Current Opinion in Anaesthesiology, Год журнала: 2024, Номер 37(5), С. 520 - 525
Опубликована: Июнь 12, 2024
Pharmacokinetics of local anesthetics are one the main determinants success and safety regional anesthesia comprise systemic distribution phases. This review aims to summarize latest research findings on this topic in context various blocks performed for different surgeries patient populations.
Язык: Английский
Regional Anesthesia & Pain Medicine, Год журнала: 2025, Номер unknown, С. rapm - 106044
Опубликована: Янв. 21, 2025
Background Intrathecal morphine is the standard for post-cesarean analgesia but often causes pruritus and may be unavailable in resource-limited settings. This study assessed whether a combination of bilateral transversus abdominis plane (TAP) block intrathecal fentanyl provides non-inferior compared with following cesarean delivery within multimodal context. Methods Eighty mothers were randomized to receive either 10 µg TAP using 15 mL 0.375% ropivacaine per side (TF group) or 75 saline sham (M group). All patients received analgesia. Primary outcome was pain score movement at 24 hours postoperatively, non-inferiority margin 1 on numeric rating scale. Secondary outcomes included opioid consumption, time first opioid, pruritus, nausea/vomiting, patient satisfaction, neonatal outcomes. Results The mean 5.4 TF group 4.8 M (mean difference (95% CI), 0.6 (−0.3 1.5), p=0.202), upper 95% CI exceeding margin. Postoperative consumption higher (median (IQR), 585 (390–745) vs 140 (55–405) µg; p<0.001). Pruritus more frequent (60% 10%; Conclusions Bilateral not However, associated incidence suggesting as suitable alternative when reducing priority. Trial registration number NCT04824274 .
Язык: Английский
Процитировано
0
British Journal of Anaesthesia, Год журнала: 2025, Номер unknown
Опубликована: Янв. 1, 2025
Язык: Английский
Процитировано
0
Cureus, Год журнала: 2024, Номер unknown
Опубликована: Окт. 23, 2024
Transversus thoracis muscle plane block (TTPB) and parasternal intercostal nerve (PICNB) inhibit the anterior branches of nerves potentially provide adequate analgesia after cardiac surgery. This study aimed to compare these two blocks for a reduction in postoperative opioid consumption
Язык: Английский
Процитировано
2
Best Practice & Research Clinical Anaesthesiology, Год журнала: 2024, Номер 38(1), С. 74 - 80
Опубликована: Март 1, 2024
Язык: Английский
Процитировано
2
Minerva Anestesiologica, Год журнала: 2024, Номер 90(6)
Опубликована: Июнь 1, 2024
Язык: Английский
Процитировано
1
Current Opinion in Anaesthesiology, Год журнала: 2024, Номер 37(5), С. 541 - 546
Опубликована: Июнь 24, 2024
Purpose of review Regional anaesthesia is increasingly prominent within anaesthesia, offering alternative analgesic options amidst concerns over opioid-based analgesia. Since Halsted's initial description, the field has burgeoned, with ultrasound visualization revolutionizing local anaesthetic spread assessment, leading to development numerous novel techniques. The benefits regional have gained increasing evidence support their application, changes training curricula. Consequently, at a defining moment, embracing core skills for general anaesthesiologist, whilst also continuing advancement specialty. Recent findings priority setting projects focussed attention on key aspects delivery, including pain management, conduct and efficacy, education, technological innovation. Developments in our current understanding anatomy pharmacology, combined strategies optimizing maximizing efficacy techniques, minimizing complications, enhancing outcomes are explored. In addition, advancements education methodologies integration progress technologies will be reviewed. Summary This highlights recent scientific advances both single-shot continuous peripheral By synthesizing these developments, this offers valuable insights into evolving landscape aiming improve clinical practice patient care.
Язык: Английский
Процитировано
1
British Journal of Anaesthesia, Год журнала: 2024, Номер 132(5), С. 1166 - 1167
Опубликована: Фев. 26, 2024
Editor—We read with interest the review article on truncal fascial plane blocks by Ní Eochagáin and colleagues,1Ní A. Carolan S. Buggy D.J. Regional anaesthesia for acute postoperative pain recovery: a narrative review.Br J Anaesth. 2024; 132: 1133-1145Abstract Full Text PDF Scopus (3) Google Scholar wish to provide several comments. Regarding erector spinae block (ESPB), authors state that 'The reported incidence of pneumothorax related ESP varies may be lower than PVB'.1Ní However, was 2.6% paravertebral (PVB) based systematic analysing 13 studies ultrasound-guided blocks,2Leong R.W. Tan E.S.J. Wong S.N. K.H. Liu C.W. Efficacy analgesia in breast surgery: meta-analysis.Anaesthesia. 2021; 76: 404-413Crossref PubMed (87) no other including ESPB,2Leong thus variation. Pneumothorax has not been ESPB, as only case report published retracted because research misconduct, there questionable causal relationship. Although is possibility pneumothorax, it should occur rarely more likely patients receiving positive pressure ventilation.3Hamilton D.L. never complication block.J Clin Anesth. 2023; 90111230Crossref (1) serratus anterior (SAPB), 'There are relatively few investigating spread injectate anatomical basis mechanism action SAPB'.1Ní multiple cadaver studies,4Daga V. Narayanan M.K. Dedhia J.D. Gaur P. Crick H. Cadaveric feasibility study use ultrasound contrast assess muscle plane.Saudi 2016; 10: 198-201Crossref (25) Scholar, 5Varghese L. Johnson M. Barbeau Rakesh S.V. Magsaysay Ganapathy The (SAP) block: an investigation regional anesthetic using injection.FASEB J. 30 (560.1-560.1. https://doi.org/10.1096/fasebj.30.1_supplement.560.1)Crossref 6Biswas Castanov Li Z. et al.Serratus cadaveric evaluate optimal spread.Reg Anesth Pain Med. 2018; 43: 854-858PubMed 7Kunigo T. Murouchi Yamamoto al.Spread study.JA Rep. 4: 10Crossref addition mentioned authors.1Ní restricted anterolateral aspect, cephalo-caudal depends volume. Axillary consistent higher-level blocks.4Daga Clinical show cranio-caudal wider increasing volumes, whereas analgesic effect similar 20 ml or above.8Kunigo Yamakage Injection volume block.Reg 2017; 42: 737-740Crossref (59) Scholar,9Shi K. Chen Y. al.Comparison different volumes ropivacaine deep undergoing prospective randomized double-blinded trial.Ann Palliat 6104-6111Crossref (5) Thus, our understanding SAPB rather clear. Lastly, 'Limited evidence exists such retrolaminar transversus thoracic oncological surgery'.1Ní limited could attributable acceptance ESPB provides promising results. Because (deep parasternal) supplement mastectomy,10Zhao Jin W. Pan Feng Fu D. Yao Ultrasound-guided plane-pectoral nerve after modified radical mastectomy: comparison block.Perioper Med (Lond). 2022; 11: 39Crossref sparse, commonly applied sternotomy pain. declare they have conflicts interest. reviewBritish Journal AnaesthesiaVol. 132Issue 5PreviewSignificant remains prevalent among who undergo surgery associated increased morbidity, prolonged patient recovery, healthcare costs. provision high-quality important component care, particularly within enhanced recovery programmes. anaesthetic techniques become increasingly multimodal regimens widespread adoption ultrasonography facilitated development novel blocks. Full-Text recovery. Response Br Anaesth 1166–7British 5PreviewEditor—We thank Sethuraman Natarajan1 their comments regarding recent recovery.2 We very much appreciate them highlighting further inclusion this topic. body literature broad topic vast, although we considered references mentioned, ultimately included those which most methodologically robust persuasive.
Язык: Английский
Процитировано
0
British Journal of Anaesthesia, Год журнала: 2024, Номер 132(5), С. 1168 - 1168
Опубликована: Март 5, 2024
Язык: Английский
Процитировано
0
British Journal of Anaesthesia, Год журнала: 2024, Номер 132(5), С. 1012 - 1015
Опубликована: Март 5, 2024
Язык: Английский
Процитировано
0
Current Opinion in Anaesthesiology, Год журнала: 2024, Номер 37(5), С. 520 - 525
Опубликована: Июнь 12, 2024
Pharmacokinetics of local anesthetics are one the main determinants success and safety regional anesthesia comprise systemic distribution phases. This review aims to summarize latest research findings on this topic in context various blocks performed for different surgeries patient populations.
Язык: Английский
Процитировано
0