Can we consider the fascia as the target of our fascial block? DOI Creative Commons
Pierfrancesco Fusco, Emanuele Nazzarro, Francesca De Sanctis

et al.

Indian Journal of Anaesthesia, Journal Year: 2024, Volume and Issue: 68(9), P. 832 - 833

Published: Aug. 16, 2024

Fascia blocks have gained popularity over the past two decades. Initially, fascia was considered a container to inject local anaesthetic. The only known mechanism of action anaesthesia nerve that runs inside fascial plane. However, anatomical and clinical studies eluded role in acute chronic pain.[1] microscopic physiological characteristics make it target not just for anaesthetic deposition. system comprises three-dimensional continuum soft, collagen-containing, loose dense fibrous connective tissues permeate body. As highlighted by Suarez-Rodriguez V et al., fasciae intrinsic innervation with Pacini Ruffini corpuscles and, above all, are rich free endings, so they believed be involved proprioception, balance perception pain.[2] Today, represents structure human body greatest number endings. It has been observed is increased pathological fasciae. Both execution perioperative treatment pain, must an important generator pain. genesis myofascial pain known, but ultrasound elasto-sonography recently revealed close relationship between administration reduction muscle stiffness transmission.[3] This article also highlights relief after block lasts much longer than effect itself. consideration led conclusion analgesic depends exclusively on anaesthetic, stimulating endings within fascia. In syndrome, such as may become either or electric mechanical stimuli 'dry needling'. confirmed warm saline solution alone plane patient suffering from which caused immediate pain.[4] If this were case, would transmission stimulation causes remodulation transmission. observation line anatomy intrafascial frequently perpendicularly oriented collagen fibres, thereby increasing likelihood their activation stretching fibres.[5] hydrodissection its objective breakdown hyaluronan macromolecules restore sliding fascia.[6] Fusco al.,[1] expert's opinion, success often unpredictable dependent several factors, including For example, septa inside, influence diffusion therefore, effectiveness block.[7] reason, performed dynamically break facilitate spread anaesthetic.[1] Considering open up new fields application management. Financial support sponsorship Nil. Conflicts interest There no conflicts interest.

Language: Английский

Fascial plane blocks for postoperative pain management after fast-track total knee arthroplasty: A narrative review DOI Creative Commons

Fabio Costa,

Alessandro Ruggiero, Pierfrancesco Fusco

et al.

Saudi Journal of Anaesthesia, Journal Year: 2025, Volume and Issue: 19(2), P. 209 - 220

Published: March 25, 2025

Total knee replacement is a common surgical procedure associated with significant postoperative pain, which can delay recovery and increase healthcare costs. Regional anesthesia techniques, including local infiltration analgesia fascial plane blocks, play crucial role in multimodal pain management strategies. These approaches aim to enhance relief while minimizing opioid use preserving motor function. This narrative review evaluates the effectiveness safety of motor-sparing blocks for total replacement, categorizing techniques based on their anatomical target areas: anterior, posterior, other approaches. A comprehensive literature search was conducted using databases such as MEDLINE, EMBASE, Cochrane Central Register Controlled Trials. The included studies regional relevant keywords "regional anesthesia," "peripheral nerve block," "motor-sparing techniques," specific block names. selection criteria randomized controlled trials, systematic reviews, meta-analyses, case studies. were analyzed relief, impact function, overall contribution enhanced after replacement. highlights that most evidence-supported technique anterior targeting adductor canal, provides effective For posterior compartment between popliteal artery capsule preferred approach. Emerging dual subsartorial para-sartorial block, show promise but require further validation. also underscores importance integrating different ensure adequate control both compartments, facilitating early mobilization fast-track protocols. Achieving optimal requires combination targeted techniques. Current evidence supports canal relief. While newer potential, research needed validate efficacy safety. Future should focus refining strategies optimize analgesic benefits impairment, thereby improving functional reducing reliance medications.

Language: Английский

Citations

0
Fascial plane blocks as the main anesthetic method: A narrative review DOI Creative Commons
Serkan Tulgar, Ali Ahişkalıoğlu, Alper Kılıçaslan

et al.

Saudi Journal of Anaesthesia, Journal Year: 2025, Volume and Issue: 19(2), P. 198 - 208

Published: March 25, 2025

This narrative review evaluates the efficacy of fascial plane blocks (FPB) as sole anesthetic method for surgery. Particularly in selected high-risk patients, may be a more useful and convenient option than general anesthesia or neuraxial anesthesia. In recent years, with use ultrasound, newly defined FPBs have emerged these techniques become popular. There are case reports literature reporting anesthesia, but clinical studies limited clinicians undecided about which block combination to apply case. this review, is first field literature, we aimed discuss combinations can used incisions surgeries.

Language: Английский

Citations

0
Continuous wound infusion as a valid alternative to tap block for postoperative analgesia after abdominal hysterectomy: A randomized controlled trial DOI Creative Commons

Fabio Costa,

Alessandro Ruggiero,

Alessandro Strumia

et al.

Saudi Journal of Anaesthesia, Journal Year: 2025, Volume and Issue: 19(2), P. 227 - 234

Published: March 25, 2025

Total abdominal hysterectomy is a procedure associated with moderate to severe postoperative pain. Regional anesthesia techniques, such as fascial plane blocks, have shown promise in improving pain control. While continuous wound infusion recommended for cesarean section, it not open hysterectomy. Our aim compare surgically placed catheter the transverse abdominis block. A single-center prospective randomized controlled trial was conducted Italy from January July 2023. Patients undergoing elective were randomly assigned receive either bilateral block or infusion. The primary outcome measure assessment of static recovery room and at 6, 12, 24, 48 hours postoperatively using numeric rating scale (NRS) Of 34 patients assessed eligibility, 32 equally distributed between groups. receiving consistently reported lower NRS scores compared those across all time points. median significantly group post surgery (P < 0.05). Importantly, similar significant differences also observed groups dynamic scores. However, no secondary outcomes, including nausea vomiting, functional capacity. Continuous properly positioned noninferior management following total may even provide superior These findings suggest viable alternative effective procedures.

Language: Английский

Citations

0
A year in review in Minerva Anestesiologica 2024: anesthesia, analgesia, and perioperative medicine DOI
Franco Cavaliere, Massimo Allegri, Alparslan Apan

et al.

Minerva Anestesiologica, Journal Year: 2025, Volume and Issue: 91(3)

Published: April 1, 2025

Language: Английский

Citations

0
A Comparison of Two Fascial Plane Blocks for Abdominal Analgesia in Laparoscopic Cholecystectomy Surgery (M-TAPA vs. External Oblique Intercostal Plane Block): A Prospective Randomized Study DOI Open Access
Bahadır Çiftçi, Selçuk Alver, Birzat Emre Gölboyu

et al.

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(9), P. 3050 - 3050

Published: April 28, 2025

Background: Modified thoracoabdominal nerve block through a perichondrial approach (M-TAPA) and external oblique intercostal plane (EOIB) provide abdominal analgesia by blocking nerves. Our aim was to compare the analgesic efficacy of M-TAPA vs. EOIB on quality recovery pain scores in patients who underwent laparoscopic cholecystectomy surgery (LC). Methods: Patients with American Society Anesthesiologists status I-II, aged between 18 65 years, scheduled for elective LC under general anesthesia were enrolled study. The randomized into two groups: Group (n = 30) 30). blocks performed 40 mL 0.25% bupivacaine total. primary outcome study global score, secondary outcomes scores, rescue requirement, adverse effects during 24-h postoperative period. Results: at 24 h similar both groups. There reduction median static dynamic numerical rating scale (NRS) first 2 postoperatively compared (p < 0.001). need significantly lower group 0.005). Conclusions: Opioid consumption group, groups similar, exception postoperatively. Both are effective following surgeries.

Language: Английский

Citations

0
Regional anesthesia: standards for reporting techniques in scientific research DOI
Alessandro De Cassai, Serkan Tulgar

Minerva Anestesiologica, Journal Year: 2025, Volume and Issue: 91(4)

Published: April 1, 2025

Language: Английский

Citations

0
Deep Rectus Sheath (Preperitoneal) Block in Laparoscopic Cholecystectomy: A Case Report DOI
Francesco Marrone,

Edoardo Gentile,

Marco Tomei

et al.

A&A Practice, Journal Year: 2025, Volume and Issue: 19(5), P. e01970 - e01970

Published: May 1, 2025

Preperitoneal injection has been considered a complication in the classical rectus sheath block. However, group of Italian anesthesiologists recently explored technique targeting preperitoneal space (also known as deep or block) for analgesia open abdominal surgery. This case report describes laparoscopically guided and block performed during laparoscopic cholecystectomy. The patient experienced effective pain control without opioids complications. Ultrasound imaging confirmed anesthetic distribution above under sheath. While promising, this remains experimental, requiring further study to clarify its mechanism standardize application.

Language: Английский

Citations

0
Enhancing Safety in Regional Anesthesia: Guidelines from the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) DOI Creative Commons
Vito Torrano,

Salvatore Anastasi,

Eleonora Balzani

et al.

Journal of Anesthesia Analgesia and Critical Care, Journal Year: 2025, Volume and Issue: 5(1)

Published: May 14, 2025

Abstract Background Regional anesthesia techniques have become integral to modern perioperative care, offering enhanced pain management and recovery outcomes. However, their application in patients with specific conditions, such as anticoagulation therapy or preexisting comorbidities, raises concerns regarding safety efficacy. Current guidelines addressing these issues are fragmented, necessitating comprehensive, evidence-based recommendations. Methods A multidisciplinary panel of experts anesthesiology was convened under the auspices Italian Society Anesthesia, Analgesia, Resuscitation, Intensive Care (SIAARTI). The presented herein were developed according GRADE system (Grading Recommendations Assessment Development Evaluations), compliance methodological manual for production clinical practice published by National Center Clinical Excellence, Quality, Safety Care, Institute Health. Results encompass recommendations on neuraxial blocks anticoagulated patients, dual guidance use peripheral nerve blocks, role sterile field preparation, post-procedural monitoring. Evidence from meta-analyses large-scale observational studies supported most recommendations, though limitations study heterogeneity noted. Conclusions These provide a structured framework clinicians enhance patient procedural efficacy regional anesthesia. Further research is encouraged address identified gaps, particularly subgroups novel techniques.

Language: Английский

Citations

0
A targeted erector spinae plane block for treatment of chronic postsurgical myofascial pain: A case report DOI Creative Commons
Pierfrancesco Fusco, Francesco Marrone, Gian M. PETRONI

et al.

JCA advances., Journal Year: 2025, Volume and Issue: unknown, P. 100128 - 100128

Published: May 1, 2025

Language: Английский

Citations

0
Fascial plane blocks: from microanatomy to clinical applications DOI
Carmelo Pirri,

Debora Emanuela Torre,

Carla Stecco

et al.

Current Opinion in Anaesthesiology, Journal Year: 2024, Volume and Issue: 37(5), P. 526 - 532

Published: Aug. 5, 2024

In the last 20 years, advancements in understanding of fasciae have significantly transformed anaesthesia and surgery. Fascial plane blocks (FPBs) gained popularity due to their validated safety profile relative ease. They are used various clinical settings for surgical nonsurgical indications. Growing evidence suggests a link between microscopic anatomy mechanism action. As result, knowledge these aspects is urgently needed better optimise pain management. The purpose this review summarise different deep/muscular fascia expand our performance FPBs.

Language: Английский

Citations

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