Advances of Techniques in Deep Regional Blocks

Lin, Jui-An; Blanco, Rafael; Shibata, Yasuyuki; Nakamoto, Tetsuji

doi:10.1155/2017/7268308

Cited by 6 publications

(4 citation statements)

References 33 publications

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“…(e DCEB incidence in the Us group was 9.38%, which was significantly reduced compared with the Lm group (55.56%, p < 0.001). In the Us group, the number of needle passes and attempts was significantly reduced (2 (1-4) vs. 9 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), p < 0.001; 1 (1-2) vs. 3 (1.25-5), p < 0.001), and the success rate on first needle pass was significantly increased (46.88% vs. 8.33%, p < 0.001), and the time to perform CEB was significantly reduced (1 (1-2.75) vs. 6 (2-7.75), p < 0.001). Moreover, the Us group needed more time to establish the puncture site, but there was a significant between-group difference in the total procedure (both p < 0.001).…”

Section: Ultrasound For Predictive Dceb Patientsmentioning

confidence: 98%

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Establishment of Difficult Caudal Epidural Blockade Prediction Model

Xie

Zhao

Chu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. We aimed to develop a predictive difficult caudal epidural blockade (pDCEB) model when ultrasound was not available and verified the role of ultrasound in difficult caudal epidural blockade (CEB). Methods. From October 2018 to March 2019, this study consisted of three phases. First, we prospectively enrolled 202 patients scheduled to undergo caudal epidural anesthesia and assessed risk factors by binary logistic regression to develop the predictive scoring system. Second, we enrolled 87 patients to validate it. The receiver operating characteristic (ROC) curve was used to evaluate the performance of the prediction model. Youden-index was used to determine the cut-off value. Third, we enrolled 68 patients with a high risk of difficult CEB (pDCEB score ≥3) and randomized them into ultrasound and landmark groups to verify the role of ultrasound. Result. The rate of difficult CEB was 14.98% overall 289 patients. We found a correlation between unclear palpation of the sacral hiatus (OR 9.688) and cornua (OR 4.725), the number of the sacral hiatus by palpation ≥1 (OR 4.451), and history of difficult CEB (OR 39.282) with a higher possibility of difficult CEB. The area under the receiver operating characteristic curve of the pDCEB model involving the aforementioned factors was 0.889 (95% CI, 0.827–0.952) in the development cohort and 0.862 (95% CI, 0.747–0.977) in the validation cohort. For patients with a pDCEB score ≥3, a preprocedure ultrasound scan could reduce the incidence of difficult CEB (55.56% in the Landmark group vs. 9.38% in the ultrasound group, p < 0.001 ). Conclusion. This novel pDCEB score, which takes into account palpation of the sacral hiatus/cornua, number of the sacral hiatus by palpation ≥1, and history of difficult CEB, showed a good predictive ability of difficult CEB. The findings suggested that performing an ultrasound scan is essential for patients with a pDCEB score ≥3. Trial registration: No: ChiCTR1800018871, Site URL: https://www.chictr.org.cn/edit.aspx?pid=31875&htm=4; Principal investigator: Jialian Zhao, Date of registration: 2018.10.14.

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Section: Ultrasound For Predictive Dceb Patientsmentioning

confidence: 98%

“…(e ultrasound technique has been applied to improve peripheral nerve blockade and central neuraxial interventions [12][13][14]. It can be used to provide sonographic images that show anatomical variations of the sacral hiatus, which is currently regarded as a gold standard for correct needle placement in the CEB technique [15,16].…”

Section: Introductionmentioning

confidence: 99%

Establishment of Difficult Caudal Epidural Blockade Prediction Model

Xie

Zhao

Chu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…Cognitive ergonomics aims to optimise the decision-making process to improve PNB performance. Physical ergonomics aims to improve PNB performance through optimising techniques and operator comfort [4].…”

Section: Conceptual Framework Of Physical Ergonomics In Pnbmentioning

confidence: 99%

Physical Ergonomics in Peripheral Nerve Block

et al. 2021

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The understanding of ergonomics is a vital competency for all peripheral nerve block operators. The essence of physical ergonomics for peripheral nerve block procedures can be summarised into three significant components: brain, musculoskeletal and needling. The first component includes strategies to optimise visuospatial neuroprocessing using equipment configuration. The second component reflects the careful planning of posture and position to improve procedural technique and reduce physical fatigue. The final component focuses on strategies to achieve needle beam alignment for optimal needle visualisation.

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“…In the article titled “Advances of Techniques in Deep Regional Blocks” [ 1 ], Table 1 was missing. Accordingly, the table is shown below, and its in-text citation is added as follows:…”

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confidence: 99%