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Ultrasound-guided thoracic nerve blocks for emergency department patients with rib fractures: A review.
J Emerg Med
August 2024
Department of Emergency Medicine, Duke University School of Medicine, Durham, North Carolina; Durham Veterans Affairs Healthcare System, 508 Fulton St, Durham, North Carolina. Electronic address:
Background: Rib fractures are frequently diagnosed and treated in the emergency department (ED). Thoracic trauma has serious morbidity and mortality, particularly in older adults, with complications including pulmonary contusions, hemorrhage, pneumonia, or death. Bedside ED-performed ultrasound-guided anesthesia is gaining in popularity, and early and adequate pain control has shown improved patient outcomes with rare complications.
View Article and Find Full Text PDFComparison of Ultrasound-guided Bilateral Anterior Quadratus Lumborum Block at the Lateral Supra-arcuate Ligament with Conventional Epidural Block in Patients Undergoing Laparoscopic Radical Gastrectomy: A Randomized Controlled Study.
J Med Ultrasound
April 2024
Department of Anesthesiology, The School of Clinical Medicine, Fujian Madical University, The First Hospital of Putian City, Fujian, China.
Background: To test the novel ultrasound (US)-guided bilateral anterior quadratus lumborum block (QLBA) at the lateral supra-arcuate ligament (supra-LAL) technique combined with postoperative intravenous analgesia was a viable alternative approach of conventional thoracic epidural analgesia (TEA) for laparoscopic radical gastrectomy (LRG).
Methods: Three hundred and four patients scheduled for LRG were randomized 1:1 into QLBA group: receiving a novel pathway of US-guided bilateral QLBA at the supra-LAL before general anesthesia (GA) and patient-controlled intravenous analgesia (PCIA) after surgery, and TEA group: receiving TEA before GA and patient-controlled epidural analgesia following surgery. The difference in procedure time between the treatment groups was set as the primary endpoint.
Recent Advances in Perioperative Analgesia in Thoracic Surgery: A Narrative Review.
J Clin Med
December 2024
Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, Aberdeen AB24 3UE, UK.
Thoracic surgery is associated with significant postoperative pain, which can hinder recovery and elevate morbidity risks. Traditionally, epidural anesthesia has been the cornerstone for pain management, but its drawbacks including technical challenges, side effects, and complications necessitate exploring alternative methods. This narrative review examined recent advances in perioperative analgesic strategies in thoracic surgery, focusing on regional anesthetic techniques like paravertebral blocks (PVBs), erector spinae plane blocks (ESPBs), intercostal blocks, and serratus anterior blocks.
View Article and Find Full Text PDFEfficacy of Methylene Blue Thoracic Paravertebral Block in Postoperative Pain After VATS Lobectomy.
Ann Thorac Surg Short Rep
June 2024
Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Naples, Italy.
Background: Paravertebral block (PVB) is effective in controlling postoperative pain after video-assisted thoracoscopic surgery (VATS) lobectomy but is subject to a high rate of failure because of incorrect site of injection. We compared methylene blue PVB with thoracic epidural anesthesia (TEA) for postoperative pain after VATS lobectomy.
Methods: We conducted a prospective randomized trial of patients undergoing VATS lobectomy; 120 patients were randomly assigned to the PVB or TEA group.
Spread of local anaesthetic after erector spinae plane block: a randomised, three-dimensional reconstruction, imaging study.
Br J Anaesth
January 2025
Department of Anaesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Background: Spread of local anaesthetic solution in the paravertebral space after erector spinae plane block (ESPB) is variable. We evaluated whether paravertebral spread of local anaesthetic is affected by patient position after ESPB.
Methods: We randomised 84 patients to receive ESPB at T with a mixture of 0.
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