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Howe D, Hulgur M. A survey about the practice of regional anesthesia in Manchester and Lancashire. Pain Pract 2024; 24:404-408. [PMID: 37864326 DOI: 10.1111/papr.13311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
INTRODUCTION In 2021, the UK Royal College of Anaesthetists published an updated curriculum which outlines specific peripheral nerve blocks in which all anesthetists must achieve competency during their training. Little is known about which nerve blocks anesthetists in the UK can perform, nor which techniques they use to perform them. METHODS We conducted a survey of anesthetists in North West England to discover their experience in anesthesia, which nerve blocks they can perform, and which techniques they use to perform them. RESULTS Overall, 195 responses were received. Seventy-nine respondents (44%) preferred to perform nerve blocks on anesthetized patients, 70 (40%) preferred to perform nerve blocks with the patient awake with no sedation. One hundred and thirty-seven (85%) respondents used ultrasound only to localize nerves when performing a block. Among consultant respondents, 21 (19%) were unable to perform any upper limb block, and 48 (44%) were unable to perform any block of the thorax, both are a required competency of trainees under the 2021 curriculum. DISCUSSION Trainees may struggle to achieve the required competencies of the new curriculum given many consultants are also unable to perform them. A structured placement in regional anesthetic training in each stage of training could help improve the acquisition of skills and knowledge among trainees. Further studies are needed to assess the ability of anesthetists nationwide in regional anesthesia.
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Affiliation(s)
- David Howe
- Department of Anesthesia, Stepping Hill Hospital, Manchester, UK
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Naguib NN, Mohasseb TM, Ezzat AM, Hussien GZ, Khattab RS, Aboul Fetouh ES, Dobal NM. Ultrasound-guided versus conventional peribulbar anaesthesia in cataract surgery: A randomised controlled study. J Perioper Pract 2023; 33:302-307. [PMID: 36196650 DOI: 10.1177/17504589221117670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Blind ophthalmic anaesthetic techniques may have serious complications. AIM To assess the safety of ultrasound as a guide in ophthalmic blocks. METHODS Fifty adult patients undergoing cataract surgery under peribulbar block anaesthesia were randomly assigned to ultrasound-guided and conventional block groups. In the ultrasound-guided block group, a large amount of the standard ultrasound gel was applied to the closed eyelids. The globes were scanned in both sagittal and transverse planes. The patients were asked to look straight ahead with closed eyes without clenching the eyelids. The depth and gain were adjusted before performing the block. The primary outcome was the rate of complications. Secondary outcomes included the volume of injected anaesthetics and surgeon and patients' satisfaction. RESULTS The local anaesthetic volume used was not significantly different between the two groups (7.08 ± 1.66 and 6.72 ± 1.97ml). The block onset, time and quality were comparable in both groups. No complications were reported, and there were no significant differences regarding surgeons' or patients' satisfaction with either procedure. CONCLUSION The ultrasound-guided local ophthalmic block is as safe as the conventional method. Although its use was not superior to the conventional procedure, direct visualisation with ultrasound may be important to avoid vulnerable structures such as staphylomas.
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Affiliation(s)
- Nader N Naguib
- Department of Anesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Tariq M Mohasseb
- Department of Anesthesia, Memorial Institute of Ophthalmology, Giza, Egypt
| | - Azza M Ezzat
- Department of Anesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Gomaa Z Hussien
- Department of Anesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rehab S Khattab
- Department of Anesthesia, Research Institute of Ophthalmology, Giza, Egypt
| | | | - Nasser M Dobal
- Department of Anesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt
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3
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Noikham A, Tivirach W, Pongraweewan O, Suphathamwit A, Puangpunngam N, Jirativanont T. Popliteal sciatic nerve block for high-risk patients undergoing lower limb angioplasty: A prospective double-blinded randomized controlled trial. Medicine (Baltimore) 2023; 102:e33690. [PMID: 37145010 PMCID: PMC10158915 DOI: 10.1097/md.0000000000033690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/13/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND To assess the rate of conversion to general anesthesia, sedative and analgesic drug-sparing effects, and complications of popliteal sciatic nerve block (PSNB) compared with a sham block during lower limb angioplasty. METHODS A randomized, controlled, double-blinded trial of patients with chronic limb-threatening ischemia (CLTI) who receive PSNB with 0.25% levobupivacaine 20 mL compared with a sham block (control) during lower limb angioplasty. Pain scores, conversion rate to general anesthesia, amount of sedoanalgesia drug usage, complications, and satisfaction with the anesthesia technique by surgeons and patients were assessed. RESULTS Forty patients were enrolled in this study. Two of 20 (10%) control group patients were converted to general anesthesia, while none of the patients in the intervention group required general anesthesia (P = .487). Pain scores before PSNB did not differ between the groups (P = .771). After the block, pain scores in the block group were lower than those in the control group: 0 (0, 1.5) (median, interquartile range) and 2.5 (0.5, 3.5), respectively (P = .024). The analgesic effect persisted until immediately after the surgery (P = .035). There was no difference in pain scores at the 24-hours follow-up visit (P = .270). The total propofol and fentanyl dosage requirements, a number of patients who required propofol and fentanyl, side effects, and satisfaction were not different between the groups. No major complications were noted. CONCLUSIONS PSNB provided effective pain relief during and immediately after lower limb angioplasty, but did not statistically affect the rate of conversion to general anesthesia, sedoanalgesia drug usage, or complications.
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Affiliation(s)
- Alif Noikham
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wannapa Tivirach
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Orawan Pongraweewan
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Aphichat Suphathamwit
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nattawut Puangpunngam
- Division of Vascular Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tachawan Jirativanont
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Cai N, Wang G, Xu L, Zhou Y, Chong H, Zhao Y, Wang J, Yan W, Zhang B, Liu N. Examining the impact perceptual learning artificial-intelligence-based on the incidence of paresthesia when performing the ultrasound-guided popliteal sciatic block: simulation-based randomized study. BMC Anesthesiol 2022; 22:392. [PMID: 36526998 PMCID: PMC9756465 DOI: 10.1186/s12871-022-01937-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To explore the impact of artificial-intelligence perceptual learning when performing the ultrasound-guided popliteal sciatic block. METHODS This simulation-based randomized study enrolled residents who underwent ultrasound-guided sciatic nerve block training at the Department of Anesthesiology of Beijing Jishuitan Hospital between January 2022 and February 2022. Residents were randomly divided into a traditional teaching group and an AI teaching group. All residents attended the same nerve block theory courses, while those in the AI teaching group participated in training course using an AI-assisted nerve identification system based on a convolutional neural network instead of traditional training. RESULTS A total of 40 residents were included. The complication rates of paresthesia during puncture in the first month of clinical sciatic nerve block practice after training were significantly lower in the AI teaching group than in the traditional teaching group [11 (4.12%) vs. 36 (14.06%), P = 0.000093]. The rates of paresthesia/pain during injection were significantly lower in the AI teaching group than in the traditional teaching group [6 (2.25%) vs. 17 (6.64%), P = 0.025]. The Assessment Checklist for Ultrasound-Guided Regional Anesthesia (32 ± 3.8 vs. 29.4 ± 3.9, P = 0.001) and nerve block self-rating scores (7.53 ± 1.62 vs. 6.49 ± 1.85, P < 0.001) were significantly higher in the AI teaching group than in the traditional teaching group. There were no significant differences in the remaining indicators. CONCLUSION The inclusion of an AI-assisted nerve identification system based on convolutional neural network as part of the training program for ultrasound-guided sciatic nerve block via the popliteal approach may reduce the incidence of nerve paresthesia and this might be related to improved perceptual learning. CLINICAL TRIAL CHiCTR2200055115 , registered on 1/ January /2022.
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Affiliation(s)
- Nan Cai
- grid.414360.40000 0004 0605 7104Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, 100000 China
| | - Geng Wang
- grid.414360.40000 0004 0605 7104Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, 100000 China
| | - Li Xu
- grid.414360.40000 0004 0605 7104Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, 100000 China
| | - Yan Zhou
- grid.414360.40000 0004 0605 7104Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, 100000 China
| | - Hao Chong
- grid.414360.40000 0004 0605 7104Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, 100000 China
| | - Yaoping Zhao
- grid.414360.40000 0004 0605 7104Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, 100000 China
| | - Jingxian Wang
- grid.414360.40000 0004 0605 7104Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, 100000 China
| | - Wenjia Yan
- grid.414360.40000 0004 0605 7104Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, 100000 China
| | - Bo Zhang
- Beijing AMIT Healthcare, Beijing, 100000 China
| | - Nan Liu
- Beijing AMIT Healthcare, Beijing, 100000 China
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Naredo E, Rodriguez-Garcia SC, Terslev L, Martinoli C, Klauser A, Hartung W, Hammer HB, Cantisani V, Zaottini F, Vlad V, Uson J, Todorov P, Tesch C, Sudoł-Szopińska I, Simoni P, Serban O, Sconfienza LM, Sala-Blanch X, Plagou A, Picasso R, Özçakar L, Najm A, Möller I, Micu M, Mendoza-Cembranos D, Mandl P, Malattia C, Lenghel M, Kessler J, Iohom G, de la Fuente J, DʼAgostino MA, Collado P, Bueno A, Bong D, Alfageme F, Bilous D, Gutiu R, Marian A, Pelea M, Fodor D. The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound - Part II: Joint Pathologies, Pediatric Applications, and Guided Procedures. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2022; 43:252-273. [PMID: 34734404 DOI: 10.1055/a-1640-9183] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The second part of the Guidelines and Recommendations for Musculoskeletal Ultrasound (MSUS), produced under the auspices of EFSUMB, following the same methodology as for Part 1, provides information and recommendations on the use of this imaging modality for joint pathology, pediatric applications, and musculoskeletal ultrasound-guided procedures. Clinical application, practical points, limitations, and artifacts are described and discussed for every joint or procedure. The document is intended to guide clinical users in their daily practice.
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Affiliation(s)
- Esperanza Naredo
- Department of Rheumatology, Bone and Joint Research Unit. Hospital Universitario Fundación Jiménez Díaz, IIS Fundación Jiménez Díaz, and Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Lene Terslev
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Carlo Martinoli
- Department of Health Science - DISSAL, University of Genova, Italy
- UO Radiologia, IRCCS Policlinico San Martino, Genova, Italy
| | - Andrea Klauser
- Department of Radiology, Medical University Innsbruck, Section Head Rheumatology and Sports Imaging, Innsbruck, Austria
| | - Wolfgang Hartung
- Clinic for Rheumatology and Clinical Immunology, Asklepios Clinic, Bad Abbach, Germany
| | - Hilde B Hammer
- Department of Rheumatology, Diakonhjemmet Hospital and Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Vito Cantisani
- Department of Radiological, Oncological and Anatomo-pathological Sciences, "Sapienza" University, Rome, Italy
| | - Federico Zaottini
- Department of Health Science - DISSAL, University of Genova, Italy
- UO Radiologia, IRCCS Policlinico San Martino, Genova, Italy
| | - Violeta Vlad
- Sf. Maria Hospital, Rheumatology Department, Bucharest, Romania
| | - Jacqueline Uson
- Department of Rheumatology Hospital Universitario Móstoles, Universidad Rey Juan Carlos, Madrid, Spain
| | - Plamen Todorov
- Department of Internal Disease Propaedeutic and Clinical Rheumatology, Medical University of Plovdiv, Plovdiv, Bulgaria
| | | | - Iwona Sudoł-Szopińska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Paolo Simoni
- Paediatric Imaging Department, "Reine Fabiola" Children's University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Oana Serban
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milano Italy
- Department of Biomedical Sciences for Health, University of Milano, Milano, Italy
| | - Xavier Sala-Blanch
- Department of Anaesthesiology, Hospital Clinic, Department of Human Anatomy, Faculty of Medicine, University of Barcelona, Spain
| | - Athena Plagou
- Ultrasound Unit, Private Radiological Institution, Athens, Greece
| | - Riccardo Picasso
- Department of Health Science - DISSAL, University of Genova, Italy
- UO Radiologia, IRCCS Policlinico San Martino, Genova, Italy
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Aurelie Najm
- Institute of Infection, Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Ingrid Möller
- Instituto Poal de Reumatologia Barcelona, EULAR Working Group Anatomy for the Image, University of Barcelona, International University of Catalunya, Spain
| | - Mihaela Micu
- Rheumatology Division, 2nd Rehabilitation Department, Rehabilitation Clinical Hospital Cluj-Napoca, Romania
| | | | - Peter Mandl
- Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Clara Malattia
- UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI) University of Genoa, Genoa, Italy
| | - Manuela Lenghel
- Radiology Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Jens Kessler
- Department of Anaesthesiology, Division of Pain Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Gabriella Iohom
- Department of Anaesthesiology and Intensive Care Medicine, Cork University Hospital and University College Cork, Cork, Ireland
| | | | - Maria Antonietta DʼAgostino
- Istituto di Reumatologia Università Cattolica del Sacro Cuore, UOC Reumatologia, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Paz Collado
- Rheumatology Department, Transitional Care Clinic, Hospital Universitario Severo Ochoa, Madrid, Spain
| | - Angel Bueno
- Department of Musculoskeletal Radiology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - David Bong
- Instituto Poal de Reumatologia Barcelona, EULAR Working Group Anatomy for the Image, University of Barcelona, International University of Catalunya, Spain
| | - Fernando Alfageme
- Dermatology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Diana Bilous
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Roxana Gutiu
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Anamaria Marian
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Michael Pelea
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daniela Fodor
- 2nd Internal Medicine Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Cho NR, Cha JH, Park JJ, Kim YH, Ko DS. Reliability and Quality of YouTube Videos on Ultrasound-Guided Brachial Plexus Block: A Programmatical Review. Healthcare (Basel) 2021; 9:1083. [PMID: 34442220 PMCID: PMC8394722 DOI: 10.3390/healthcare9081083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/09/2021] [Accepted: 08/18/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Ultrasound-guided regional anesthesia has gained popularity over the last decade. This study aimed to assess whether YouTube videos sufficiently serve as an adjunctive tool for learning how to perform an ultrasound-guided brachial plexus block (BPB). METHODS All YouTube videos were classified, based on their sources, as either academic, manufacturer, educational, or individual videos. The metrics, accuracy, utility, reliability (using the Journal of American Medical Association Score benchmark criteria (JAMAS)), and educational quality (using the Global Quality Score (GQS) and Brachial Plexus Block Specific Quality Score (BSQS)) were validated. RESULTS Here, 175 videos were included. Academic (1.19 ± 0.62, mean ± standard deviation), manufacturer (1.17 ± 0.71), and educational videos (1.15 ± 0.76) had better JAMAS accuracy and reliability than individual videos (0.26 ± 0.67) (p < 0.001). Manufacturer (11.22 ± 1.63) and educational videos (10.33 ± 3.34) had a higher BSQS than individual videos (7.32 ± 4.20) (p < 0.001). All sources weakly addressed the equipment preparation and post-procedure questions after BSQS analysis. CONCLUSIONS The reliability and quality of ultrasound-guided BPB videos differ depending on their source. As YouTube is a useful educational platform for learners and teachers, global societies of regional anesthesiologists should set a standard for videos.
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Affiliation(s)
- Noo Ree Cho
- Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, Incheon 21565, Korea; (N.R.C.); (J.H.C.)
| | - Jeong Ho Cha
- Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, Incheon 21565, Korea; (N.R.C.); (J.H.C.)
| | - Jeong Jun Park
- Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13496, Korea;
| | - Yun Hak Kim
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan 50612, Korea;
| | - Dai Sik Ko
- Division of Vascular Surgery, Department of Surgery, Gachon University Gil Medical Center, Incheon 21565, Korea
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Bomberg H, Lorenzana D, Aguirre J, Eichenberger U. [Peripheral Regional Anaesthesia for Perioperative Analgesia]. PRAXIS 2021; 110:579-589. [PMID: 34344186 DOI: 10.1024/1661-8157/a003682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Peripheral Regional Anaesthesia for Perioperative Analgesia Abstract. Peripheral regional anaesthesia is the actual gold standard of opioid-sparing perioperative analgesia and is mainly used for surgery of the shoulder, arm and leg. Well-trained anaesthesiologists are the prerequisite for the correct individual risk-benefit assessment and the performance of the nerve blocks using a combination of ultrasound guidance and peripheral nerve stimulation (dual guidance). The postoperative care of the patients requires trained staff.
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Affiliation(s)
- Hagen Bomberg
- Abteilung für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinik Balgrist, Zürich
| | - David Lorenzana
- Abteilung für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinik Balgrist, Zürich
| | - José Aguirre
- Abteilung für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinik Balgrist, Zürich
| | - Urs Eichenberger
- Abteilung für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinik Balgrist, Zürich
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Vallapureddy SK, Fultambkar G, Rajeswar Rao V, Kukreja V, Gurram R, Nair A. Comparison between Single- and Double-Injection Technique for Ultrasound-Guided Supraclavicular Block: A Randomized Controlled Study. DUBAI MEDICAL JOURNAL 2021. [DOI: 10.1159/000517357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
<b><i>Background:</i></b> The supraclavicular approach to brachial plexus block is a commonly employed regional anesthesia technique for providing surgical anesthesia and postoperative analgesia for patients undergoing upper limb fractures. With ultrasound (US) guidance, the success rate of the block is increased, and complications like pneumothorax and vascular puncture are minimized. The block can be performed using single injection at the corner pocket or double injection, that is, half of the drug at the corner pocket and the remaining half at the cluster of brachial plexus divisions. <b><i>Methods:</i></b> After institutional ethics committee approval, we randomized 40 patients scheduled with fractures for elective upper extremity surgery under US-guided supraclavicular brachial plexus block. Twenty patients received 30 mL of local anesthetic at the corner pocket (group SI), and 20 patients received 30 mL of local anesthetic using the dual-injection technique in divided doses (group DI). Demographic data, time to block performance, time to sensory and motor block, total anesthesia-related time (TART), block success, and failure were compared between both groups. <b><i>Results:</i></b> The demographic data were comparable between both groups. The DI group had a significantly faster onset than the SI group (<i>p</i> = 0.0172). There was a statistically significant lesser performance time in group SI than in group DI (<i>p</i> < 0.034). The sensory and motor block achieved was comparable between both groups. <b><i>Conclusion:</i></b> The success rates in both the SI and DI techniques are comparable. The DI technique results in a faster onset and hence a shorter TART; however, it may not be clinically relevant.
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Awake Regional Anesthesia for Upper Limb Orthopedic Surgery During the COVID-19 Pandemic. Tech Orthop 2021. [PMCID: PMC8868011 DOI: 10.1097/bto.0000000000000562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19 illness, is mainly transmitted because of close contact with respiratory droplets and airborne particles. Aerosol-generating procedures during general anesthesia can increase the risk of COVID-19 transmission. An effective alternative to general anesthesia for upper limb orthopedic surgery is regional anesthesia (RA) using brachial plexus block. Materials and Methods: Seventy-eight patients who received a brachial plexus block for upper limb trauma and elective operations before and during the COVID-19 pandemic, from 2017 to 2020, were included in this study. A protocol was devised for patient positioning, draping and equipment positioning for each location group—shoulder and upper arm; elbow and forearm; and distal extremities. Results: RA was effective for upper limb surgery in 77 of 78 (98.7%) patients. Sixty-five patients (83.3%) were discharged the same day, with the average time from leaving the operating theater to discharge from hospital of 2.8 hours. No postoperative complications were recorded, and no patient nor staff member contracted COVID-19 infection 2 weeks after the operation. Conclusion: We demonstrate the efficacy of awake RA for upper limb orthopedic procedures. We share our tips and tricks for implementing this into clinical practice and discuss the specific advantages of RA in the context of the COVID-19 global pandemic.
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Li H, Cho DH, Tokhner V. Unique Considerations for Complete Surgical Analgesia for Below-the-Knee Amputations. Cureus 2021; 13:e14224. [PMID: 33948413 PMCID: PMC8086737 DOI: 10.7759/cureus.14224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Recent cadaver studies have suggested that posterior femoral cutaneous nerve (PFCN) may contribute to the sensory innervation of the posterior lower leg. Whether this is clinically relevant may be revealed in patients who underwent below-the-knee amputation (BKA) with monitored anesthesia care (MAC) and peripheral nerve blocks. We performed femoral and sciatic nerve blocks for a 55-year-old male patient who underwent BKA and subsequent formalization surgeries as the main surgical analgesia while providing MAC in the operating room. In both cases, the patient could not tolerate surgical incisions in the posteromedial aspect of the lower leg, despite reporting no pain in other areas of the lower leg with surgical stimulation. There may exist a small population of patients in which PFCN makes significant contribution to the sensory innervation of the posterior lower leg. For these patients, the combination of femoral and sciatic nerve blocks may not be adequate in providing surgical analgesia for BKA and related procedures.
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Affiliation(s)
- He Li
- Department of Anesthesiology, Harbor-University of California, Los Angeles Medical Center, Torrance, USA
| | - David H Cho
- Department of Anesthesiology, Harbor-University of California, Los Angeles Medical Center, Torrance, USA
| | - Vadim Tokhner
- Department of Anesthesiology, Harbor-University of California, Los Angeles Medical Center, Torrance, USA
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11
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The Application of Fascia Iliaca Compartment Block for Acute Pain Control of Hip Fracture and Surgery. Curr Pain Headache Rep 2021; 25:22. [PMID: 33694008 DOI: 10.1007/s11916-021-00940-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW Over 300,000 patients are hospitalized annually following hip fractures in the USA. Many patients experienced inadequate analgesia. We will review the perioperative effects of the fascia iliaca compartment block (FICB) in hip fracture patients. RECENT FINDINGS FICB by injecting local anesthetics beneath the fascia iliaca results in significant pain relief in hip fractures. Neuropathies and vascular injuries are almost unlikely. Single-shot FICB is faster to place, yet providing about 8 h of analgesia when bupivacaine is used. Continuous FICB provides prolonged titratable analgesia, improved patient satisfaction, and leads to faster hospital discharge. FICB reduces opioid consumption, decreases morbidity and mortality, reduces hospital stay, reduces delirium, and improves satisfaction. FICB should form part of a multimodal analgesic regime, in the context of a multidisciplinary approach to the management of hip fracture patients. More clinical investigations are needed to validate the long-term outcome benefits of FICB in hip fracture patients.
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Ultrasound Guidance and Nerve Stimulation Combined Versus Nerve Stimulation alone for Lumbar Plexus Block: A Randomized Controlled Trial. Curr Med Sci 2021; 40:1182-1190. [PMID: 33428148 DOI: 10.1007/s11596-020-2307-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 07/07/2020] [Indexed: 10/22/2022]
Abstract
A nerve stimulation-guided lumbar plexus block is a well-established technique. It is not clear whether ultrasound guidance has additional value for this deep block technique. This study aimed to examine whether ultrasound guidance using a paramedian transverse scan through the intertransverse space (PMTS-ITS) approach in combination with nerve stimulation reduces the onset time of a complete sensory block. Forty-four patients who were scheduled to undergo arthroscopic knee surgery with an ultrasound visibility score (UVS) of ≥10 for the lumbar plexus were enrolled and randomly allocated to the ultrasound guidance with nerve stimulation group (group U-N) or nerve stimulation group (group N) in this prospective, randomized, parallel-group, active-controlled study. The primary outcome was the onset time of a complete sensory block. The results showed that the onset time of a complete sensory block to pinprick and cold was 10 (10-40) min and 10 (10-40) min in group U-N, respectively, and 30 (10-40) min and 20 (10-40) min in group N (P=0.005, P=0.004), respectively. The performance time was 658±87 s in group U-N and 528±97 s in group N (P<0.001). There was no (0%) patient who required 5 or more needle passes in group U-N and 6 (27.3%) in group N (P=0.028). The block failure rate was 9.1% in group U-N and 31.8% in group N (P>0.05). In conclusion, ultrasound guidance using the PMTS-ITS approach in combination with nerve stimulation led to a faster onset of a complete sensory block than nerve stimulation alone for a lumbar plexus block in patients with a UVS ≥10. Ultrasound guidance with nerve stimulation significantly decreased the number of patients who required 5 or more needle passes.
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Ultrasound-guided diagnostic deep peroneal nerve blocks prior to potential neurectomy: a retrospective review. Skeletal Radiol 2020; 49:1313-1321. [PMID: 32296877 DOI: 10.1007/s00256-020-03443-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 04/01/2020] [Accepted: 04/05/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe our technical and preliminary clinical experience with ultrasound-guided diagnostic deep peroneal nerve (DPN) blocks for patients considering deep peroneal neurectomy. MATERIALS AND METHODS Retrospective analysis of ultrasound-guided diagnostic DPN blocks performed in the anterior lower leg in patients pursuing deep peroneal neurectomy for foot pain not directly attributable to the DPN. Patient age, sex, foot laterality, diagnosis, nerve block complications, location of the DPN with respect to vascular landmarks in the lower leg, pain relief from nerve block, and pain relief from neurectomy (if performed) were recorded. RESULTS Twenty-six DPN blocks were performed for 25 feet, of which a majority had pain attributable to midfoot osteoarthritis (22/25). Variable DPN locations with respect to vascular landmarks in the lower leg were observed, including lateral to the anterior tibial artery (12/25), anterior to the artery (5/25), medial to the artery (3/25), lateral to the lateral paired vein (4/25), and 1-cm lateral to the artery (1/25). After DPN blocks, patients reported pain relief in 22/25 feet. Of the eleven patients who proceeded to have a deep peroneal neurectomy, ten reported improved foot pain. CONCLUSION Diagnostic deep peroneal nerve blocks for patients considering deep peroneal neurectomy for denervation therapy should be performed in the anterior lower leg where the anterior tibial vessels serve as anatomic landmarks. Those who perform DPN blocks with ultrasound guidance should be aware of variable DPN position with respect to the vascular landmarks.
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Sidhu NS, Chuan A, Mitchell CH. Recommendations and resources for regional anaesthesia Fellowships in Australia and New Zealand. Anaesth Intensive Care 2019; 47:452-460. [PMID: 31438720 DOI: 10.1177/0310057x19861113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Regional anaesthesia is a fundamental aspect of anaesthesia practice. Structured Fellowships in regional anaesthesia facilitate the development of expert clinicians, scholars and future leaders. The Australian and New Zealand College of Anaesthetists accredits training sites for the final year of Fellowship training but does not outline specific guidance for subspecialty training. Based on evidence from a systematic literature review and best-practice medical education principles, the ideal structure for a regional anaesthesia Fellowship programme in Australia and New Zealand is outlined in four categories: (a) structure and duration of training; (b) educational aspects; (c) institutional organization; (d) evaluation and improvement. Departments may use this resource to help design, implement and improve their Fellowship programmes while trainees may employ it as a reference to achieve their learning goals at any training stage. Continuing professional education plays a central role in achieving and maintaining mastery of regional anaesthesia competencies.
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Affiliation(s)
- Navdeep S Sidhu
- Department of Anaesthesia and Perioperative Medicine, North Shore Hospital, Auckland, New Zealand
- Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
| | - Alwin Chuan
- South West Sydney Clinical School, University of New South Wales, Sydney, Australia
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Abstract
OBJECTIVES Education in regional anaesthesia covers several complex and diverse areas, from theoretical aspects to procedural skills, professional behaviours, simulation, curriculum design and assessment. The objectives of this study were to summarise these topics and to prioritise these topics in order of research importance. DESIGN Electronic structured Delphi questionnaire over three rounds. SETTING International. PARTICIPANTS 38 experts in regional anaesthesia education and training, identified through the American Society of Regional Anesthesia Education Special Interest Group research collaboration. RESULTS 82 topics were identified and ranked in order of prioritisation. Topics were categorised into themes of simulation, curriculum, knowledge translation, assessment of skills, research methodology, equipment and motor skills. Thirteen topics were ranked as essential research priority, with four topics each on simulation and curriculum, three topics on knowledge translation, and one topic each on methodology and assessment. CONCLUSIONS Researchers and educators can use these identified topics to assist in planning and structuring their research and training in regional anaesthesia education.
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Affiliation(s)
- Alwin Chuan
- Faculty of Medicine, University of New South Wales, Liverpool, New South Wales, Australia
- Department of Anaesthesia, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Reva Ramlogan
- University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Zhang XH, Li YJ, He WQ, Yang CY, Gu JT, Lu KZ, Yi B. Combined ultrasound and nerve stimulator-guided deep nerve block may decrease the rate of local anesthetics systemic toxicity: a randomized clinical trial. BMC Anesthesiol 2019; 19:103. [PMID: 31185905 PMCID: PMC6560859 DOI: 10.1186/s12871-019-0750-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 05/08/2019] [Indexed: 02/03/2023] Open
Abstract
Background Ultrasound guidance might decrease the incidence of local anesthetics systemic toxicity (LAST) for many peripheral nerve blocks compared with nerve stimulator guidance. However, it remains uncertain whether ultrasound guidance is superior to nerve stimulator guidance for deep nerve block of the lower extremity. This study was designed to investigate whether deep nerve block with ultrasound guidance would decrease the incidence of LAST compared with that with nerve stimulator guidance, and to identify associated risk factors of LAST. Methods Three hundred patients undergoing elective lower limb surgery and desiring lumbar plexus blocks (LPBs) and sciatic nerve blocks (SNBs) were enrolled in this study. The patients were randomly assigned to receive LPBs and SNBs with ultrasound guidance (group U), nerve stimulator guidance (group N) or dual guidance (group M). The primary outcome was the incidence of LAST. The secondary outcomes were the number of needle redirection, motor and sensory block onset and nerve distribution restoration time, as well as associated risk factors. Results There were 18 patients with LAST, including 12 in group U, 4 in group N and 2 in group M. By multiple comparisons among the three groups, we found that the incidence of LAST in group U (12%) was significantly higher than that in group N (4%)(P = 0.037) and group M(2%)(P = 0.006). The OR of LAST with hepatitis B (HBV) infection and the female sex was 3.352 (95% CI,1.233–9.108, P = 0.013) and 9.488 (95% CI,2.142–42.093, P = 0.0004), respectively. Conclusions Ultrasound guidance, HBV infection and the female sex were risk factors of LAST with LPBs and SNBs. For patients infected with HBV or female patients receiving LPBs and SNBs, we recommended that combined ultrasound and nerve stimulator guidance should be used to improve the safety. Trial registration This study was approved by the Ethical Committee of the First Affiliated Hospital of Army Medical University. The protocol was registered prospectively with the Chinese Clinical Trial Registry (ChiCTR-IOR-16008099) on March 15, 2016.
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Affiliation(s)
- Xu-Hao Zhang
- Department of Anesthesia, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Yu-Jie Li
- Department of Anesthesia, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Wen-Quan He
- Department of Anesthesia, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Chun-Yong Yang
- Department of Anesthesia, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Jian-Teng Gu
- Department of Anesthesia, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Kai-Zhi Lu
- Department of Anesthesia, Southwest Hospital, Army Medical University, Chongqing, 400038, China
| | - Bin Yi
- Department of Anesthesia, Southwest Hospital, Army Medical University, Chongqing, 400038, China.
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Kahn RL, Ellis SJ, Cheng J, Curren J, Fields KG, Roberts MM, YaDeau JT. The Incidence of Complications Is Low Following Foot and Ankle Surgery for Which Peripheral Nerve Blocks Are Used for Postoperative Pain Management. HSS J 2018; 14:134-142. [PMID: 29983654 PMCID: PMC6031533 DOI: 10.1007/s11420-017-9588-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 10/09/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The incidence of neurologic complications from foot and ankle surgery utilizing regional anesthesia is not well established. QUESTIONS/PURPOSES The purpose of this study was to prospectively determine the incidence of neurologic and peripheral nerve block (PNB) site complications on a busy foot and ankle service that utilizes ankle blocks (ABs) and popliteal blocks (POPs). PATIENTS AND METHODS This prospective observational study included patients undergoing foot and ankle surgery with ABs or POPs. Block choice was determined by surgeon's preference. Patients were assessed for complications during postoperative visits at 2, 6, and 12 weeks. The relation of each complication to the block was scored by a surgeon and anesthesiologist. RESULTS From October 2012 to October 2014, 2516 patients underwent 2704 surgeries. There were 195 complications (7.2%) considered neurologic or at the PNB site. The incidence of serious complications was 0.7%. A higher complication rate was reported for POPs (8.8%) than for ABs (2.5%). However, when analysis was limited to forefoot surgery, this difference was not significant. Dexamethasone use was associated with increased complications for POPs. Only 5 of the 195 total complications, and 2 of 20 serious complications, were deemed to have been likely caused by the block by both the surgeon and anesthesiologist reviewer. CONCLUSIONS The incidences of neurologic or block-related complications and serious complications were 7.2 and 0.7%, respectively, most without a clear surgical vs. nerve block etiology. The higher complication rate for POPs using perineural dexamethasone should be interpreted cautiously in light of the lack of randomization and likely confounders.
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Affiliation(s)
- Richard L. Kahn
- 0000 0001 2285 8823grid.239915.5Department of Anesthesiology, Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 USA
| | - Scott J. Ellis
- 0000 0001 2285 8823grid.239915.5Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY USA
| | - Jennifer Cheng
- 0000 0001 2285 8823grid.239915.5Department of Anesthesiology, Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 USA
| | - Jodie Curren
- 0000 0001 2285 8823grid.239915.5Department of Anesthesiology, Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 USA
| | - Kara G. Fields
- 0000 0001 2285 8823grid.239915.5Healthcare Research Institute, Hospital for Special Surgery, New York, NY USA
| | - Matthew M. Roberts
- 0000 0001 2285 8823grid.239915.5Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY USA
| | - Jacques T. YaDeau
- 0000 0001 2285 8823grid.239915.5Department of Anesthesiology, Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 USA
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Abstract
The use of point-of-care ultrasound in trauma is widespread. Focused Assessment with Sonography for Trauma examination is a prototypical bedside examination used by the treating provider to quickly determine need for intervention and appropriate patient disposition. The role of bedside ultrasound in trauma, however, has expanded beyond the Focused Assessment with Sonography for Trauma examination. Advancements in diagnostics include contrast-enhanced ultrasound, thoracic, and musculoskeletal applications. Ultrasound is also an important tool for trauma providers for procedural guidance including vascular access and regional anesthesia. Its portability, affordability, and versatility have made ultrasound an invaluable tool in trauma management in resource-limited settings. In this review, we discuss these applications and the supporting evidence for point-of-care ultrasound in trauma.
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Affiliation(s)
- Timothy Gleeson
- Department of Emergency Medicine, University of Massachusetts, University of Massachusetts Medical School, Worcester, MA.
| | - David Blehar
- Department of Emergency Medicine, University of Massachusetts, University of Massachusetts Medical School, Worcester, MA
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Ketelaars R, Stollman JT, van Eeten E, Eikendal T, Bruhn J, van Geffen GJ. Emergency physician-performed ultrasound-guided nerve blocks in proximal femoral fractures provide safe and effective pain relief: a prospective observational study in The Netherlands. Int J Emerg Med 2018; 11:12. [PMID: 29500558 PMCID: PMC5834411 DOI: 10.1186/s12245-018-0173-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 02/15/2018] [Indexed: 12/26/2022] Open
Abstract
Background The treatment of acute pain in the emergency department is not always optimal. Peripheral nerve blocks using “blind” or nerve stimulator techniques have substantial disadvantages. Ultrasound-guided regional anesthesia may provide quick, safe, and effective pain relief in patients with proximal femoral fractures with severe pain. However, no evidence exists on emergency physician-performed ultrasound-guided regional anesthesia in these patients in Dutch emergency departments. We hypothesized that emergency physicians can be effectively trained to safely perform and implement ultrasound-guided femoral nerve blocks, resulting in effective pain relief in patients with proximal femoral fractures. Methods In this prospective observational study, emergency physicians were trained by expert anesthesiologists to perform ultrasound-guided femoral nerve blocks during a single-day course. Femoral nerve blocks were performed on patients with proximal femoral fractures. A system of direct supervision by skilled anesthesiologists and residents was put in place. Results A total of 64 femoral nerve blocks were performed. After 30 min, blocks were effective in 69% of patients, and after 60 min, in 83.3%. The mean reduction in pain scores after 30 and 60 min was 3.84 and 4.77, respectively (both p < 0.001). Patients reported a mean satisfaction of 8.42 (1 to 10 scale). No adverse events occurred. Conclusions Ultrasound-guided femoral nerve block is an effective, safe, and easy to learn (single-day course) procedure for emergency physicians to implement and perform in the emergency department. Patient satisfaction was high.
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Affiliation(s)
- Rein Ketelaars
- Department of Anesthesiology, Pain and Palliative medicine, Radboud university medical center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
| | - Joram T Stollman
- Emergency Department, Radboud university medical center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.,Emergency Department, Slingeland Hospital, Kruisbergseweg 25, 7009 BL, Doetinchem, The Netherlands
| | - Evelien van Eeten
- Emergency Department, Radboud university medical center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Ties Eikendal
- Emergency Department, Radboud university medical center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Jörgen Bruhn
- Department of Anesthesiology, Pain and Palliative medicine, Radboud university medical center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Geert-Jan van Geffen
- Department of Anesthesiology, Pain and Palliative medicine, Radboud university medical center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands
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From visualizing nerves to visualizing blocks: a natural trend? Can J Anaesth 2017; 64:1098-1100. [DOI: 10.1007/s12630-017-0955-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 08/16/2017] [Indexed: 10/19/2022] Open
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Affiliation(s)
- Jae Hang Shim
- Department of Anesthesiology and Pain Medicine, Hanyang University School of Medicine, Seoul, Korea
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Scholten HJ, Pourtaherian A, Mihajlovic N, Korsten HHM, A. Bouwman R. Improving needle tip identification during ultrasound-guided procedures in anaesthetic practice. Anaesthesia 2017; 72:889-904. [DOI: 10.1111/anae.13921] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2017] [Indexed: 12/16/2022]
Affiliation(s)
- H. J. Scholten
- Department of Anaesthesiology; Intensive Care and Pain Medicine; Catharina Hospital; Eindhoven the Netherlands
| | - A. Pourtaherian
- Department of Electrical Engineering; Eindhoven University of Technology; Eindhoven the Netherlands
| | | | - H. H. M. Korsten
- Department of Anaesthesiology; Intensive Care and Pain Medicine; Catharina Hospital; Eindhoven the Netherlands
- Department of Electrical Engineering; Eindhoven University of Technology; Eindhoven the Netherlands
| | - R. A. Bouwman
- Department of Anaesthesiology; Intensive Care and Pain Medicine; Catharina Hospital; Eindhoven the Netherlands
- Department of Electrical Engineering; Eindhoven University of Technology; Eindhoven the Netherlands
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Point-of-Care Ultrasound for the Regional Anesthesiologist and Pain Specialist. Reg Anesth Pain Med 2017; 42:281-282. [DOI: 10.1097/aap.0000000000000570] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fanelli A, Ghisi D, Melotti RM. An update around the evidence base for the lower extremity ultrasound regional block technique. F1000Res 2016; 5. [PMID: 26918177 PMCID: PMC4755408 DOI: 10.12688/f1000research.7199.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2016] [Indexed: 11/20/2022] Open
Abstract
Ultrasound guidance currently represents the gold standard for regional anesthesia. In particular for lower extremity blocks, despite the heterogeneity and the lack of large randomized controlled trials, current literature shows a modest improvement in block onset and quality compared with other localization techniques. This review aims to present the most recent findings on the application of ultrasound guidance for each single lower extremity approach.
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Affiliation(s)
- Andrea Fanelli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Daniela Ghisi
- Department of Anaesthesia and Postoperative Intensive Care, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Rita Maria Melotti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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The Second American Society of Regional Anesthesia and Pain Medicine Evidence-Based Medicine Assessment of Ultrasound-Guided Regional Anesthesia. Reg Anesth Pain Med 2016; 41:181-94. [DOI: 10.1097/aap.0000000000000331] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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