Advances in regional anaesthesia: A review of current practice, newer techniques and outcomes

Wahal, Christopher; Kumar, Amanda H.; Pyati, Srinivas

doi:10.4103/ija.ija_433_17

Cited by 52 publications

(34 citation statements)

References 57 publications

(58 reference statements)

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“…Mastering the techniques of effective and safe blockade of neural conduction, including that of sensory stimuli at the level of plexuses, ganglia, specific nerves, or infiltration anesthesia of the wound margins provide the basis for the use and popularization of these methods in postoperative analgesia. 128 So-called continuous techniques are also used, such as administration of local analgesics through implanted subcutaneous catheters and continuous blocks of neural plexuses by transdermal catheters introduced into these structures. An example of such target neural structures are intercostal nerves after thoracic surgery and rib fractures.…”

Section: Other Regional Anesthesia Techniquesmentioning

confidence: 99%

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Assessment and pathophysiology of pain in cardiac surgery

Zubrzycki¹,

Liebold²,

Skrabal³

et al. 2018

JPR

139

106

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Analysis of the problem of surgical pain is important in view of the fact that the success of surgical treatment depends largely on proper pain management during the first few days after a cardiosurgical procedure. Postoperative pain is due to intraoperative damage to tissue. It is acute pain of high intensity proportional to the type of procedure. The pain is most intense during the first 24 hours following the surgery and decreases on subsequent days. Its intensity is higher in younger subjects than elderly and obese patients, and preoperative anxiety is also a factor that increases postoperative pain. Ineffective postoperative analgesic therapy may cause several complications that are dangerous to a patient. Inappropriate postoperative pain management may result in chronic pain, immunosuppression, infections, and less effective wound healing. Understanding and better knowledge of physiological disorders and adverse effects resulting from surgical trauma, anesthesia, and extracorporeal circulation, as well as the development of standards for intensive postoperative care units are critical to the improvement of early treatment outcomes and patient comfort.

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Section: Other Regional Anesthesia Techniquesmentioning

confidence: 99%

“…An example of such target neural structures are intercostal nerves after thoracic surgery and rib fractures. 128 …”

Section: Other Regional Anesthesia Techniquesmentioning

confidence: 99%

Assessment and pathophysiology of pain in cardiac surgery

Zubrzycki¹,

Liebold²,

Skrabal³

et al. 2018

JPR

139

106

View full text Add to dashboard Cite

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“…[ 6 ] Recently, many myofascial blocks and regional techniques have been introduced, including transverus abdominis plane block, rectus sheath block, and quadratus lumborum block for abdominal surgeries, pectoral nerve block for breast surgeries and intercostals, and interpleural blocks for thoracic surgeries. [ 7 8 9 ]…”

Section: Discussionmentioning

confidence: 99%

Erector spinae plane block: Relatively new block on horizon with a wide spectrum of application – A case series

2018

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Erector spinae plane (ESP) block is an interfascial plane block where a local anaesthetic is injected in a plane preferably below the erector spinae muscle. It is supposed to work at the origin of spinal nerves based on cadaveric and contrast study. It has emerged as an effective and safe analgesic regional technique. It has a wide variety of applications ranging from control of acute postoperative pain to chronic pain. In this series, we report a series of six cases, which include postoperative pain management in breast, thoracic, and abdominal surgeries along with management of two chronic pain cases to illustrate the potential uses of continuous and single-shot ESP block.

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“…[ 7 8 ] Newer techniques of regional analgesia, longer acting LA and adjuvants and safety with ultrasound are not only beneficial in adequate management of acute pain but also in preventing development of chronic pain. [ 9 ] Ultrasound (US)-guided quadratus lumborum (QL) block is a recently introduced block shown to provide both somatic and visceral analgesia as compared to transversus abdominis plane (TAP) block which prevents somatic pain. [ 10 11 ]…”

Section: Introductionmentioning

confidence: 99%

To evaluate the effect of quadratus lumborum block on the tramadol sparing effect in patients undergoing open inguinal hernia surgery: A randomised controlled trial

et al. 2020

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Background and Aims: An ultrasound-guided quadratus lumborum (QL) block provides both somatic and visceral analgesia in abdominal surgeries. We aimed to evaluate the postoperative tramadol sparing effect of single-shot anterior QL block in inguinal hernia surgery patients. Methods: This prospective, randomised controlled trial was conducted in a single tertiary care centre over a period of 1 year. A total of 50 patients, American Society of Anaesthesiologists (ASA) physical status I–II of both sexes aged 18–80 years with body mass index (BMI) ≥20 to ≤35 kg/m 2 undergoing uncomplicated unilateral inguinal hernia surgery under spinal anaesthesia (SA) were randomly allocated to either of the two groups. The block group ( n = 25) received single-shot anterior QL block with 20 ml of 0.5% ropivacaine and the control group ( n = 25) received no block. Postoperatively, patients received intravenous (IV) paracetamol 1g every 6 h and tramadol patient-controlled analgesia up to 24 h. Primary outcome was total tramadol consumption at 24 h postoperatively. Results: The total tramadol consumption mean ± SD [95% CI (range)] at 24 h in the block group was 84.00 ± 37.86 [68.37–99.63 (20–160)] mg versus 93.60 ± 34.99 [79.16–108.04 (20–160)] mg in control group, (p value = 0.36). Postoperative VAS score, haemodynamics, and patient satisfaction score were similar in both the groups. No adverse events were reported. Conclusion: A single-shot anterior QL block did not establish a postoperative tramadol-sparing effect at 24 h as compared to no block in patients undergoing inguinal hernia surgery under SA.

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Advances in regional anaesthesia: A review of current practice, newer techniques and outcomes

Cited by 52 publications

References 57 publications

Assessment and pathophysiology of pain in cardiac surgery

Assessment and pathophysiology of pain in cardiac surgery

Erector spinae plane block: Relatively new block on horizon with a wide spectrum of application – A case series

To evaluate the effect of quadratus lumborum block on the tramadol sparing effect in patients undergoing open inguinal hernia surgery: A randomised controlled trial

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