Ultrasound-guided infraclavicular brachial plexus block for emergency management of a posterior elbow dislocation

Heflin, Thomas; Ahern, Terry; Herring, Andrew A.

doi:10.1016/j.ajem.2015.06.019

Cited by 8 publications

(2 citation statements)

References 11 publications

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“…Peripheral nerve blocks should be used to ensure their comfort and to reduce the use of opioid drugs. 30,31 Our study demonstrates that excellent results can be obtained by using low doses of LA in upper extremity fractures.…”

Section: Discussionmentioning

confidence: 60%

Can ultrasound-guided infraclavicular block be an alternative option for forearm reduction in the emergency department? A prospective randomized study

et al. 2021

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Objective Ultrasound-guided infraclavicular nerve block (IB) has become a well-established method in several outpatient procedures; however, its use in emergency departments (EDs) remains limited. The aim of this study was to compare procedural sedation and anlagesia (PSA) and IB in the pain management for patients who underwent forearm fracture reduction in the ED.Methods This prospective randomized study included 60 patients aged 18 to 65 years, who visited the ED with forearm fractures. They were randomly divided into two groups: Group PSA (n=30) and Group IB (n=30). The pain scores of patients were evaluated before and during the procedure with the visual analog scale. Complications and patient and operator satisfaction levels were recorded.Results There was no difference between the two groups in terms of demographic characteristics. The median (interquartile range) pain scores observed during the procedures were significantly higher in Group PSA than in Group IB (4 [4–6] vs. 2 [0–2], respectively; P<0.001). Patient and operator satisfaction levels were significantly higher in Group IB (P<0.001). Oxygen desaturation was statistically higher in Group PSA than in Group IB (40.00% vs. 3.33%, respectively; P=0.002).Conclusion IB was an effective alternative for reducing pain and increasing patient satisfaction in ED patients undergoing forearm fracture reduction.

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Section: Discussionmentioning

confidence: 60%

Can ultrasound-guided infraclavicular block be an alternative option for forearm reduction in the emergency department? A prospective randomized study

et al. 2021

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“…O homem de 29 anos com dor intensa em membro superior esquerdo e deformidade do olécrano foi submetido a uma redução sem dor do cotovelo 20 minutos após realização do bloqueio. Complicações como dispneia, pneumotórax ou paralisia não foram relatadas (HEFLIN T, et al, 2015).…”

Section: Lesão Em Extremidades Superioresunclassified

Indicações para bloqueios anestésicos guiados por ultrassom na emergência: Uma revisão narrativa

2019

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Objetivo: Fornecer a médicos emergencistas exemplos de aplicações bem sucedidas de bloqueios nervosos guiados por ultrassom relatadas na literatura. Revisão Bibliográfica: Dos artigos nesta revisão incluem 11 (onze) estudos prospectivos (7 com amostras de conveniência e 4 randomizados), 1 estudo de coorte, 1 revisão sistemática e 19 relatos de casos, únicos ou em série. Didaticamente, o conteúdo dos estudos sobre bloqueio guiado por US foi descrito de maneira narrativa em forma de indicações categorizadas de acordo com a porção do corpo acometida pela intervenção, grupo populacional específico ou condições específicas com grande densidade de estudos, a saber: Lesão em extremidades superiores; Luxação de ombro; Fratura de arcos costais; Lesão em parede abdominal; Lesão de extremidades inferiores; Fraturas de quadril e colo de fêmur; População pediátrica; Outras indicações. Considerações Finais: Esta revisão demonstra que bloqueios anestésicos guiados por ultrassom são viáveis no departamento de emergência e destaca que diminuição significativa e sustentada da dor pode ser alcançada com essa intervenção.

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A Review of Current and Emerging Approaches to Pain Management in the Emergency Department

Todd

2017

Pain Ther

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IntroductionPain is the most common symptom prompting an emergency department visit and emergency physicians are responsible for managing both acute pain and acute exacerbations of chronic pain resulting from a broad range of illnesses and injuries. The responsibility to treat must be balanced by the duty to limit harm resulting from analgesics. In recent years, opioid-related adverse effects, including overdose and deaths, have increased dramatically in the USA. In response to the US opioid crisis, emergency physicians have broadened their analgesic armamentarium to include a variety of non-opioid approaches. For some of these therapies, sparse evidence exists to support their efficacy for emergency department use. The purpose of this paper is to review historical trends and emerging approaches to emergency department analgesia, with a particular focus on the USA and Canada.MethodsWe conducted a qualitative review of past and current descriptive studies of emergency department pain practice, as well as clinical trials of emerging pain treatment modalities. The review considers the increasing use of non-opioid and multimodal analgesic therapies, including migraine therapies, regional anesthesia, subdissociative-dose ketamine, nitrous oxide, intravenous lidocaine and gabapentinoids, as well as broad programmatic initiatives promoting the use of non-opioid analgesics and nonpharmacologic interventions.ResultsWhile migraine therapies, regional anesthesia, nitrous oxide and subdissociative-dose ketamine are supported by a relatively robust evidence base, data supporting the emergency department use of intravenous lidocaine, gabapentinoids and various non-pharmacologic analgesic interventions remain sparse.ConclusionAdditional research on the relative safety and efficacy of non-opioid approaches to emergency department analgesia is needed. Despite a limited research base, it is likely that non-opioid analgesic modalities will be employed with increasing frequency. A new generation of emergency physicians is seeking additional training in pain medicine and increasing dialogue between emergency medicine and pain medicine researchers, educators and clinicians could contribute to better management of emergency department pain.

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Ultrasound-guided infraclavicular brachial plexus block for emergency management of a posterior elbow dislocation

Cited by 8 publications

References 11 publications

Can ultrasound-guided infraclavicular block be an alternative option for forearm reduction in the emergency department? A prospective randomized study

Can ultrasound-guided infraclavicular block be an alternative option for forearm reduction in the emergency department? A prospective randomized study

Indicações para bloqueios anestésicos guiados por ultrassom na emergência: Uma revisão narrativa

A Review of Current and Emerging Approaches to Pain Management in the Emergency Department

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