Remote transmission monitoring for postoperative perineural analgesia after major orthopedic surgery: A multicenter, randomized, parallel-group, controlled trial.

Study Objective: After surgery, patients reported the delay in receiving help as the primary factor for poorly controlled pain. This study aimed to compare the effectiveness of patient management through two communication modalities: remote transmission (RT) versus bedside control (BC). We hypothesized that using remote technology for pump programming may provide the best postoperative infusion regimen for the patient's self-assessment of pain and adverse events.

Impact of multiple nerves blocks anaesthesia on intraoperative hypotension and mortality in hip fracture surgery intermediate-risk elderly patients: A propensity score-matched comparison with spinal and general anaesthesia.

Background: A Hip fracture in the intermediate-risk elderly patient is common and associated with a high rate of postoperative morbidity and mortality. There is a lack of consensus on the optimal anaesthetic technique but there is a clear association between intraoperative hypotension and postoperative morbidity and mortality. We aimed to compare the haemodynamic stability of three anaesthesia techniques: general anaesthesia (GA), continuous spinal anaesthesia (CSA), and multiple nerve blocks (MNB).

An uncommon cause of nerve stimulator's malfunction during a dual guidance lumbar plexus block: A technical brief report and an algorithm for prevention of complications.

Posterior Lumbar plexus block (PLPB) combined with an ipsilateral sacral plexus block is a valuable anaesthetic technique in patients undergoing hip fracture surgery. PLPB is performed through the acoustic window of the lumbar ultrasound trident and the position of the needle tip, before injection of LA, was confirmed by observing quadriceps femoris muscle contraction to peripheral nerve stimulation (i.e.

Posterior Quadratus Lumborum Block in Total Hip Arthroplasty: A Randomized Controlled Trial.

Background: Pain management is important for ensuring early mobilization after hip arthroplasty; however, the optimal components remain controversial. Recently, the quadratus lumborum block has been proposed as an analgesic option. The current study tested the hypothesis that the posterior quadratus lumborum block combined with multimodal analgesia decreases morphine consumption after hip arthroplasty.

Preoperative erythropoietin within a patient blood management program decreases both blood transfusion and postoperative anemia: a prospective observational study.

Background: In orthopedic surgery, a patient blood management program (PBM) has been proposed to reduce blood transfusion. The aim of this observational study was to assess, within a PBM, the specific efficacy of preoperative erythropoietin (EPO).

Study Design And Methods: In a single hospital, 723 patients undergoing elective primary hip or knee arthroplasty were prospectively studied.

Preoperative Epoetin-α with Intravenous or Oral Iron for Major Orthopedic Surgery: A Randomized Controlled Trial.

What We Already Know About This Topic: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Preoperative administration of epoetin-α with iron is commonly used in anemic patients undergoing major orthopedic surgery, but the optimal route of iron intake is controversial. The aim of this study was to compare the clinical effects of erythropoietin in combination with oral or intravenous iron supplementation.

Methods: This study was a prospective, randomized, single-blinded, parallel arm trial.

Effects of pressure support ventilation mode on emergence time and intra-operative ventilatory function: a randomized controlled trial.

Unlabelled: We tested the hypothesis that pressure-support ventilation (PSV) allows a reduction in emergence time and laryngeal mask airway (LMA) removal time after general anesthesia compared to volume-controlled mechanical ventilation (CMV). Because spontaneous breathing (SB) is often used with LMA under general anesthesia, patients were allocated randomly to three groups (CMV, SB and PSV). Thirty-six consecutive ASA I-II patients scheduled for knee arthroscopic surgery under general anesthesia with a LMA and breathing throughout the ventilator circuit were included.

Where should the tip of the needle be located in ultrasound-guided peripheral nerve blocks?

Purpose Of Review: Data now exist describing the appropriate positioning of the needle tip and pattern of local anaesthetic spread after injection. The recent literature has been analysed in search of studies on the optimal procedure for common approaches centred on block efficacy, performance time, and safety.

Recent Findings: Large peripheral nerves are surrounded by a gliding layer, the adventitia or paraneurium.

Hemodynamic profile of target-controlled spinal anesthesia compared with 2 target-controlled general anesthesia techniques in elderly patients with cardiac comorbidities.

Background And Objectives: The impact of anesthesia techniques in patients experiencing hip fracture is controversial. This study compares the effects on blood pressure of 3 anesthesia techniques that are considered safe for the elderly.

Methods: Forty-five patients older than 75 years, with American Society of Anesthesiologists physical status III or IV, with cardiac comorbidities, and undergoing surgery for hip fracture, were randomized to receive continuous spinal anesthesia (CSA), propofol target-controlled infusion (TCI), or sevoflurane (SEVO).

Ultrasound-guided evaluation of the local anesthetic spread parameters required for a rapid surgical popliteal sciatic nerve block.

Background: The ideal spread of local anesthetic (LA) solution around the sciatic nerve during a popliteal block remains unclear. We tested the hypothesis that a circumferential spread of LA and/or intraneural injection could lead to rapid surgical block.

Methods: Patients (n = 100) scheduled for foot or ankle surgery underwent popliteal sciatic nerve block using nerve stimulation according to Borgeat's technique and injection of ropivacaine (0.

The ultrasound-guided transversus abdominis plane block for anterior iliac crest bone graft postoperative pain relief: a prospective descriptive study.

Background: Acute postoperative pain and nerve injuries frequently lead to neuropathic chronic pain after anterior iliac crest (AIC) bone graft. This prospective study evaluated postoperative pain relief after preoperative ultrasound-guided transversus abdominis plane (TAP) block for orthopedic surgery with an AIC bone harvest and the prevalence of pain chronicization at 18 months after surgery.

Methods: Thirty-three consecutive patients scheduled for major orthopedic surgery with an AIC harvest for autologous bone graft were studied.

Estimation and pharmacodynamic consequences of the minimum effective anesthetic volumes for median and ulnar nerve blocks: a randomized, double-blind, controlled comparison between ultrasound and nerve stimulation guidance.

Background: Nerve stimulation and ultrasound guidance are the most popular techniques for peripheral nerve blocks. However, the minimum effective anesthetic volume (MEAV) in selected nerves for both techniques and the consequences of decreasing the local anesthetic volume on the pharmacodynamic characteristics of nerve block remain unstudied. We designed a randomized, double-blind controlled comparison between neurostimulation and ultrasound guidance to estimate the MEAV of 1.

Effect of patient-controlled perineural analgesia on rehabilitation and pain after ambulatory orthopedic surgery: a multicenter randomized trial.

Background: Efficacy of continuous perineural and patient-controlled ropivacaine infusion at home after orthopedic surgery was compared with patient-controlled intravenous morphine for functional recovery and postoperative analgesia in a multicenter randomized trial.

Methods: Eighty-three patients scheduled to undergo acromioplasty or hallux valgus surgery received an interscalene (n = 40) or popliteal (n = 43) peripheral nerve block with 30 ml ropivacaine, 0.5%.

Percutaneous electrode guidance using the insulated needle for prelocation of peripheral nerves during axillary plexus blocks.

Background And Objectives: Short reports have noted that percutaneous prelocation is helpful in determining the anatomic course of a peripheral nerve, and, thereby, may serve as a guide for block needle insertion. We prospectively studied percutaneous electrode guidance to assist axillary brachial plexus blocks.

Methods: In 131 consecutive patients, the tip of an insulated needle emitting 5 mA was placed on the skin above and below the axillary artery to obtain a hand motor response characteristic of the median, ulnar, and radial nerves in succession.

Postoperative analgesia after total-hip arthroplasty: Comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or psoas compartment block. a prospective, randomized, double-blind study.

Background: The authors compared the analgesic effects and quality of rehabilitation of three analgesic techniques after total-hip arthroplasty in a double-blind, randomized trial.

Methods: Forty-five patients were assigned to 1 of 3 groups, patient-controlled analgesia with morphine (PCA), femoral nerve block (FNB), or psoas compartment block (PCB). At the end of the procedure performed under general anesthesia, nerve blocks using 2 mg/kg of 0.

Comparison of continuous 3-in-1 and fascia Iliaca compartment blocks for postoperative analgesia: feasibility, catheter migration, distribution of sensory block, and analgesic efficacy.

Background And Objectives: Efficacy and technical aspects of continuous 3-in-1 and fascia iliaca compartment blocks were compared.

Methods: Forty-four patients scheduled for cruciate ligament repair or femur surgery were randomly divided into 2 groups. After surgery with the patient anesthetized, catheters were placed for continuous 3-in-1 blocks by means of a nerve stimulator (group 1).

Continuous psoas compartment block for postoperative analgesia after total hip arthroplasty: new landmarks, technical guidelines, and clinical evaluation.

Unlabelled: A computed tomographic scan was obtained in 35 patients to measure the depth and the relationship of the branches of the lumbar plexus to the posterior superior iliac spine projection and the vertebral column. In addition, we prospectively studied 80 patients scheduled for total hip arthroplasty who received a continuous psoas compartment block (CPCB) in the postoperative period. CPCB was performed after surgical procedures by using modified Winnie's landmarks and nerve stimulation.

Continuous three-in-one block for postoperative pain after lower limb orthopedic surgery: where do the catheters go?

Unlabelled: Continuous three-in-one block is widely used for postoperative analgesia after proximal lower limb surgery, but location of the catheter has not been well addressed in the literature. We prospectively studied, in 100 patients, the characteristics of catheter threading under the iliac fascia and the correlations between catheter tip location and effective sensory and motor blockade of the three principal nerves of the lumbar plexus. Postoperatively, in conscious patients, 16 to 20 cm of a catheter was placed in the fascial sheath after femoral nerve location with a nerve stimulator.