Low-Volume Ultrasound-Guided Nerve Block Provides Inferior Postoperative Analgesia Compared to a Higher-Volume Landmark Technique

2011 ◽  
Vol 36 (4) ◽  
pp. 393-398 ◽  
Author(s):  
Michael J. Fredrickson ◽  
Richard White ◽  
Tony K. Danesh-Clough
Keyword(s):  
Nerve Block ◽  
Postoperative Analgesia ◽  
Ultrasound Guided ◽  
Volume Ultrasound ◽  
Low Volume ◽  
Landmark Technique

scholarly journals Ultrasound Guided Femoral Nerve Block with Bupivacaine versus Bupivacaine and Tramadol for Postoperative Analgesia in Patients Undergoing Total Knee Arthroplasty under Spinal Anesthesia

2021 ◽  
pp. 23-32
Author(s):  
Mohammad Mostafa Abo Farrag ◽  
Laila Elahwal ◽  
Hesham Mohammad Maroof ElDomairy ◽  
Mohammad Ibrahem Okab
Keyword(s):  
Total Knee Arthroplasty ◽  
Spinal Anesthesia ◽  
Nerve Block ◽  
Knee Arthroplasty ◽  
Postoperative Analgesia ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Ultrasound Guided ◽  
Group I ◽  
Total Knee

Background: Effective pain control in Total knee arthroplasty (TKA) is important for optimizing the rehabilitation process in order to achieve patient satisfaction with a good functional outcome as well as reduce hospitalization duration and costs. Combined use of aesthetic with tramadol has been reported to achieve a longer duration of sensory and motor block. The aim of this study is to evaluate the quality and duration of postoperative analgesia produced by ultrasound guided femoral nerve block (FNB) by bupivacaine versus (bupivacaine & tramadol) in patients undergoing total knee arthroplasty under spinal anesthesia. Methods: This prospective randomized controlled double blinded study was carried out on 60 patients aged above 50 years; American Society of Anesthesiologists physical status (ASA) I-III scheduled for total knee arthroplasty under spinal anesthesia. Patients were randomized to one of two equal groups: Group I control (C): received FNB with 30 ml 0.25% bupivacaine. Group II tramadol (T): received FNB with 30ml 0.25% bupivacaine and 100 mg tramadol. Results: Postoperative heart rate was significantly increased in group C than group T at 8h, 12h, 16h and 24h. Postoperative mean arterial blood pressure was significantly increased in group C than group T at 6h, 8h, 12h, 16h and 24h. There were 30 (100%) patients required rescue analgesia in group C and 19 (63.33%) patients in group T which was increased significantly in group C than group T. The time to first analgesic requirement was significantly decreased in group C than group T. Total morphine consumption was increased significantly in group C than group T. VAS was increased significantly in group C than group T at 6, 8, 12, 16 and 24 hours. Adverse effects were insignificantly different between both groups. Conclusion: Adding tramadol (100 mg) to 0.25% bupivacaine (to a volume of 30 ml) during US guided FNB of TKA under spinal anesthesia was associated with better postoperative analgesia when compared with 0.25% bupivacaine alone.

scholarly journals Landmark Technique vs Ultrasound-Guided Approach for Posterior Tibial Nerve Block in Cadaver Models

2020 ◽  
Vol 54 (1) ◽  
pp. 38-42
Author(s):  
Ashish Shah ◽  
Sara Morris ◽  
Bradley Alexander ◽  
Haley McKissack ◽  
James Rush Jones ◽  
...  
Keyword(s):  
Nerve Block ◽  
Tibial Nerve ◽  
Posterior Tibial Nerve ◽  
Ultrasound Guided ◽  
Posterior Tibial ◽  
Landmark Technique

scholarly journals Ultrasound-Guided Continuous Femoral Nerve Block with Dexmedetomidine Combined with Low Concentrations of Ropivacaine for Postoperative Analgesia in Elderly Knee Arthroplasty

2019 ◽  
Vol 28 (5) ◽  
pp. 457-462 ◽  
Author(s):  
Xiao-Ying Zhao ◽  
Er-Fei Zhang ◽  
Xiao-Li Bai ◽  
Zi-Jian Cheng ◽  
Peng-Yun Jia ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Nerve Block ◽  
Knee Arthroplasty ◽  
Postoperative Analgesia ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Ultrasound Guided ◽  
Low Concentrations ◽  
Functional Exercise ◽  
Continuous Femoral Nerve Block

Objectives: This study aims to investigate the clinical effect of dexmedetomidine (DEX) combined with low concentrations of ropivacaine in ultrasound-guided continuous fem­oral nerve block for postoperative analgesia in elderly patients with total knee arthroplasty (TKA). Materials and Methods: Patients were divided into three groups: group C, group D1, and group D2. For postoperative analgesia, patients in group C were given 0.15% ropivacaine, patients in group D1 were given 0.15% ropivacaine + 0.02 μg × kg–1 × h–1 DEX, and patients in group D2 were given 0.15% ropivacaine + 0.05 μg × kg–1 × h–1 DEX. The visual analogue scores in the resting state, active state (AVAS), and passive functional exercise state (PVAS), degree of joint bending, and Ramsay scores were recorded. Results: The Ramsay scores were significantly higher, AVAS scores were significantly lower, PVAS scores were significantly decreased, the degree of joint bending was significantly higher, and the time to the first postoperative ambulation was shorter in groups D1 and D2 than group C. Furthermore, the time to the first postoperative ambulation was shorter in group D2 than in group D1, patients in groups D1 and D2 were more satisfied than patients in group C, and patients in group D2 were more satisfied than patients in group D1. Conclusion: The protocol of 0.05 μg × kg–1 × h–1 of DEX combined with 0.15% ro­pivacaine in ultrasound-guided continuous femoral nerve block for postoperative analgesia in elderly patients with TKA provides a better analgesic effect than without DEX performance.

scholarly journals Application of Intelligent Ultrasound in Real-Time Monitoring of Postoperative Analgesic Nerve Block

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Zhengwei Li ◽  
Ling Zhao ◽  
Wutao Wang ◽  
Ling Zheng
Keyword(s):  
Brachial Plexus ◽  
Success Rate ◽  
Real Time ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Nerve Stimulator ◽  
Ultrasound Guided ◽  
Intelligent Monitoring ◽  
Average Success Rate ◽  
Plexus Block

In order to monitor the effect of nerve block in postoperative analgesia more accurately, this paper puts forward the application research of ultrasonic real-time intelligent monitoring of nerve block in postoperative analgesia. Ultrasonic real-time intelligent monitoring of nerve block in upper limb surgery, lower limb surgery, and abdominal surgery combined with the nerve stimulator. The experiments show that there are 5 cases of adverse reactions when the nerve stimulator is only used, but no adverse reactions occur when combined with ultrasound-guided block. Continuous subclavian brachial plexus block with the ultrasound-guided nerve stimulator can clearly see the subclavian brachial plexus and its surrounding tissue structure, the direction of needle insertion in the plane, and the diffusion of narcotic drugs. The average success rate of block was up to 95.2%, which was significantly higher than that of nerve stimulator alone, and the success rate of recatheterization after the first failure was also improved. The average postoperative analgesia satisfaction was 85.6%, the average operation time was only 20 min, and the subclavian artery and pleura were avoided effectively. No pneumothorax and other complications occurred. The average success rate of ultrasound-guided subclavicular brachial plexus block in 1-2-year-old children was 97%, which was much higher than the average success rate of nerve stimulator localization with 63%. Ultrasound-guided nerve block not only directly blocks nerves under visual conditions but also helps to observe the structures around nerves and dynamically observe the diffusion of local anesthetics, which can significantly improve the accuracy and success rate of nerve block and reduce the incidence of complications.

Clinical Utility of Low-Volume Ultrasound-Guided Interscalene Blockade

2009 ◽  
Vol 28 (9) ◽  
pp. 1251-1258 ◽  
Author(s):  
Hugh M. Smith ◽  
Christopher M. Duncan ◽  
James R. Hebl
Keyword(s):  
Clinical Utility ◽  
Ultrasound Guided ◽  
Volume Ultrasound ◽  
Low Volume

scholarly journals Ultrasound-Guided Transversus Thoracic Muscle Plane-Pectoral Nerve Block for Postoperative Analgesia After Modified Radical Mastectomy: A Comparison with the Thoracic Paravertebral Nerve Block

2021 ◽  
Author(s):  
Ying Zhao ◽  
Weilin Jin ◽  
Peng Pan ◽  
Shuquan Feng ◽  
Danyun Fu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Inflammatory Response ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Radical Mastectomy ◽  
Modified Radical Mastectomy ◽  
Ultrasound Guided ◽  
Flurbiprofen Axetil ◽  
Pectoral Nerve ◽  
Fentanyl Consumption

Abstract Background: Modified radical mastectomy (MRM) is a most effective and common type of invasive surgery for breast cancer. However, it causes moderate to severe acute pain even last for a long postoperative period. Transversus thoracic muscle plane-pectoral nerve block (TTP-PECS) is a novel and promising interfacial plane block which can provide analgesia for MRM while thoracic paravertebral nerve block (TPVB) is also widely used for this purpose. This study compared the postoperative analgesia between the ultrasound-guided TTP-PECS and TPVB in patients undergoing MRM.Methods: In this randomized controlled pilot trial, eighty female breast cancer patients were randomized to receive either ultrasound-guided TTP-PECS (TTP-PECS group, n=40) or TPVB (TPVB group, n=40). The primary outcome was 24 h postoperative fentanyl consumption. Secondary outcome measures included intraoperative fentanyl and postoperative flurbiprofen axetil consumption, duration of analgesia, pain intensity at rest and during activity, inflammatory response, and the quality of recovery 40 (QoR-40) score.Results: Intraoperative fentanyl requirement was similar between the two groups; Postoperative fentanyl consumption was decreased in the TTP-PECS group copmared with the TPVB group, as well as the rate of postoperative flurbiprofen axetil consumption, but the duration of analgesia was longer; Pain scores at rest and during activity were dramatically decreased at postoperative 12 h; Moreover, the levels of IL-6, MCP-1 and TNF-α, as well as the levels of PGE2, NPY and β-endorphins were decreased at 12 h after surgery; Finally, the total QoR-40 score, especially for the scores of pain, emotional state and patient support were increased.Conclusion: Both TTP-PECS and TPVB are effective for analgesia after MRM. However, TTP-PECS reduced postoperative fentanyl and flurbiprofen axetil consumption in the first 24 h after MRM, and prolonged the duration of analgesia. Furthermore, TTP-PECS reduced postoperative pain intensity at rest and during activity, and inflammatory response at 12 h postoperation. Finally, TTP-PECS improved QoR-40 scores on the postoperative day. Thus, TTP-PECS is an attractive alternative to TPVB for postoperative analgesia after MRM.

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