Costoclavicular brachial plexus block reduces hemidiaphragmatic paralysis more than supraclavicular brachial plexus block: retrospective, propensity score matched cohort study.

Costoclavicular brachial plexus block reduces hemidiaphragmatic paralysis more than supraclavicular brachial plexus block: retrospective, propensity score matched cohort study. Korean J Pain. 2020 Apr 01;33(2):144-152 Authors: Oh C, Noh C, Eom H, Lee S, Park S, Lee S, Shin YS, Ko Y, Chung W, Hong B Abstract Background: Hemidiaphragmatic paralysis, a frequent complication of the brachial plexus block performed above the clavicle, is rarely associated with an infraclavicular approach. The costoclavicular brachial plexus block is emerging as a promising infraclavicular approach. However, it may increase the risk of hemidiaphragmatic paralysis because the proximity to the phrenic nerve is greater than in the classical infraclavicular approach. Methods: This retrospective analysis compared the incidence of hemidiaphragmatic paralysis in patients undergoing costoclavicular and supraclavicular brachial plexus blocks. Of 315 patients who underwent brachial plexus block performed by a single anesthesiologist, 118 underwent costoclavicular, and 197 underwent supraclavicular brachial plexus block. Propensity score matching selected 118 pairs of patients. The primary outcome was the incidence of hemidiaphragmatic paralysis, defined as a postoperative elevation of the hemidiaphragm> 20 mm. Factors affecting the incidence of hemidiaphragmatic paralysis were also evaluated. Results: Hemidiaphragmatic paralysis was observed in three patients (2.5%) who underwe...
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research

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We reported 10 ASA I –II patients admitted for elective primary THA, receiving LIA during (5) and at the end of surgery (5). For the PENG block we used a single injection of 40 ml levobupivacaine 0.25% and dexamethasone 4 mg. For LIA, a mixture of 0.25% levobupivacaine, ketorolac, epinephrine, and morphine was injec ted into periarticular tissues. The pain intensity was evaluated with a numeric rating scale. All patients were fully satisfied and improvement in pain relief, symptoms, and functional activity was remarkable. Intraoperative blood losses ranged 100–600 ml. No intraoperative complicati...
Source: Journal of Anesthesia - Category: Anesthesiology Source Type: research
ConclusionsAnalgesic effects of continuous QLB were inferior to those of continuous FNB in patients undergoing THA under the current study condition.
Source: Journal of Anesthesia - Category: Anesthesiology Source Type: research
In this study, we evaluated the effects of perioperative dexmedetomidine infusion on postoperative analgesia in patients undergoing lateral thoracotomy for thoracic esophageal cancer. Methods: A total of 62 patients undergoing lateral thoracotomy for thoracic esophageal cancer were randomized to receive adjuvant therapy with either dexmedetomidine (0.5 μg/kg intravenous bolus injection for 10 min before induction of anesthesia, followed by continuous infusion of 0.2-0.4 μg/kg/h until the end of surgery, and 0.06 μg/kg/h for 5 days after surgery) or equal volumes of saline. Acute po...
Source: Pain Research and Management - Category: Anesthesiology Authors: Tags: Pain Res Manag Source Type: research
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Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
CONCLUSION: The study was limited by methodological flaws of included trials, overall relatively low numbers of patients and difficulty in contacting authors to clarify information and obtain raw data. However, this systematic review found no evidence to support the use of throat packs. This supports the proposal that there is no indication for the routine use of throat packs in ENT, maxillofacial and dental procedures. PMID: 32452470 [PubMed - as supplied by publisher]
Source: Rhinology - Category: ENT & OMF Tags: Rhinology Source Type: research
It is unclear whether regional anesthesia with infraclavicular nerve block or general anesthesia provides better postoperative analgesia after distal radial fracture fixation, especially when combined with reg...
Source: BMC Anesthesiology - Category: Anesthesiology Authors: Tags: Research article Source Type: research
As a fourth-year anesthesiology resident, I opened up my email eagerly, awaiting the results of the pain fellowship match. It was official; I was heading to a major academic program in New York City. First came excitement and relief immediately followed by a rush of all-encompassing fear. I had grown up in Arizona my entire […]Find jobs at  Careers by KevinMD.com.  Search thousands of physician, PA, NP, and CRNA jobs now.  Learn more.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Anesthesiology Source Type: blogs
Conditions:   Inguinal Hernia;   Analgesia;   Pain, Acute;   Pain, Chronic;   Pain, Neuropathic Interventions:   Procedure: local anesthetic and dexmedetomidine;   Procedure: local anesthetic and placebo Sponsor:   Aretaieion University Hospital Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Authors: Abdelhamid BM, Khaled D, Mansour M, Hassan MM Abstract BACKGROUND: Pain control in the morbidly obese has presented as an anesthetic challenge. The aim of this study is to assess the analgesic efficacy of ultrasound guided bilateral erector spinae block compared to bilateral subcostal transversus abdominis plane block. METHODS: Prospective randomized, double-blinded controlled study was conducted at Kasr Alainy Hospital on 66 patients scheduled for laparoscopic sleeve gastrectomy. Patients were randomly allocated into three groups and received general anesthesia: bilateral erector spinae block at the l...
Source: Minerva Anestesiologica - Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research
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Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
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