Pericapsular nerve group block: a 3D CT scan imaging study to determine the spread of injectate.

Background: Current understanding of the mechanism of action of the pericapsular nerve group (PENG) block is primarily based on cadaver studies. We performed an imaging study in patients undergoing hip surgery to enhance the understanding of the analgesic mechanisms following a PENG block.

Materials And Methods: 10 patients scheduled for hip surgery received an ultrasound-guided PENG block with 18 mL of 0.

Motor-Sparing Nerve Blocks Can Improve the Results of Digit Tendon Surgery: A Case Report.

A 56-year-old woman presented with flexion dysfunction of the fifth digit 6 weeks after surgical repair of a flexor digitorum profundus laceration. She was scheduled for surgical adhesiolysis and restoration of the functionality of the finger. Intraoperative monitoring of the range of motion by active flexion was deemed important to prevent incomplete release of the tendon and residual dysfunction.

Effect of Lidocaine 2% Versus Bupivacaine 0.5% and 1 Versus 2 Dual Separate Injections on Onset and Duration of Ultrasound-Guided Wrist Blocks: A Blinded 2 × 2 Factorial Randomized Clinical Trial.

Background: Local anesthetics are often selected or mixed to accomplish faster onset of anesthesia. However, with ultrasound guidance, local anesthetics are delivered with greater precision, which may shorten the onset time with all classes of local anesthetics. In this study, we compared onset time and duration of ultrasound-guided wrist blocks with a fast onset versus a longer lasting local anesthetic administered via single or dual (spatially separate) injections at the level of the midforearm.

From emergency department to operating room: interventional analgesia techniques for hip fractures.

Purpose Of Review: To provide an update on pain management options with regional anesthesia for patients with hip fractures at the emergency department (ED).

Recent Findings: Patients who sustain a hip fracture are typically admitted and diagnosed in the ED before being transferred to the operating room for surgery. Studies have clearly demonstrated the ability of the fascia iliaca compartment blocks (FICBs) and femoral nerve blocks (FNBs) to reduce pain and the risk of an acute confusional state.

Selective periarticular blocks for postoperative pain after hip and knee arthroplasty.

Purpose Of Review: This review aims to provide an overview of selective periarticular blocks for postoperative pain after hip and knee arthroplasty and the current evidence for their use.

Recent Findings: Most interventional analgesia techniques for hip and knee arthroplasty result in a motor block and muscle weakness. Therefore, these are not well suited for fast-track protocols.

Quadratus lumborum block: an imaging study of three approaches.

Background And Objectives: Different injection techniques for the quadratus lumborum (QL) block have been described. Data in human cadavers suggest that the transverse oblique paramedian (TOP) QL3 may reach the thoracic paravertebral space more consistently than the QL1 and QL2. However, the distribution of injectate in cadavers may differ from that in patients.

Peripheral nerve catheters: A critical review of the efficacy.

Continuous peripheral nerve blocks are commonly used for postoperative analgesia after surgery. However, catheter failure may occur due to either primary (incorrect insertion) or secondary reasons (displacement, obstruction, disconnection). Catheter failure results in unanticipated pain, need for opioid use, and risk of readmission or delay in hospital discharge.

Fascia iliaca compartment blocks: Different techniques and review of the literature.

The fascia iliaca compartment block has been promoted as a valuable regional anesthesia and analgesia technique for lower limb surgery. Numerous studies have been performed, but the evidence on the true benefits of the fascia iliaca compartment block is still limited. Recent anatomical, radiological, and clinical research has demonstrated the limitations of the landmark infrainguinal technique.

In search of the Holy Grail: Poisons and extended release local anesthetics.

Regional anesthesia has been advocated as adjunct to a multimodal analgesia regimen. The limited duration of the action of available local anesthetics limits their application. Catheters, perineural or IV adjuvants, or repetition of blocks are modalities available to prolong the analgesic benefit of LRA.

Extended release bupivacaine formulations for postoperative analgesia: an update.

Purpose Of Review: New formulations of local anesthetics with sustained release and longer duration of action are being developed to improve patient outcomes following surgery. This review summarizes the efficacy and safety of the three most recently developed extended-release formulations of the local anesthetic, bupivacaine.

Recent Findings: Bupivacaine liposome injectable suspension (EXPAREL) encapsulates bupivacaine in biodegradable liposomes.