Expanding Role of the Erector Spinae Plane Block for Postoperative and Chronic Pain Management

AbstractPurpose of ReviewThe erector spinae plane block (ESPB), first described in 2016, offers the promise of becoming a safe, less invasive, and technically less demanding alternative to conventional thoracic regional anesthetic techniques including thoracic epidurals and traditional paravertebral blocks. Clinical and cadaveric studies suggest that ESPB acts on the ventral rami of spinal nerves in the paravertebral space via penetration of the intertransverse connection tissues and moreover achieves visceral analgesia via the rami communicantes and sympathetic chain.Recent FindingsThe block has garnered considerable appeal related to an inherently lower risk of neurovascular and pleural injury, low risk of local anesthetic systemic toxicity, and relative technical simplicity in comparison with epidural or paravertebral blockade. It has been utilized in the treatment of acute perioperative pain in a variety of clinical applications including breast, thoracic, and abdominal surgeries and trauma and may even offer some benefit in spine surgery.SummaryGiven the combination of its efficacy and decreased associated risk when performed for perioperative pain, use of ESPB should be further explored for the management of chronic pain. Current literature at this time is limited to case studies and series performed by select groups. Though it is important to consider ESPB for chronic pain, further studies are needed to evaluate the efficacy and safety of the ESPB in the management of ...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research

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In this study, we used an ex-vivo model to investigate the recovery pattern of both the train-of-four (TOF) ratio and first twitch tension of TOF (T1), and determined their relationship during recovery from rocuronium-induced neuromuscular blockade at various concentrations of sugammadex. Methods: Tissue specimens of the phrenic nerve-diaphragm were obtained in 60 adult Sprague-Dawley rats. Each specimen was immersed in an organ bath filled with Krebs buffer solution and stimulated with the TOF pattern using indirect supramaximal stimulation at 20-second intervals. After a 30-minute stabilization period, rocuronium loa...
Source: Korean Journal of Anesthesiology - Category: Anesthesiology Tags: Korean J Anesthesiol Source Type: research
Conclusions: This is a rare case of sugammadex-induced anaphylaxis that both sugammadex and sugammadex- rocuronium complex were confirmed as allergenic epitopes. PMID: 31619026 [PubMed - as supplied by publisher]
Source: Korean Journal of Anesthesiology - Category: Anesthesiology Tags: Korean J Anesthesiol Source Type: research
CONCLUSION: Patients with MFP present lower PPT than asymptomatic individuals. Muscle contraction was able to increase PPT in relation to relaxed muscles, but not in a statistically significant way. PMID: 31619659 [PubMed - in process]
Source: Stomatologija - Category: Dentistry Tags: Stomatologija Source Type: research
Authors: Sheldon RR, Weiss JB, Do WS, Forte DM, Carter PL, Eckert MJ, Sohn VY Abstract INTRODUCTION: Surgery is a known gateway to opioid use that may result in long-term morbidity. Given the paucity of evidence regarding the appropriate amount of postoperative opioid analgesia and variable prescribing education, we investigated prescribing habits before and after institution of a multimodal postoperative pain management protocol. MATERIALS AND METHODS: Laparoscopic appendectomies, laparoscopic cholecystectomies, inguinal hernia repairs, and umbilical hernia repairs performed at a tertiary military medical cent...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
ConclusionThis study showed that calcitonin could be helpful analgesic agent in different painful situations. Calcitonin can be considered an eligible treatment for acute pains related to vertebral fractures and a feasible alternative for the treatment of the acute and chronic neuropathic pains where other medications might fail.ResumoJustificativa e objetivosA calcitonina é um hormônio polipeptídico que regula o metabolismo do cálcio no organismo. Por muitos anos a calcitonina tem sido usada para manter e melhorar a densidade mineral óssea e reduzir a incidência de fraturas. Muitos ...
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research
“Once you learn the art of relaxation, everything happens spontaneously and effortlessly.” – Amma During hectic times, it’s tough to remember that relaxation is more than a luxury. In fact, humans need to relax to maintain balance in their lives. Work stress, family strife, and mounting responsibilities can exact a tremendous toll. Relaxing should be at the top of the list as a healthy coping measure and as a rewarding self-gift. Why do we so often neglect this healing self-care? Do you know the healthiest ways to relax your mind, body and soul? Perhaps the biggest obstacle to relaxing is that some ...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Mental Health and Wellness Mindfulness Self-Help Source Type: blogs
We examined the expression of TRPV1 in peripheral tissue and DRG neurons of CPIP model rats and we studied whether CPIP model could induce peripheral sensitization of TRPV1 channel and enhance DRG neuron excitability. Then we examined the therapeutic effects of locally applied TRPV1 specific antagonist AMG9810 on pain responses of CPIP model rats. Lastly, we explored the effects of AMG9810 on DRG neuron hyperexcitability and spinal glial activation induced by CPIP. Our results demonstrate that TRPV1 plays an important role in mediating the behavioral hypersensitivity of CPIP model rats via promoting peripheral nociceptor a...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusion: Characteristics and nonverbal behaviors of experimenters/clinicians contribute to the elicitation and modulation of pain, placebo, and nocebo effects.IntroductionThe present qualitative review investigated whether the characteristics or nonverbal behavior (NB) of the person administrating painful stimulation affected pain or placebo/nocebo effects in the research participant. The placebo effect is a psychobiological response that may occur following the application of active and inactive interventions (1). Applying an inactive medication paired with positive information about its analgesic effects can reduce pa...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Ryan R. Kelly1,2†, Lindsay T. McDonald1,2†, Nathaniel R. Jensen1,2, Sara J. Sidles1,2 and Amanda C. LaRue1,2* 1Research Services, Ralph H. Johnson VA Medical Center, Charleston, SC, United States 2Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States The significant biochemical and physiological effects of psychological stress are beginning to be recognized as exacerbating common diseases, including osteoporosis. This review discusses the current evidence for psychological stress-associated mental health disorders as risk factors for os...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
CONCLUSION: The results demonstrated that oral AQU-118 attenuates mechanical allodynia in both neuropathic pain models and with efficacies that mirror gabapentin at the 40 mg/kg dose used in the CCI-IoN model but without effect on basal sensitivity to mechanical stimulation/locomotive activity. These findings support a possible role for MMP-2/-9 in the etiology of neuropathic pain and also suggest that inhibition strategies represent a viable treatment option. PMID: 26244437 [PubMed - in process]
Source: Journal of Orofacial Pain - Category: ENT & OMF Tags: J Oral Facial Pain Headache Source Type: research
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