. Blocks were performed with 20 mL of 0.2% Ropivacaine under ultrasound guidance after induction of anesthesia. Patients were administered morphine through patient controlled analgesia (PCA) pump with a bolus dose of 1 mg, 10 min lockout interval, and a basal infusion rate of 0.1 mg/h. The pain was assessed by the Visual Analog Scale (VAS) scores of one to ten. The total morphine consumption, time to first request for rescue analgesia, and VAS scores at rest and with movement, and complications, if any, were recorded.</p><p><strong>Results: </strong>The morphine consumption in Group B was 5.67 ± 1.98 mg and in Group T was 5.17 ± 1.85 mg, which was found to be statistically insignificant (p-value = 0.317). The time to first request for rescue analgesia was 759.33 ± 80.29 min in Group B which was comparable to 854 ± 93.01 min in Group T and statistically insignificant (p-value = 0.295). The average VAS scores at rest as well as on movement were comparable in both the groups during the entire 24 h postoperative period. No complications were encountered in our study.</p><p><strong>Conclusion: </strong>Ultrasound-guided modified BRILMA block is equally efficacious as subcostal TAP block in providing postoperative analgesia with similar morphine consumption and no significant difference in VAS scores at rest and movement following laparoscopic cholecystectomy.</p><p><strong>Trial registration number: </strong>CTRI/2020/02/023457.</p>","PeriodicalId":18203,"journal":{"name":"Local and Regional Anesthesia","volume":"14 ","pages":"109-116"},"PeriodicalIF":2.9,"publicationDate":"2021-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/04/5c/lra-14-109.PMC8259940.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39166426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Analysis of Epidural Waveform to Determine Correct Epidural Catheter Placement After CSE Labor Analgesia. 剖宫产镇痛后硬膜外置管波形分析。
IF 2.9
Local and Regional Anesthesia Pub Date : 2021-06-17 eCollection Date: 2021-01-01 DOI: 10.2147/LRA.S312194
Alessandra Coccoluto, Giorgio Capogna, Michela Camorcia, Mark Hochman, Matteo Velardo
{"title":"Analysis of Epidural Waveform to Determine Correct Epidural Catheter Placement After CSE Labor Analgesia.","authors":"Alessandra Coccoluto,&nbsp;Giorgio Capogna,&nbsp;Michela Camorcia,&nbsp;Mark Hochman,&nbsp;Matteo Velardo","doi":"10.2147/LRA.S312194","DOIUrl":"https://doi.org/10.2147/LRA.S312194","url":null,"abstract":"<p><strong>Background: </strong>The epidural pressure is pulsatile and synchronized with arterial pulsations. Monitoring the epidural waveform has been suggested as a technique to reliably confirm the appropriate localization of the epidural catheter.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the sensitivity and specificity of the Computer Controlled Drug Delivery System with continuous pressure and waveform sensing technology (CCDDS) (CompuFlo<sup>®</sup> CathCheck™) as an instrument to assess the correct placement of the catheter in the epidural space in parturients who have received combined spinal-epidural technique (CSE) for labor analgesia.</p><p><strong>Methods: </strong>We enrolled 40 consecutive healthy patients undergoing CSE labor analgesia with successful analgesia. All the cases in which pulsatile waveforms in synchrony with heart rate were detected were considered to be true positives; all the cases in which there was the absence of pulsatile waves were followed up. If these patients had to eventually relocate or manipulate the epidural catheter, they were considered to be true negative. If the absence of pulse waves was observed in the presence of successful analgesia during labor, the patients were considered to be false negatives.</p><p><strong>Results: </strong>Pulsatile waveforms synchronous with heart rate were observed in 33 cases associated with adequate analgesia. In 5 cases, the pulsatile waveforms were absent due to unilateral analgesia or catheter occlusion (true negatives). In 2 cases, the patients had effective analgesia but we were not able to observe a distinct pulsatile waveform. The pressure waveform analysis through the epidural catheter had a sensitivity of 95%, a positive predictive value of 100%, a specificity of 100% and a negative predictive value of 60%.</p><p><strong>Conclusion: </strong>Pulsatile pressure waveform recording with CCDDS through the epidural catheter resulted in high sensitivity and positive predictive value which can help the proper placement of the epidural catheter.</p>","PeriodicalId":18203,"journal":{"name":"Local and Regional Anesthesia","volume":"14 ","pages":"103-108"},"PeriodicalIF":2.9,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bc/e1/lra-14-103.PMC8216732.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39105832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Combination of the T7 Unilateral Erector Spinae Plane Block and T10 Bilateral Retrolaminar Blocks in a Patient with Multiple Rib Fractures on the Right and T10-12 Vertebral Compression Fractures: A Case Report. T7单侧竖脊肌平面阻滞联合T10双侧椎板后阻滞治疗右侧多发肋骨骨折并T10-12椎体压缩性骨折1例
IF 2.9
Local and Regional Anesthesia Pub Date : 2021-06-15 eCollection Date: 2021-01-01 DOI: 10.2147/LRA.S312881
Vicko Gluncic, Lara Bonasera, Sergio Gonzalez, Ivan Krešimir Lukić, Kenneth Candido
{"title":"Combination of the T7 Unilateral Erector Spinae Plane Block and T10 Bilateral Retrolaminar Blocks in a Patient with Multiple Rib Fractures on the Right and T10-12 Vertebral Compression Fractures: A Case Report.","authors":"Vicko Gluncic,&nbsp;Lara Bonasera,&nbsp;Sergio Gonzalez,&nbsp;Ivan Krešimir Lukić,&nbsp;Kenneth Candido","doi":"10.2147/LRA.S312881","DOIUrl":"https://doi.org/10.2147/LRA.S312881","url":null,"abstract":"<p><p>Multiple vertebral compression and rib fractures in elderly patients with pre-existing chronic obstructive pulmonary disease is a common scenario associated with significant morbidity and mortality. Severe pain prevents normal ventilation and leads to atelectasis, consolidation, and pneumonia. Subsequently, these patients frequently develop respiratory failure and require intubation and critical care. Therefore, adequate analgesia is often a life-saving intervention. Anesthetic management of a 78-year-old kyphotic patient with T6, T7, and T9 rib fractures on the right and T10-12 vertebral compression fractures sustained in an accidental fall is presented. She had inadequate pain control and was unable to take a deep breath or cough. Her respiratory status was deteriorating, with tachypnea and worsening hypoxia, necessitating bi-level positive airway pressure (BiPAP) support. Since thoracic epidural analgesia was contraindicated owing to compressive vertebral fractures and to the pending respiratory failure, we opted for a unilateral erector spinae plane (ESP) block at the T7 level and bilateral retrolaminar (RL) blocks at the T10 level. Following the procedure, the pain was immediately relieved and the patient was able to take deep breaths. Shortly thereafter, her respiratory status improved, with the respiratory rate coming back close to the baseline. The patient was subsequently weaned from BiPAP support and discharged from the intensive care unit. While the combination of ESP and RL blocks is not routinely used in patients with multiple rib and vertebral compression fractures, our report indicates that it may be an excellent alternative for analgesia in situations where thoracic epidural and/or paravertebral blocks are contraindicated and when timely intervention could be potentially life-saving.</p>","PeriodicalId":18203,"journal":{"name":"Local and Regional Anesthesia","volume":"14 ","pages":"99-102"},"PeriodicalIF":2.9,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2a/08/lra-14-99.PMC8214557.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39101924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Ultrasound-Guided Local Anesthetic Infiltration Between the Popliteal Artery and the Capsule of the Posterior Knee (IPACK) Block for Primary Total Knee Arthroplasty: A Systematic Review of Randomized Controlled Trials. 超声引导下腘动脉与后膝关节囊(IPACK)阻滞之间的局麻药浸润用于初次全膝关节置换术:随机对照试验的系统综述。
IF 2.9
Local and Regional Anesthesia Pub Date : 2021-05-12 eCollection Date: 2021-01-01 DOI: 10.2147/LRA.S303827
Ryan S D'Souza, Brendan J Langford, David A Olsen, Rebecca L Johnson
{"title":"Ultrasound-Guided Local Anesthetic Infiltration Between the Popliteal Artery and the Capsule of the Posterior Knee (IPACK) Block for Primary Total Knee Arthroplasty: A Systematic Review of Randomized Controlled Trials.","authors":"Ryan S D'Souza,&nbsp;Brendan J Langford,&nbsp;David A Olsen,&nbsp;Rebecca L Johnson","doi":"10.2147/LRA.S303827","DOIUrl":"https://doi.org/10.2147/LRA.S303827","url":null,"abstract":"<p><p>Posterior knee pain after total knee arthroplasty (TKA) is common despite multimodal analgesia and regional anesthesia use. This review included randomized controlled trials (RCTs) comparing analgesic outcomes after inclusion of local anesthetic infiltration between the popliteal artery and capsule of the knee (iPACK) block versus pathways without iPACK. Electronic databases (MEDLINE, Cochrane Library, Web of Science, Scopus) were searched from inception to 10/11/2020. Eligible studies evaluated iPACK use on primary outcomes: opioid consumption and pain scores with movement. Secondary outcomes included rest pain, patient satisfaction, length of stay (LOS), gait distance, knee range of motion (ROM), and complications. Bias and quality were appraised using the Cochrane Risk of Bias tool and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) guidelines. Eight RCTs (777 patients) were included. iPACK block use demonstrated similar opioid consumption in the PACU (4/7 RCTs) and 24 hours after TKA (5/7 RCTs) compared to without iPACK (moderate-quality GRADE evidence). Additionally, iPACK block use demonstrated lower movement pain scores in PACU (3/5 RCTs) but similar or higher pain scores after 24 hours (5/7 RCTs; low-quality GRADE evidence). Studies consistently reported no difference in gait distance (4/4 RCTs) or complications (7/7 RCTs) between treatment arms (high-quality GRADE evidence), although differing effect estimates were observed with resting pain, satisfaction, LOS, and knee ROM. This review provides a foundation of knowledge on iPACK efficacy. While evidence does not currently support widespread inclusion of iPACK within enhanced recovery pathways for TKA, limitations suggest further study is warranted.</p>","PeriodicalId":18203,"journal":{"name":"Local and Regional Anesthesia","volume":"14 ","pages":"85-98"},"PeriodicalIF":2.9,"publicationDate":"2021-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/41/lra-14-85.PMC8126972.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38929741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 13
Effects of Ultrasound-Guided Bilateral Cervical Plexus Block Combined with General Anesthesia in Patients Undergoing Total Parathyroidectomy and Partial Gland Autotransplantation Surgery. 超声引导下双侧颈丛阻滞联合全身麻醉在甲状旁腺全切除和部分腺体自体移植手术中的应用效果。
IF 2.9
Local and Regional Anesthesia Pub Date : 2021-04-23 eCollection Date: 2021-01-01 DOI: 10.2147/LRA.S299312
Jing Gong, Youxiu Yao, Yanbiao Wang
{"title":"Effects of Ultrasound-Guided Bilateral Cervical Plexus Block Combined with General Anesthesia in Patients Undergoing Total Parathyroidectomy and Partial Gland Autotransplantation Surgery.","authors":"Jing Gong,&nbsp;Youxiu Yao,&nbsp;Yanbiao Wang","doi":"10.2147/LRA.S299312","DOIUrl":"https://doi.org/10.2147/LRA.S299312","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to evaluate the effect of ultrasound-guided bilateral cervical plexus block on general anesthesia, postoperative analgesia, and surgical outcomes in patients undergoing total parathyroidectomy with autotransplantation.</p><p><strong>Patients and methods: </strong>Forty-eight ASA III-IV patients with hyperparathyroidism secondary to renal failure were included: 24 patients received ultrasound-guided bilateral superficial and deep cervical plexus block combined with general anesthesia (group A), and 24 patients received general anesthesia alone (group B). Postoperative patient-controlled intravenous analgesia was provided with sufentanil 2 μg/kg. The primary outcome is the postoperative pain scores. Secondary outcomes include intraoperative remifentanil dosage, changes in hemodynamics, extubation time, and sufentanil consumption. Surgical outcomes regarding calcium, phosphorus and parathormone values were also noted.</p><p><strong>Results: </strong>The patients in group A required less remifentanil than group B (2.56±0.92mg vs 3.38±0.84mg, <i>P</i>=0.002) and lower VAS scores at 1, 3, 10, 24, and 48h postoperatively (<i>P</i> < 0.001). While the systolic blood pressure in group A patients was significantly greater than that in group B at T3 (immediately after extubation, [138.33±11.36 vs 129.08±17.06 mmHg; <i>P</i>=0.032]), heart rates in group A were lower than in group B at 1 min before induction (T1 [89.46 ± 9.14 vs 96.71±14.19, <i>P</i>=0.042]) and 1 min after intubation (T2 [70.08 ± 5.35 vs 79.25 ± 11.81, <i>P</i>=0.002]). The extubation time in group A was shorter than that in group B (<i>P</i> < 0.001). There was no difference in calcium, phosphorus and parathormone values, nor in sufentanil consumption between the groups.</p><p><strong>Conclusion: </strong>Ultrasound-guided bilateral superficial and deep cervical plexus block combined with general anesthesia for TPTA is an effective strategy to improve anesthesia management and achieve better postoperative analgesia, and has no impact on surgical outcomes.</p>","PeriodicalId":18203,"journal":{"name":"Local and Regional Anesthesia","volume":"14 ","pages":"75-83"},"PeriodicalIF":2.9,"publicationDate":"2021-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/fc/lra-14-75.PMC8079358.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38938191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Transmuscular Quadratus Lumborum Block versus Suprainguinal Fascia Iliaca Block for Hip Arthroplasty: A Randomized, Controlled Pilot Study. 经肌腰方肌阻滞与腹股沟上髂筋膜阻滞用于髋关节置换术:一项随机、对照的先导研究。
IF 2.9
Local and Regional Anesthesia Pub Date : 2021-04-20 eCollection Date: 2021-01-01 DOI: 10.2147/LRA.S308964
Heba Nassar, Ahmed Hasanin, Mahmoud Sewilam, Heba Ahmed, Mohamed Abo-Elsoud, Omar Taalab, Ashraf Rady, Heba Allah Zoheir
{"title":"Transmuscular Quadratus Lumborum Block versus Suprainguinal Fascia Iliaca Block for Hip Arthroplasty: A Randomized, Controlled Pilot Study.","authors":"Heba Nassar,&nbsp;Ahmed Hasanin,&nbsp;Mahmoud Sewilam,&nbsp;Heba Ahmed,&nbsp;Mohamed Abo-Elsoud,&nbsp;Omar Taalab,&nbsp;Ashraf Rady,&nbsp;Heba Allah Zoheir","doi":"10.2147/LRA.S308964","DOIUrl":"https://doi.org/10.2147/LRA.S308964","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the analgesic efficacy and motor block profile of single-shot transmuscular quadratus lumborum block (QLB) in comparison with those of suprainguinal fascia iliaca block (FIB) in patients undergoing hip arthroplasty.</p><p><strong>Methods: </strong>This randomized, double-blinded, controlled trial included adult patients undergoing hip arthroplasty under spinal anesthesia. Patients were allocated to one of two groups according to the regional block received: FIB group (n=19) or QLB group (n=17). Both study groups were compared with regard to the duration of analgesia (primary outcome), block performance time, pain during positioning for spinal anesthesia, total morphine consumption in the first postoperative 24-h period, quadriceps muscle power, and static and dynamic visual analog scale.</p><p><strong>Results: </strong>Thirty-six patients were included in the final analysis. Both study groups had comparable durations of analgesia. Postoperative visual analog scale (static and dynamic) values were comparable between the two groups in most readings. The block performance time was shorter in the FIB group. The number of patients with pain during positioning for the subarachnoid block was lower in the QLB group. The total morphine requirement during the first 24 h was marginally lower in the FIB group, whereas the quadriceps motor grade was higher in the FIB group than in the QLB group at 4 h and 6 h after surgery.</p><p><strong>Conclusion: </strong>Both single-shot blocks, namely the suprainguinal FIB and transmuscular QLB, provide effective postoperative analgesia after hip arthroplasty. FIB showed slightly lower 24-h morphine consumption, while QLB showed better quadriceps motor power.</p><p><strong>Clinical trial registration: </strong>The study was registered at clinical trials registry system before enrollment of the first participant (NCT04005326; initial release date, 2 July 2019; https://clinicaltrials.gov/ct2/show/NCT04005326).</p>","PeriodicalId":18203,"journal":{"name":"Local and Regional Anesthesia","volume":"14 ","pages":"67-74"},"PeriodicalIF":2.9,"publicationDate":"2021-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5f/8f/lra-14-67.PMC8068517.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38923369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 13
Quadratus Lumborum Blocks in Nephrectomy: A Narrative Review. 腰方肌阻滞在肾切除术中的应用综述。
IF 2.9
Local and Regional Anesthesia Pub Date : 2021-04-19 eCollection Date: 2021-01-01 DOI: 10.2147/LRA.S290224
Christopher Little, Siamak Rahman
{"title":"Quadratus Lumborum Blocks in Nephrectomy: A Narrative Review.","authors":"Christopher Little,&nbsp;Siamak Rahman","doi":"10.2147/LRA.S290224","DOIUrl":"https://doi.org/10.2147/LRA.S290224","url":null,"abstract":"<p><p>The quadratus lumborum block is a novel truncal block where local anaesthetic is injected adjacent to the quadratus lumborum muscle. It is used for caesarean sections, hip arthroplasty, gynecologic surgery, colectomy, and recently nephrectomy. To date, there are no reviews that outline the efficacy and performance of the quadratus lumborum blocks in patients receiving laparoscopic nephrectomy. The objective of this project was to outline the current available data from both clinical trials along with case series and reports regarding the methods and utility of quadratus lumborum blocks for analgesia in patients receiving nephrectomy. For this literature review, we searched Pubmed, Embase, and Web of Science from their inception until 5/31/2020. Our search terms were as follows: \"(nephrectomy OR laparoscopic nephrectomy) AND (QL block OR Quadratus Lumborum block OR QL OR TQL OR Thoracolumbar fascia block).\" We analyzed all relevant clinical trials for quality using the Jadad scale. Our search yielded a total of 30 articles, 23 of which we ultimately reviewed for this manuscript. The qualitative sum of these data show that patients receiving quadratus lumborum block for nephrectomies have reduced opioid requirements, reduced pain scores, and improved side-effects relative to other analgesic modalities like epidurals. Based on these findings, we conclude that the quadratus lumborum block is a useful analgesic for patients undergoing nephrectomy.</p>","PeriodicalId":18203,"journal":{"name":"Local and Regional Anesthesia","volume":"14 ","pages":"57-65"},"PeriodicalIF":2.9,"publicationDate":"2021-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/22/lra-14-57.PMC8064613.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38923368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
The Current Practice of Spinal Anesthesia in Anesthetists at a Comprehensive Specialized Hospital: A Single Center Observational Study. 综合专科医院麻醉师脊柱麻醉的现状:一项单中心观察研究
IF 2.9
Local and Regional Anesthesia Pub Date : 2021-03-31 eCollection Date: 2021-01-01 DOI: 10.2147/LRA.S300054
Metages Hunie, Efrem Fenta, Simegnew Kibret, Diriba Teshome
{"title":"The Current Practice of Spinal Anesthesia in Anesthetists at a Comprehensive Specialized Hospital: A Single Center Observational Study.","authors":"Metages Hunie,&nbsp;Efrem Fenta,&nbsp;Simegnew Kibret,&nbsp;Diriba Teshome","doi":"10.2147/LRA.S300054","DOIUrl":"https://doi.org/10.2147/LRA.S300054","url":null,"abstract":"<p><strong>Background: </strong>Spinal anesthesia block is the most widely practiced anesthesia technique due to its safety margin. It is an invasive procedure that could be associated with a variety of complications like total spinal, cardiovascular collapse, meningitis, paralysis, and even death. The aim of this study to assess the current practice of spinal anesthesia.</p><p><strong>Methods: </strong>A Cross-sectional study design was conducted in Debre Tabor Comprehensive Specialized Hospital from November 01 to December 15, 2020. All anesthesia professionals who are working in the study Hospital were surveyed by the Purposive sampling technique. A standardized structured checklist prepared from recommendations of New York school of regional anesthesia guideline regarding the current Practice of spinal anesthesia was used to collect the data after taking written informed consent. Descriptive statistics were employed to summarize the results.</p><p><strong>Results: </strong>A total of 24 anesthetists were observed of their practice before, during, and after administer of spinal anesthesia. All of the anesthetists were practicing the preparation and assembling of all necessary anesthesia equipments, resuscitation drugs, and basic monitors while all of the anesthetists did not wash their hands, wore a sterile gown, and draped the back of the patient with fenestrated drapes in a sterile fashion.</p><p><strong>Conclusion: </strong>Most of the anesthesiology professionals in our setting have a good preparation of all necessary anesthesia equipments, and resuscitation drugs, while the assessment of patient's emotional reaction and pain during injection, the skin preparation allowed to being dry and assessment of the degree of sensory and motor block of the patient were insufficient.</p>","PeriodicalId":18203,"journal":{"name":"Local and Regional Anesthesia","volume":"14 ","pages":"51-56"},"PeriodicalIF":2.9,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/e4/lra-14-51.PMC8020134.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25572874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Levobupivacaine Consumption in Automated Intermittent Bolus in Ultrasound Guided Subparaneural Sciatic Nerve Catheters: A Prospective Double-Blind Randomized Trial. 超声引导下坐骨神经下导管自动间歇注射左旋布比卡因:一项前瞻性双盲随机试验。
IF 2.9
Local and Regional Anesthesia Pub Date : 2021-03-25 eCollection Date: 2021-01-01 DOI: 10.2147/LRA.S299870
Margaretha B Breebaart, Jordi Branders, Luc Sermeus, Sultan Termurziev, Helene Camerlynck, Lennert Van Putte, Marnik Van Putte Minelli, Stefan De Hert
{"title":"Levobupivacaine Consumption in Automated Intermittent Bolus in Ultrasound Guided Subparaneural Sciatic Nerve Catheters: A Prospective Double-Blind Randomized Trial.","authors":"Margaretha B Breebaart,&nbsp;Jordi Branders,&nbsp;Luc Sermeus,&nbsp;Sultan Termurziev,&nbsp;Helene Camerlynck,&nbsp;Lennert Van Putte,&nbsp;Marnik Van Putte Minelli,&nbsp;Stefan De Hert","doi":"10.2147/LRA.S299870","DOIUrl":"https://doi.org/10.2147/LRA.S299870","url":null,"abstract":"<p><strong>Purpose: </strong>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. This double blind prospective randomized trial compares the 48-hour local anesthetic (LA) dose consumption of an automated intermittent bolus technique to a continuous infusion regimen in a subparaneural sciatic nerve catheter after hallux valgus surgery.</p><p><strong>Patients and methods: </strong>Patients scheduled for hallux valgus surgery were randomized to receive either a continuous infusion of levobupivacaine 0.125% at 5mL/h (group A) or an intermittent automated bolus of 9.8 mL every 2 hours with a background of 0.1 mL/h (group B), both with a PCA bolus of 6 mL and lockout of 30 minutes. The 48 hour LA consumption, PCA boluses, Numeric Rating Scale (NRS), satisfaction and return of normal sensation were recorded.</p><p><strong>Results: </strong>Sixteen patients were excluded because of protocol violation or technical problems and 42 patients remained for analysis. The 48 hour ropivacaine consumption was higher in group A (293 ±60 mL) than group B (257±33 mL). The median and highest NRS scores and patient satisfaction were not statistically different between groups. Normal sensation returned after 75 ± 22 hours (group A) and 70 ± 17 hours (group B).</p><p><strong>Conclusion: </strong>Programmed bolus administration in subparaneural sciatic nerve catheters reduces LA consumption 48 hours after surgery with equal analgesia and patient satisfaction. Return of sensation is variable and can last more than 75 hours.</p>","PeriodicalId":18203,"journal":{"name":"Local and Regional Anesthesia","volume":"14 ","pages":"43-50"},"PeriodicalIF":2.9,"publicationDate":"2021-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/93/lra-14-43.PMC8007557.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25535734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信