1
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Kessler P. [Old and New Regional Anesthesia Procedures Under Review - Abdomen to Toe]. Anasthesiol Intensivmed Notfallmed Schmerzther 2024; 59:159-179. [PMID: 38513641 DOI: 10.1055/a-2065-7660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Ultrasound (US) technology has significantly expanded the spectrum of regional anesthesiological procedures in recent years. Abdominal wall blocks are becoming an increasingly integral part of a multimodal postoperative pain concept after abdominal surgery, gynecological or urological interventions. Thoracic epidural analgesia remains the gold standard for extensive surgery. The requirement for rapid postoperative mobilization and discharge after lower extremity surgery has led to the abandonment of neuroaxial or plexus blocks in favor of selective, peripheral blocks such as the PENG block or adductor canal block. The following article is intended to show the reader the change in the use of regional anesthesiological procedures for abdominal wall and lower extremity blocks using selected blockages.
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2
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Aggarwal AK, Ottestad E, Pfaff KE, Huai-Yu Li A, Xu L, Derby R, Hecht D, Hah J, Pritzlaff S, Prabhakar N, Krane E, D’Souza G, Hoydonckx Y. Review of Ultrasound-Guided Procedures in the Management of Chronic Pain. Anesthesiol Clin 2023; 41:395-470. [DOI: 10.1016/j.anclin.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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3
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Peripheral Nerve Injections. Phys Med Rehabil Clin N Am 2022; 33:489-517. [DOI: 10.1016/j.pmr.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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4
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Jané D, Gusmão B, Oliveira B, Custódio L, Reis Filho N, Trein T, Floriano B. Comparison of two volumes for sciatic perineural injection using 1% methylene blue in rabbit cadavers. ARQ BRAS MED VET ZOO 2021. [DOI: 10.1590/1678-4162-12302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT The purpose of this study was to assess the efficacy of a blind technique for sciatic and femoral nerve block in rabbit cadavers by evaluating the spread of 1% methylene blue at two different volumes. Nine recently euthanized rabbits weighing 2.5(0.3kg were used. The sciatic (SN) and femoral (FN) nerves of each limb were randomly assigned for injection with 1% methylene blue at 0.2mL/kg (G0.2) or 0.3mL/kg (G0.3). Nerves were dissected and measured for depth and extension of staining (cm). Mean comparisons were performed using paired t test. The relation between volume and nerve staining ( 2cm was assessed using chi-square test. The mean depth of SN was 1.9±0.2 and 1.6±0.3cm and staining 1.9±1.4 and 2.0±1.2cm, respectively in G0.2 and G0.3. No relation was found between depth and dye spread and there was no association between nerve staining ( 2.0cm and volume of solution. The FN failed to be stained in all subjects. In conclusion, SN injection can be successfully performed without guidance in rabbits. The lower volume (0.2mL/kg) is recommended to avoid systemic toxicity.
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Affiliation(s)
- D.R. Jané
- Centro Universitário das Faculdades Integradas de Ourinhos, Brasil
| | - B.S. Gusmão
- Centro Universitário das Faculdades Integradas de Ourinhos, Brasil
| | - B.B. Oliveira
- Centro Universitário das Faculdades Integradas de Ourinhos, Brasil
| | - L.P. Custódio
- Centro Universitário das Faculdades Integradas de Ourinhos, Brasil
| | - N.P. Reis Filho
- Centro Universitário das Faculdades Integradas de Ourinhos, Brasil
| | | | - B.P. Floriano
- Centro Universitário das Faculdades Integradas de Ourinhos, Brasil
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Pogatzki-Zahn EM, Freys SM. [Procedure Specific Pain Therapy - the PROSPECT Idea]. Anasthesiol Intensivmed Notfallmed Schmerzther 2021; 56:586-598. [PMID: 34507382 DOI: 10.1055/a-1188-0945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Acute pain therapy following operative or interventional procedures has become a compulsory component of a modern perioperative patient management. A structured pain regimen has several clear advantages: it leads to an improvement of the patients' quality of life in the short term, it reduces perioperative morbidity in the medium term, it reduces pain chronification in the long term, at the same time improving the economic efficiency due to an accelerated mobilization, a reduction of the hospitalization and an avoidance of complication inherent costs.This article provides detailed information on the change of paradigm, away from a generalized and rather unspecific acute pain therapy towards a problem oriented procedure specific regimen. It points out two examples of the PROSPECT (PROcedure SPECific pain managemenT) methodology and explains its background.
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Abstract
This article addresses the importance of anesthesiologists providing regional anesthesia techniques that are beneficial to the care of trauma patients in the field. It also discusses the advantages and risks associated with regional anesthesia in the field along with how to avoid those risks. In addition, it describes some of the benefits of modern ultrasound techniques compared with landmark techniques with stimulation and other important considerations when performing regional anesthesia in the field. The article gives the unique indications, risks, and key points of the most useful regional techniques for anesthesiologists operating in field environments.
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Affiliation(s)
- Robert Vietor
- Anesthesiology, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
| | - Chester Buckenmaier
- Anesthesiology, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
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7
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Abstract
Advances in anesthesia techniques and guidance imaging have made regional anesthetics effective both for pain management and as a primary anesthesia modality for patients undergoing operative and other invasive procedures. Patients can receive regional anesthesia in most areas of the body, including the upper and lower extremities and torso. It is critical that perioperative nurses are familiar with regional anesthetic options and understand them well enough to support their patients in the preoperative, intraoperative, and postoperative phases of surgical care. They also should be familiar with the signs and symptoms of local anesthetic systemic toxicity and be prepared to help treat this condition as soon as indicated. Nurses play a pivotal role in ensuring patients are properly educated about regional anesthetics and remain safe throughout all phases of perioperative care.
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8
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Korwin-Kochanowska K, Potié A, El-Boghdadly K, Rawal N, Joshi G, Albrecht E. PROSPECT guideline for hallux valgus repair surgery: a systematic review and procedure-specific postoperative pain management recommendations. Reg Anesth Pain Med 2020; 45:702-708. [PMID: 32595141 PMCID: PMC7476301 DOI: 10.1136/rapm-2020-101479] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/18/2020] [Accepted: 05/24/2020] [Indexed: 11/17/2022]
Abstract
Hallux valgus repair is associated with moderate-to-severe postoperative pain. The aim of this systematic review was to assess the available literature and develop recommendations for optimal pain management after hallux valgus repair. A systematic review using PROcedure SPECific Postoperative Pain ManagemenT (PROSPECT) methodology was undertaken. Randomized controlled trials (RCTs) published in the English language from inception of database to December 2019 assessing postoperative pain using analgesic, anesthetic, and surgical interventions were identified from MEDLINE, EMBASE, and Cochrane Database, among others. Of the 836 RCTs identified, 55 RCTs and 1 systematic review met our inclusion criteria. Interventions that improved postoperative pain relief included paracetamol and non-steroidal anti-inflammatory drugs or cyclo-oxygenase-2 selective inhibitors, systemic steroids, ankle block, and local anesthetic wound infiltration. Insufficient evidence was found for the use of gabapentinoids or wound infiltration with extended release bupivacaine or dexamethasone. Conflicting evidence was found for percutaneous chevron osteotomy. No evidence was found for homeopathic preparation, continuous local anesthetic wound infusion, clonidine and fentanyl as sciatic perineural adjuncts, bioabsorbable magnesium screws, and plaster slippers. No studies of sciatic nerve block met the inclusion criteria for PROSPECT methodology due to a wider scope of included surgical procedures or the lack of a control (no block) group. The analgesic regimen for hallux valgus repair should include, in the absence of contraindication, paracetamol and a non-steroidal anti-inflammatory drug or cyclo-oxygenase-2 selective inhibitor administered preoperatively or intraoperatively and continued postoperatively, along with systemic steroids, and postoperative opioids for rescue analgesia.
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Affiliation(s)
- Katarzyna Korwin-Kochanowska
- Department of Cardiovascular Sciences and Department of Anesthesiology, University Hospitals of the KU Leuven, Leuven, Belgium
| | - Arnaud Potié
- Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Kariem El-Boghdadly
- Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, King's College London, London, United Kingdom
| | - Narinder Rawal
- Department of Anesthesiology and Intensive Care, University Hospital of Örebro, Örebro, Sweden
| | - Girish Joshi
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, United States
| | - Eric Albrecht
- Department of Anaesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
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9
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Su MP, Huang PJ, Tseng KY, Shen YC, Chen PN, Cheng KI. Pretreatment of ankle nerve block provides better postoperative analgesia than peri-incisional local anesthetic infiltration in hallux valgus correction surgery. Kaohsiung J Med Sci 2019; 35:168-174. [PMID: 30887717 DOI: 10.1002/kjm2.12029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 12/14/2018] [Indexed: 11/07/2022] Open
Abstract
Adequate postoperative analgesia after hallux valgus (HV) correction surgery improves early mobilization and decreases hospital stay. Peripheral nerve block and peri-incisional local anesthetic (LA) infiltration are both widely used for pain management in orthopedic surgeries. The aim of this study was to compare the analgesic effects between the ankle block and peri-incisional infiltration technique in patients undergoing HV correction surgery. Ninety patients scheduled for hallux valgus correction surgery were randomly allocated into three groups. In group N, patients were pretreated with tibial and peroneal nerve blocks with 8-10 mL of 0.25% bupivacaine before surgery. In group P, patients received the same LA for peri-incisional infiltration preoperatively. In group C, patients underwent surgery without regional analgesic pretreatment. All patients had intravenous fentanyl patient control analgesia as part of multimodal postoperative pain management. Fentanyl consumption, rest and moving pain scale, and adverse effects were evaluated at postoperative 6 h (Poh6), Poh12, Poh 24, and Poh36, respectively. Patients receiving bilateral feet surgeries were excluded in this study. Seventy-five patients were enrolled into final analysis. The patients in group N expressed lower resting and moving pain scores at Poh6, but the pain scores turned similarly among the three groups following Poh12 and then. The total fentanyl consumption was significantly less in group N than in group P. The postoperative activities and mood disturbance were not significantly different between groups after Poh12 and then. We conclude that ankle block is better than peri-incisional LA infiltration in HV correction surgery in pain relief and fentanyl consumption.
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Affiliation(s)
- Miao-Pei Su
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Peng-Ju Huang
- Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuang-Yi Tseng
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ya-Chun Shen
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po-Nien Chen
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuang-I Cheng
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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10
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Delbos A, Philippe M, Clément C, Olivier R, Coppens S. Ultrasound-guided ankle block. History revisited. Best Pract Res Clin Anaesthesiol 2019; 33:79-93. [PMID: 31272656 DOI: 10.1016/j.bpa.2019.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Following forefoot surgery, compared to the traditional multimodal approach, regional anesthesia and analgesia provides high quality pain relief, decreases opioids consumption and leads to very high satisfaction scores. Traditional regional techniques relied either on wound infiltration, landmark technique ankle blocks or popliteal sciatic nerve block. Numerous anatomic variations of the different nerves might lead to failure following a blind technique. The current evolution towards ambulatory care will push surgical teams to favor techniques that simplify postoperative treatment and encourages immediate ambulation. The development of Ultrasound Guided Blocks has enabled us to perform very selective and precise nerve blocks. Ankle blocks provide excellent intraoperative anesthesia as well as long postoperative pain relief. Complications are rare using regional anesthesia for postoperative analgesia even after extensive foot surgery. Revival of ankle blocks is a perfect example of the high impact of new technological advances in improving ambulatory surgical care after foot surgery.
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Affiliation(s)
| | | | | | | | - Steve Coppens
- Department of Anaesthesiology, University Hospitals of the KU Leuven, Herestraat 49, 3000, Leuven, Belgium
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11
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Carles M, Beloeil H, Bloc S, Nouette-Gaulain K, Aveline C, Cabaton J, Cuvillon P, Dadure C, Delaunay L, Estebe JP, Hofliger E, Martinez V, Olivier M, Robin F, Rosencher N, Capdevila X. Anesthésie loco-régionale périnerveuse (ALR-PN). ANESTHÉSIE & RÉANIMATION 2019. [DOI: 10.1016/j.anrea.2019.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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12
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Cisewski DH, Alerhand S. 'SCALD-ED' Block: Superficial Cutaneous Anesthesia in a Lateral Leg Distribution within the Emergency Department - A Case Series. J Emerg Med 2019; 56:282-287. [PMID: 30638643 DOI: 10.1016/j.jemermed.2018.12.005] [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: 09/29/2018] [Revised: 11/22/2018] [Accepted: 12/08/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND In the midst of a nationwide opioid epidemic, focus has been placed on identifying and utilizing safe, effective opioid-free analgesic alternatives. Lower-extremity peripheral nerve blockades are common and often involve both motor and sensory anesthesia, resulting in leg weakness and ambulatory difficulty. The aim of this case report is to describe an ultrasound-guided peripheral nerve block technique (superficial cutaneous anesthesia in a lateral (leg) distribution within the emergency department ['SCALD-ED' block]) that provides motor-sparing, purely sensory anesthesia after a superficial injury to the lateral leg in patients presenting to the emergency department. DISCUSSION Two separate patients presenting with lateral leg pain after superficial injury (burn, cellulitis) reported continued breakthrough pain despite a standard analgesic modality of combination acetaminophen and ibuprofen. With the patient placed in prone position for ultrasound-guided access to lower-extremity nerve branches, the lateral sural cutaneous nerve (LSCN) was identified by tracing its pathway from the proximal sciatic nerve to the common peroneal (fibular) nerve to the superficial peroneal (fibular) nerve. Five mL of lidocaine (1%, with epinephrine) was injected along the superficial LSCN route for anesthetic blockade. Temporal assessments of anesthetic effect and pain improvement, and monitoring of motor or ambulatory impairment were conducted at regular intervals to assess the efficacy and feasibility of the blockade. Regional anesthesia along the LSCN sensory distribution was experienced at 7-9 min post blockade. Peak analgesic effect was experienced at 25-29 min. The duration of anesthesia was 120-150 min. A negligible amount of delayed sensory anesthesia was noted along the distal sural nerve distribution. No motor deficit, ambulatory difficulty, or adverse effects were experienced in either patient post blockade. CONCLUSION The LSCN is an identifiable target under ultrasound guidance, susceptible to localized, purely sensory blockade of pain from superficial cutaneous lateral leg injuries.
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Affiliation(s)
- David H Cisewski
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai Hospital, New York, New York
| | - Stephen Alerhand
- Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, New Jersey
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13
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Tran DQ, Salinas FV, Benzon HT, Neal JM. Lower extremity regional anesthesia: essentials of our current understanding. Reg Anesth Pain Med 2019; 44:rapm-2018-000019. [PMID: 30635506 DOI: 10.1136/rapm-2018-000019] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/14/2018] [Accepted: 05/23/2018] [Indexed: 12/16/2022]
Abstract
The advent of ultrasound guidance has led to a renewed interest in regional anesthesia of the lower limb. In keeping with the American Society of Regional Anesthesia and Pain Medicine's ongoing commitment to provide intensive evidence-based education, this article presents a complete update of the 2005 comprehensive review on lower extremity peripheral nerve blocks. The current review article strives to (1) summarize the pertinent anatomy of the lumbar and sacral plexuses, (2) discuss the optimal approaches and techniques for lower limb regional anesthesia, (3) present evidence to guide the selection of pharmacological agents and adjuvants, (4) describe potential complications associated with lower extremity nerve blocks, and (5) identify informational gaps pertaining to outcomes, which warrant further investigation.
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Affiliation(s)
- De Q Tran
- Department of Anesthesiology, McGill University, Montreal, Quebec, Canada
| | - Francis V Salinas
- Department of Anesthesiology, US Anesthesia Partners-Washington, Swedish Medical Center, Seattle, Washington, USA
| | - Honorio T Benzon
- Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Joseph M Neal
- Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington, USA
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14
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Walter WR, Burke CJ, Adler RS. Ultrasound-guided therapeutic injections for neural pathology about the foot and ankle: a 4 year retrospective review. Skeletal Radiol 2017; 46:795-803. [PMID: 28303298 DOI: 10.1007/s00256-017-2624-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 03/05/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe a 4-year clinical experience with ultrasound-guided therapeutic perineural injections of peripheral nerves about the foot and ankle. MATERIALS AND METHODS Retrospective analysis of foot and ankle perineural injections performed between January 2012 and August 2016. Demographics, clinical indications, presence of structural pathology, immediate and interval pain relief, as well as complications were recorded. RESULTS Fifty-nine therapeutic injections were performed among 46 patients, accounting for multiple injections in a single visit or multiple visits [mean age = 43 years (range 18-75), 31 female (67%) and 15 male (33%)]. Most commonly, perineural injections involved the hallux branch of the medial plantar nerve (n = 17, 22%). Least commonly, perineural injections involved the saphenous nerve (n = 3, 4%). Other injections in our series include sural (10), superficial (11) and deep (7) peroneal, medial (5) and lateral (3) plantar nerves, and the posterior tibial nerve (3). Ultrasound evaluation revealed structural abnormality associated with the nerve in 30 cases (51%)-most commonly thickening with perineural scarring (n = 14). Of 45 injections with complete documentation, immediate relief of symptoms was reported in 43 (96%) cases. Interval symptom relief was achieved in 23 injections [short term (n = 12), intermediate (n = 6), and long term (n = 5)] out of 38 for which follow-up was available (61%). Complications are rare, occurring in only one case. CONCLUSION Ultrasound-guided perineural injections about the foot and ankle are safe and provide lasting symptomatic relief for many indications. Concomitant sonographic evaluation identifies structural abnormalities that may contribute to neuropathic symptoms, allowing targeting of injection or clinical therapy.
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Affiliation(s)
- William R Walter
- Hospital for Joint Diseases, New York University Langone Medical Center, 301 E 17th St, New York, NY, 10003, USA.
| | - Christopher J Burke
- Hospital for Joint Diseases, New York University Langone Medical Center, 301 E 17th St, New York, NY, 10003, USA
| | - Ronald S Adler
- Center for Musculoskeletal Care, New York University Langone Medical Center, New York, NY, USA
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Rose B, Kunasingam K, Barton T, Walsh J, Fogarty K, Wines A. A Randomized Controlled Trial Assessing the Effect of a Continuous Subcutaneous Infusion of Local Anesthetic Following Elective Surgery to the Great Toe. Foot Ankle Spec 2017; 10:116-124. [PMID: 27613814 DOI: 10.1177/1938640016666923] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
UNLABELLED Local anesthetic use for wound infusions, single injection, and continuous nerve blocks for postoperative analgesia is well established. No study has investigated the effect of a continuous block of the saphenous and superficial peroneal nerves at the level of the ankle joint following first ray surgery. A double blind randomized controlled trial was designed. One hundred patients with hallux valgus and rigidus requiring surgical correction were recruited and randomized to receive a postoperative continuous infusion at the ankle of normal saline or ropivacaine for 24 hours. Pain scores were recorded on postoperative days 1 and 7. There were more females than males. Follow-up was 100%. There were no significant differences in demographic data between the 2 randomized groups. There was no significant difference between the absolute visual analog scale scores on day 1 (P = .14) and day 7 (P = .16); nor was there a significant difference in reduction in scores between days 1 and 7 (P = .70). This study has shown no benefit to postoperative analgesia with the use of a continuous infusion of ropivacaine at the ankle. We, therefore, cannot currently recommend its use in the way described. Further studies may still identify a role for continuous local anesthetic infusions at the ankle to improve postoperative analgesia. LEVELS OF EVIDENCE Level I : Prospective randomised control trial.
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Affiliation(s)
- Barry Rose
- Royal North Shore Hospital, Reserve Road, Sydney, New South Wales, Australia (BR, KK, TB, JW, KF, AW).,Royal United Hospital, Combe Park, Bath, United Kingdom (TB).,Cappagh National Orthopaedic Hospital, Finglas, Republic of Ireland (JW).,North Sydney Orthopaedic Sports Medicine, Sydney, New South Wales, Australia (AW)
| | - Kumar Kunasingam
- Royal North Shore Hospital, Reserve Road, Sydney, New South Wales, Australia (BR, KK, TB, JW, KF, AW).,Royal United Hospital, Combe Park, Bath, United Kingdom (TB).,Cappagh National Orthopaedic Hospital, Finglas, Republic of Ireland (JW).,North Sydney Orthopaedic Sports Medicine, Sydney, New South Wales, Australia (AW)
| | - Tristan Barton
- Royal North Shore Hospital, Reserve Road, Sydney, New South Wales, Australia (BR, KK, TB, JW, KF, AW).,Royal United Hospital, Combe Park, Bath, United Kingdom (TB).,Cappagh National Orthopaedic Hospital, Finglas, Republic of Ireland (JW).,North Sydney Orthopaedic Sports Medicine, Sydney, New South Wales, Australia (AW)
| | - James Walsh
- Royal North Shore Hospital, Reserve Road, Sydney, New South Wales, Australia (BR, KK, TB, JW, KF, AW).,Royal United Hospital, Combe Park, Bath, United Kingdom (TB).,Cappagh National Orthopaedic Hospital, Finglas, Republic of Ireland (JW).,North Sydney Orthopaedic Sports Medicine, Sydney, New South Wales, Australia (AW)
| | - Karen Fogarty
- Royal North Shore Hospital, Reserve Road, Sydney, New South Wales, Australia (BR, KK, TB, JW, KF, AW).,Royal United Hospital, Combe Park, Bath, United Kingdom (TB).,Cappagh National Orthopaedic Hospital, Finglas, Republic of Ireland (JW).,North Sydney Orthopaedic Sports Medicine, Sydney, New South Wales, Australia (AW)
| | - Andrew Wines
- Royal North Shore Hospital, Reserve Road, Sydney, New South Wales, Australia (BR, KK, TB, JW, KF, AW).,Royal United Hospital, Combe Park, Bath, United Kingdom (TB).,Cappagh National Orthopaedic Hospital, Finglas, Republic of Ireland (JW).,North Sydney Orthopaedic Sports Medicine, Sydney, New South Wales, Australia (AW)
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Carles M, Beloeil H, Bloc S, Nouette-Gaulain K, Aveline C, Cabaton J, Cuvillon P, Dadure C, Delaunay L, Estebe JP, Hofliger E, Martinez V, Olivier M, Robin F, Rosencher N, Capdevila X. Anesthésie locorégionale périnerveuse. ANESTHESIE & REANIMATION 2017. [DOI: 10.1016/j.anrea.2017.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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17
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Effect of Nerve Stimulation Use on the Success Rate of Ultrasound-Guided Subsartorial Saphenous Nerve Block. Reg Anesth Pain Med 2017; 42:25-31. [DOI: 10.1097/aap.0000000000000522] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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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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19
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Shaw M, Czech A, Ong C. Application of and Choice of Nerves Determine the Success of Regional Anesthesia at the Ankle. Reg Anesth Pain Med 2016; 41:293. [PMID: 26890654 DOI: 10.1097/aap.0000000000000371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Michael Shaw
- Guy's and St. Thomas' NHS Foundation Trust London, UK
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20
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Girón-Arango L, Vásquez-Sadder MI, González-Obregón MP, Gamero-Fajardo CE. Bloqueo de tobillo guiado por ultrasonido: una técnica anestésica atractiva para cirugía de pie. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2015. [DOI: 10.1016/j.rca.2015.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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21
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Girón-Arango L, Vásquez-Sadder MI, González-Obregón MP, Gamero-Fajardo CE. Ultrasound-guided ankle block: An attractive anaesthetic technique for foot surgery. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2015. [DOI: 10.1016/j.rcae.2015.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Vadivelu N, Kai AM, Maslin B, Kodumudi V, Antony S, Blume P. Role of regional anesthesia in foot and ankle surgery. Foot Ankle Spec 2015; 8:212-9. [PMID: 25655517 DOI: 10.1177/1938640015569769] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
UNLABELLED Regional anesthesia has increasingly expanded its role in the perioperative care of patients undergoing foot and ankle surgery. In addition to avoiding side effects associated with both general anesthesia and neuraxial anesthetic techniques, especially those related to cardiovascular and pulmonary systems, regional nerve blocks have been shown to improve postoperative pain and reduce hospital stay and associated expenses. The techniques utilized to achieve analgesia of the foot and ankle are diverse, multifaceted, and often incorporate ultrasound guidance. Given the aging of patient populations, and especially the growing incidence of cardiovascular-, pulmonary-, and obesity-related morbidity, the use of regional blocks is likely to expand in these surgical procedures. This review highlights some of the most current developments in the expanding role of regional anesthesia in foot and ankle surgery. LEVELS OF EVIDENCE Therapeutic, Level II.
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Affiliation(s)
- Nalini Vadivelu
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (NV, BM, SA)Stony Brook University School of Medicine, Stony Brook, New York (AMK)College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut (VK)Yale-New Haven Hospital, New Haven, Connecticut (PB)
| | - Alice M Kai
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (NV, BM, SA)Stony Brook University School of Medicine, Stony Brook, New York (AMK)College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut (VK)Yale-New Haven Hospital, New Haven, Connecticut (PB)
| | - Benjamin Maslin
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (NV, BM, SA)Stony Brook University School of Medicine, Stony Brook, New York (AMK)College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut (VK)Yale-New Haven Hospital, New Haven, Connecticut (PB)
| | - Vijay Kodumudi
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (NV, BM, SA)Stony Brook University School of Medicine, Stony Brook, New York (AMK)College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut (VK)Yale-New Haven Hospital, New Haven, Connecticut (PB)
| | - Sible Antony
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (NV, BM, SA)Stony Brook University School of Medicine, Stony Brook, New York (AMK)College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut (VK)Yale-New Haven Hospital, New Haven, Connecticut (PB)
| | - Peter Blume
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (NV, BM, SA)Stony Brook University School of Medicine, Stony Brook, New York (AMK)College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut (VK)Yale-New Haven Hospital, New Haven, Connecticut (PB)
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Ultrasound-guided ankle block: An attractive anaesthetic technique for foot surgery☆. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2015. [DOI: 10.1097/01819236-201543040-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Ultrasound-guided ankle block for forefoot surgery: is sural nerve block necessary? Reg Anesth Pain Med 2013; 38:251. [PMID: 23598729 DOI: 10.1097/aap.0b013e31828c6842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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