Complex issues in new ultrasound-guided nerve blocks: how to name, where to inject, and how to publish

Yamauchi, M.; Satō, Yutaka

doi:10.1007/s00540-018-2452-5

Cited by 10 publications

(5 citation statements)

References 50 publications

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“…There is no clarity over the anatomical nomenclature for these sacral interfascial plane blocks currently as suggested by Hamilton et al and proposed for sacral retrolaminar block as an alternative name [17]. Piracinni et al proposed the name of sacral multifidus plane block instead of retrolaminar or ESP nomenclature [13,14,[18][19][20]. We suggest using any of the above nomenclatures as each of them are identical but with different proposed anatomical names.…”

Section: Discussionmentioning

confidence: 92%

Sacral Erector Spinae Plane Block for Gender Reassignment Surgery

Kukreja¹,

Deichmann²,

Selph³

et al. 2020

Cureus

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The erector spinae plane block (ESPB) is an interfascial plane block that has been used to provide perioperative analgesia for a variety of indications. This case report describes the novel use of the sacral ESPB on a transgender patient undergoing male-to-female gender reassignment surgery for perioperative pain control. The sacral ESPB technique was described and post-operative pain score and opioid requirements were reported. The sacral ESPB was successfully used as an alternative to neuraxial, caudal, or peripheral nerve blocks for gender reassignment surgery.

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Section: Discussionmentioning

confidence: 92%

Sacral Erector Spinae Plane Block for Gender Reassignment Surgery

Kukreja¹,

Deichmann²,

Selph³

et al. 2020

Cureus

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“…Tis fnding is not difcult to understand because although the pectointercostal fascial block is injecting local anesthetic between pectoralis major and intercostal muscles, the nerves acted on are the anterior cutaneous branch of intercostal nerves. Even some scholars suggested that it is a diferent name for the same type of nerve block [45].…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of Open-Heart Surgery Pain Relief Using Transversus Thoracic Plane Blocks

Ye,

Zou,

Chen

et al. 2024

Journal of Cardiac Surgery

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Background. Severe postoperative pain is commonly reported following open-heart surgery, necessitating the implementation of effective pain management strategies to facilitate patient recovery. The benefits of the transverse thoracic muscle plane (TTMP) block for open-heart surgery remain unclear. Therefore, a meta-analysis was conducted to systematically evaluate the effect of TTMP on postoperative analgesia and recovery in patients undergoing open-heart surgery. Methods. A computer search was performed in PubMed, Cochrane, Embase, CNKI, and Wangfang databases. The primary outcome was 24-hour postoperative opioid consumption, and the secondary outcomes were 12- and 24-hour postoperative resting and motor pain scores, time of first analgesia demand, extubation time, length of stay in the intensive care unit (ICU), time of first feces, incidence of nausea and vomiting, and length of hospitalization. Results. Thirteen randomized controlled trials (RCTs) involving a total of 766 patients were included in this meta-analysis. Compared with the control group, the TTMP group showed a significant reduction in opioid consumption within 24 h postoperatively (mean difference = −41.88 mg; 95% confidence interval: −51.99, −31.77; p<0.001; and I2 = 98%). However, the 12- and 24-hour postoperative resting and moment VAS pain scores were significantly lower in the TTMP group. In addition, the TTMP group had a longer time of first analgesic demand; shorter endotracheal intubation time, ICU stay duration, time of first feces, and length of hospital stay; and a lower incidence of nausea and vomiting. Conclusions. Perioperative TTMP block can reduce the use of opioids in patients undergoing open-heart surgery for 24 h postoperatively, decrease the early postoperative pain scores, prolong the time of first analgesic demand, shorten the time of extubation and the length of ICU stay and hospitalization, and reduce the incidence of nausea and vomiting, which are all conducive to the recovery of patients. Registration. This trial is registered with PROSPERO database (CRD42022312435).

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“…1 Fascia blocks target intermuscular fascia layers in which peripheral nerves lay; the correct identification of musculoskeletal anatomy and needle tip placement within a specific layer is vital to the success of a block. 2 One type of fascia block is the transversus abdominis plane (TAP) block. 3 TAP and its variants provide analgesia for abdominal surgeries 4,5 and have played an important role in opioid-reduced surgery and enhanced recovery after surgery (ERAS) protocols.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Fiber-Needle Swept-Source Optical Coherence Tomography for the Real-Time Visualization of the Transversus Abdominis Plane Block Procedure in a Swine Model

Teng

Kao²,

Ting

et al. 2020

Anesthesia &Amp; Analgesia

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BACKGROUND: Fascia blocks (eg, the transversus abdominis plane [TAP] block) target the intermuscular fascia layers. Ultrasound techniques have allowed peripheral blocks to be performed with accuracy and safety, however, with limitations. Optical coherence tomography (OCT) is based on low-coherence interferometry. In this study, we examined the ability of OCT to identify the TAP. METHODS: A swept-source OCT probe was placed in a 17-gauge needle to obtain imaging. The needle was inserted within 2 different angle ranges (0°–30° and 30°–60°) on a slice of pork belly to assess imaging characteristics. A series of real-time OCT imaging of the muscle, fascia, and interfascial space was obtained. The tissue location of the needle tip was identified using near-infrared (NIR) imaging. In vivo OCT imaging was further done on 3 female 6-month-old native Chinese Landrance Duroc pigs. Real-time images of tissue layers were obtained with needle insertion. Ultrasound imaging of the OCT needle probe was also performed at the same time for needle trajectory guidance. After imaging, the OCT probe was removed, and 5 mL of normal saline was injected via the needle to confirm correct fascia plane identification. RESULTS: In and ex vivo studies showed clear visual distinction of muscle, fascia, and interfascial layer with OCT, with limitations. Independent validation of OCT criteria for the muscle/fascia differentiation by 20 OCT readers for the in vivo data demonstrated the sensitivity = 0.91, specificity = 0.90, and accuracy = 0.89. Although the angle of needle entry affected the depth of OCT penetration in the muscle, the attenuation coefficient values of the fascia and muscle tissue were statistically different (P < .001) and with high area under the receiver operating characteristics (ROC) curve (AUC) (AUC = 0.93 in 0°–30° and AUC = 1 in 30°–60°) for fascia identification. CONCLUSIONS: This study introduced a novel needle imaging probe method to identify the transversus abdominis fascia plane in real-time. Quantitative calculation of the attenuation coefficients can further aid objective identification by providing direct confirmation of the tip position, increasing the first-pass success rate, and decreasing the need for needle repositioning. Combining OCT and ultrasound may improve the accuracy of anesthetics placement.

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Complex issues in new ultrasound-guided nerve blocks: how to name, where to inject, and how to publish

Cited by 10 publications

References 50 publications

Sacral Erector Spinae Plane Block for Gender Reassignment Surgery

Sacral Erector Spinae Plane Block for Gender Reassignment Surgery

Meta-Analysis of Open-Heart Surgery Pain Relief Using Transversus Thoracic Plane Blocks

Fiber-Needle Swept-Source Optical Coherence Tomography for the Real-Time Visualization of the Transversus Abdominis Plane Block Procedure in a Swine Model

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