The Potential Role of Regional Anesthesia in Perioperative Anti-Inflammatory Treatments

Faiz, Seyed Hamid Reza; Mohseni, Masood

doi:10.5812/anesthpain.5067

Cited by 5 publications

(1 citation statement)

References 17 publications

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“…Regional nerve blocks have great importance in anaesthesia practice. They can provide safe and effective anaesthesia with long-lasting analgesia (1). Interscalene block represents a safe and reliable approach for the shoulder surgeries.…”

Section: Introductionmentioning

confidence: 99%

Prolonged Interscalene Blockade for 30 Hours with 0.5% Plain Bupivacaine in a Case of Shoulder Arthroscopy

Tiwari¹,

Avhad²,

Mathkar³

et al. 2019

Turk J Anaesthesiol Reanim

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We present a case of unusually prolonged motor and sensory block for 30 hours after a successful single injection of ultrasound-guided interscalene block with 0.5% plain bupivacaine. All safety measures such as negative aspiration of blood injection at every 3 mL of drug with usual resistance, slow rate of injection and ultrasound documentation of spread of drug around C 5 and C 6 were followed. There was no evidence of neurological injury, but we should always be prepared to consider the possibility of nerve injury and take appropriate measures to prevent them.

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Section: Introductionmentioning

confidence: 99%

Prolonged Interscalene Blockade for 30 Hours with 0.5% Plain Bupivacaine in a Case of Shoulder Arthroscopy

Tiwari¹,

Avhad²,

Mathkar³

et al. 2019

Turk J Anaesthesiol Reanim

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The effect of anesthesia methods on the neutrophil–lymphocyte ratio in patients undergoing forearm surgery: A monocentric and retrospective study

Köksal,

Bollucuoğlu,

Şahin

et al. 2024

Medicine

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Surgical trauma can induce systemic inflammation. The selected anesthesia method may modulate the inflammatory response and surgical results in the inflammatory process that occurs during surgical trauma. In this retrospective study, we aimed to compare the anti-inflammatory effects of general anesthesia and peripheral nerve block (infraclavicular block). Demographic, clinical, and laboratory records (hemogram, total leukocyte count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume) were obtained from the archival data. The patients were divided into 2 groups: Group G, who received general anesthesia, and Group P, who received a peripheral nerve block (infraclavicular block) for forearm surgery. The amount of opioid consumed postoperatively was significantly lower in Group P. Infraclavicular block as an alternative to general anesthesia was found to be associated with a significant decrease in the neutrophil-to-lymphocyte ratio, total leukocyte count, and platelet-to-lymphocyte ratio levels compared to those observed after general anesthesia. Peripheral nerve blocks may play a role in reducing inflammation and alleviating stress.

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Perioperative approaches to prevent delayed neurocognitive recovery and postoperative neurocognitive disorder in older surgical patients: A systematic review and meta-analysis of randomized controlled trials

Alhamdah,

Li,

Nagappa

et al. 2024

Journal of Anaesthesiology Clinical Pharmacology

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Background and and Aims: Delayed neurocognitive recovery (DNR) and postoperative neurocognitive disorder (P-NCD) are common postoperative complications affecting older patients. This review evaluates perioperative approaches for preventing DNR and P-NCD in older noncardiac surgical patients. Material and Methods: We searched databases for relevant articles from inception through June 2022 and updated in May 2023 (PROSPERO ID CRD42022359289). Randomized controlled trials (RCTs) utilizing intervention for DNR and/or P-NCD were included. Results: We included 39 RCTs involving anesthetic (25 RCTs, 7422 patients) and other pharmacological and nonpharmacological approaches (14 RCTs, 2210 patients). Seventeen trials investigating four interventions were included in the meta-analysis for DNR. Perioperative dexmedetomidine (relative risk [RR]: 0.59, 95% confidence interval [CI]: 0.35–0.97; P = 0.04) and propofol-based total intravenous anesthesia (TIVA) (RR: 0.81, 95% CI: 0.66–0.98; P = 0.03) significantly decreased the risk of DNR versus control. There was no significant decrease in the risk of DNR with regional anesthesia (RA) versus general anesthesia (GA) (RR: 0.89, 95% CI: 0.63–1.26) or bispectral index (BIS) monitoring (RR: 0.79, 95% CI: 0.60–1.04) versus the control groups. Evidence regarding the effects of interventions on P-NCD is limited. Although all included trials were at low risk of bias, the quality of meta-analysis pooled estimates was low. Conclusions: Our meta-analysis of RCTs showed that dexmedetomidine and TIVA decrease the risk of DNR in older patients undergoing noncardiac surgery by 41% and 20%, respectively, versus control. Further RCTs of adequate power and methodology on the effects of interventions on DNR and P-NCD are warranted. Key Messages: Our meta-analysis of RCTs showed that dexmedetomidine and TIVA decrease the risk of DNR in older patients undergoing noncardiac surgery by 41% and 20%, respectively, versus controls, whereas RA and BIS monitoring do not.

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The Potential Role of Regional Anesthesia in Perioperative Anti-Inflammatory Treatments

Cited by 5 publications

References 17 publications

Prolonged Interscalene Blockade for 30 Hours with 0.5% Plain Bupivacaine in a Case of Shoulder Arthroscopy

Prolonged Interscalene Blockade for 30 Hours with 0.5% Plain Bupivacaine in a Case of Shoulder Arthroscopy

The effect of anesthesia methods on the neutrophil–lymphocyte ratio in patients undergoing forearm surgery: A monocentric and retrospective study

Perioperative approaches to prevent delayed neurocognitive recovery and postoperative neurocognitive disorder in older surgical patients: A systematic review and meta-analysis of randomized controlled trials

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