Controlled, clinical trial assessing saphenous, tibial and common peroneal nerve blocks for the control of perioperative pain following femoro-tibial joint surgery in the nonchondrodystrophoid dog

Abstract Background Postoperative pain management is becoming an integral part of anaesthesia care. Various techniques of pain relief have been designed among which the most commonly practiced are peripheral nerve blocks. We have designed the study to assess analgesic efficacy, duration of postoperative analgesia, hemodynamic stability, and total need of analgesics and opioids after adding morphine to levobupivacaine in TAP block for open appendectomy. A substantial component of the pain experienced by patients after major abdominal surgery is derived from the abdominal wall incision. The abdominal wall consists of three muscle layers, the external oblique, the internal oblique and the transversus abdominis, and their associated fascial sheaths. This muscular wall is innervated by nerve afferents that course through the transversus abdominis neuro-fascial plane. Different adjuvants have been studied to improve the quality and increase the duration of local anaesthetics during various nerve block techniques. Aim of the work The aim of this study is to assess the analgesic effect of peripherally administered morphine with levobupivacaine for ipsilateral TAP block in patients undergoing appendectomy under general anaesthesia. Patient and Methods Type of Study prospective, randomized and double blind controlled clinical trial. Study Setting Ain Shams University Hospitals. Study Period 6 months. Sampling Method randomized double blind clinical trial. suction evacuation for molar pregnancy, all cases were included in the study were agreed on a consent for inclusion in the current study after explanation for the details of the study. Conclusion TAP block was effective in reducing postoperative pain scores, lowering total 24-h postoperative analgesic consumption. Morphine as an adjunct to levobupivacaine in ipsilateral ultrasound guided transversus abdominis plane block as more effective postoperative analgesia with reduced analgesic requirement in patients undergoing appendectomy.

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Ambulatory continuous peripheral nerve blocks to treat post-amputation phantom limb pain a multicenter, randomized, quadruple-masked, placebo-controlled clinical trial

Pain ◽

10.1097/j.pain.0000000000002087 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Brian M. Ilfeld ◽

Bahareh Khatibi ◽

Kamal Maheshwari ◽

Sarah J. Madison ◽

Wael Ali Sakr Esa ◽

...

Keyword(s):

Clinical Trial ◽

Peripheral Nerve ◽

Phantom Limb Pain ◽

Phantom Limb ◽

Controlled Clinical Trial ◽

Limb Pain ◽

Nerve Blocks ◽

Peripheral Nerve Blocks

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Implementation of magnesium sulphate as an adjunct to multimodal analgesic approach for perioperative pain control in lumbar laminectomy surgery: A randomized placebo-controlled clinical trial

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2020.106091 ◽

2020 ◽

Vol 197 ◽

pp. 106091

Author(s):

Georgia Tsaousi ◽

Anastasia Nikopoulou ◽

Ioakeim Pezikoglou ◽

Vasiliki Birba ◽

Vasilios Grosomanidis

Keyword(s):

Clinical Trial ◽

Magnesium Sulphate ◽

Pain Control ◽

Controlled Clinical Trial ◽

Perioperative Pain

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Ultrasound-Guided Multiple Peripheral Nerve Blocks in a Superobese Patient

Case Reports in Anesthesiology ◽

10.1155/2014/896914 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Alper Kilicaslan ◽

Ahmet Topal ◽

Atilla Erol ◽

Hale Borazan ◽

Onur Bilge ◽

...

Keyword(s):

Peripheral Nerve ◽

Peroneal Nerve ◽

Subcutaneous Tissue ◽

Common Peroneal Nerve ◽

Obese Patients ◽

Ultrasound Guided ◽

Nerve Blocks ◽

Ps Ii ◽

Peripheral Nerve Blocks ◽

Plane Technique

The number of obese patients has increased dramatically worldwide. Morbid obesity is associated with an increased incidence of medical comorbidities and restricts the application choices in anesthesiology. We report a successfully performed combined ultrasound-guided blockade of the femoral, tibial, and common peroneal nerve in a superobese patient. We present a case report of a 31-year-old, ASA-PS II, super obese man (190 kg, 180 cm, BMI: 58 kg/m2) admitted to the emergency department with a type II segmental tibia shaft fracture and ankle dislocation after a vehicle accident. After two failed spinal anesthesia attempts, we decided to apply a femoral block combined with a sciatic block. Femoral blocks were successfully performed with US guided in-plane technique. Separate blocks of the tibial and common peroneal nerves were planned after the sciatic nerve could not be located due to the thick subcutaneous tissue. We performed a tibial nerve block at 2 cm above the popliteal crease and common peroneal nerve at the level of the fibular head with US guided in-plane technique. The blocks were successful and no block-related complications were noted. Ultrasound guidance allows new approaches for multiple peripheral nerve blocks with low local anesthetic doses in obese patients.

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A New Anterior Approach to the Sciatic Nerve Block

Anesthesiology ◽

10.1097/00000542-199912000-00017 ◽

1999 ◽

Vol 91 (6) ◽

pp. 1655-1655 ◽

Cited By ~ 70

Author(s):

Jacques E. Chelly ◽

Laurent Delaunay

Keyword(s):

Sciatic Nerve ◽

Nerve Block ◽

Anterior Approach ◽

Peroneal Nerve ◽

Tibial Nerve ◽

Common Peroneal Nerve ◽

Sensory Block ◽

Pubic Symphysis ◽

Sciatic Nerve Block ◽

Nerve Blocks

Background Although several anterior approaches to sciatic nerve block have been described, they are used infrequently. The authors describe a new anterior approach that allows access to the sciatic nerve with the patient in the supine position. Method Sciatic nerve blocks were performed in 22 patients. A line was drawn between the inferior border of the anterosuperior iliac spine and the superior angle of the pubic symphysis tubercle. Next, a perpendicular line bisecting the initial line was drawn and extended 8 cm caudad. The needle was inserted perpendicularly to the skin, and the sciatic nerve was identified at a depth of 10.5 cm (9.5-13.5 cm; median and range) using a nerve stimulator and a 15-cm b-beveled insulated needle. After appropriate localization, either 30 ml mepivacaine, 1.5% (group 1 = knee arthroscopy; n = 16), or 15 ml mepivacaine, 1.5%, plus 15 ml ropivacaine, 0.75%, (group 2 = other procedures; n = 6) was injected. Results Appropriate landmarks were determined within 1.3 min (0.5-2.0 min). The sciatic nerve was identified in all patients within 2.5 min (1.2-5 min), starting from the beginning of the appropriate landmark determination to the stimulation of its common peroneal nerve component in 13 cases and its tibial nerve component in 9 cases. A complete sensory block in the distribution of both the common peroneal nerve component and the tibial nerve component was obtained within 15 min (5-30 min). A shorter onset was observed in patients who received mepivacaine alone compared with those who received a mixture of mepivacaine plus ropivacaine (10 min [5-25 min] vs. 20 min [10-30 min]; P < 0.05). Recovery time was 4.6 h (2.5-5.5 h) after mepivacaine administration. The addition of ropivacaine produced a block of a much longer duration 13.8 h (5.2-23.6 h); P < 0.05. No complications were observed. Conclusions This approach represents an easy and reliable anterior technique for performing sciatic nerve blocks.

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Foot Surgery in Vanuatu: Results of Combined Tibial, Common Peroneal and Saphenous Nerve Blocks in Fifty-six Adults

Anaesthesia and Intensive Care ◽

10.1177/0310057x8901700316 ◽

1989 ◽

Vol 17 (3) ◽

pp. 336-339 ◽

Cited By ~ 8

Author(s):

C. J. Sparks ◽

T. Higeleo

Keyword(s):

Peroneal Nerve ◽

Common Peroneal Nerve ◽

Saphenous Nerve ◽

Popliteal Fossa ◽

Constant Current ◽

Foot And Ankle ◽

Nerve Stimulator ◽

Foot Surgery ◽

Nerve Blocks ◽

Ankle Surgery

Combined tibial and common peroneal nerve anaesthesia was used for foot and ankle surgery in fifty-six adults. Where necessary, the saphenous nerve was also blocked. A calibrated constant current nerve stimulator was used to localise the nerves in the popliteal fossa. Using lignocaine 1%, an opioid premedication, but no other sedation or top-up injection, 60% of the blocks were successful. If a patient felt pain at incision or during surgery, the block was recorded as a failure.

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