Low-concentration distal nerve blocks with 0.125% levobupivacaine versus systemic analgesia for ambulatory trapeziectomy performed under axillary block: a randomized controlled trial

Prieto, Mireia Rodríguez; González, Francisco; Sabaté, Sergi; García, Mercedes; Lamas, C.; Font, A. E. Gonzalez; Moreno, Marisa; Proubasta, I.; Bernabé, Mª Angels Gil de; Moral, M. V.; Hoffmann, Ralph

doi:10.23736/s0375-9393.18.12291-7

Cited by 3 publications

(5 citation statements)

References 31 publications

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“…Local anaesthetics primarily block sodium channels in nerves, which prevents nerve depolarization and propagation of the action potential, thus preventing propagation of the pain stimulus. Blockade of pain signals may have a more profound impact than modulation of pain signals as humans receiving local blocks alone had lower pain scores and a reduced requirement for rescue analgesia than those receiving systemic opioids alone following thoracic limb surgery (Rodríguez et al, 2018). In veterinary medicine, dogs receiving local blocks following a thoracotomy had lower pain scores than those receiving systemic opioids (Conzemius, Brockman, King, & Perkowski, 1994).…”

mentioning

confidence: 99%

Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1)

Grubb

Lobprise

2020

Veterinary Medicine & Sci

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Pain management in veterinary patients is a crucial component of appropriate patient care. Multimodal analgesia that includes both systemically and locally/regionally administered drugs is generally the most effective approach to providing pain relief. Local anaesthetic drugs used in local and regional blockade are unique in that they can completely block the transmission of pain (in conscious patients) or nociceptive (in anaesthetized patients) signals, thereby providing profound analgesia. In addition, local and regional administration of drugs, when compared with systemic bolus administration, generally results in a lower incidence of dose‐related adverse effects. Due to the potential to provide profound analgesia and the high safety margin (when used correctly) of this drug class, local anaesthetics are recommended as part of the analgesic protocol in the majority of patients undergoing surgical procedures or suffering traumatic injuries. This manuscript, Part 1 of a two‐part instalment, emphasizes the importance of using local and regional anaesthesia as a component of multimodal analgesia, provides a review of the basic pharmacokinetics/pharmacodynamics of local anaesthetic drugs in general, lists information on commonly used local anaesthetic drugs for local and regional blockade in dogs and cats, and briefly introduces the novel liposome‐encapsulated bupivacaine (NOCITA®). Part 2 is a review of local and regional anaesthetic techniques used in dogs and cats (Grubb & Lobprise, 2020).

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confidence: 99%

Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1)

Grubb

Lobprise

2020

Veterinary Medicine & Sci

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“…Among the included studies, the sample sizes vary signi cantly, ranging from relatively small cohorts of 20 patients Xavier P et al, 2002 (31) to large-scale investigations such as the study by Ottokar et al, 2014 (24), which encompassed an extensive cohort of 17,157 individuals. This variability in sample size re ects the heterogeneity in research methodologies, with studies employing randomized controlled trials (RCTs) like Mireia et al, 2018 (27), and large retrospective cohort studies such as that conducted by Matthew T et al, 2016 (25). The distribution of mean age across the studies also demonstrates diversity, with mean ages ranging from 64.5 years in studies like Matthew T et al, 2016 (25) to 77 years in Xavier P et al, 2002 (31).…”

Section: Resultsmentioning

confidence: 99%

“…In addition, most of the non-randomized trial studies have a low risk of bias in multiple domains, but there is an unclear risk in the rst domain for many of the included studies as elicited in Fig. As observed on Table 1, one of the studies was an observational study (39), three retrospective studies (24)(25)(26), four randomized control trials (27)(28)(29)(30), and 10 prospective studies (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41). Among the included studies, the sample sizes vary signi cantly, ranging from relatively small cohorts of 20 patients Xavier P et al, 2002 (31) to large-scale investigations such as the study by Ottokar et al, 2014 (24), which encompassed an extensive cohort of 17,157 individuals.…”

Section: Resultsmentioning

confidence: 99%

“…Using distal nerve blocks with lowconcentration levobupivacaine provided better post-trapeziectomy analgesia under axillary block than systemic analgesia. This indicates that targeted nerve blocks with a low concentration of local anesthetic are effective in managing postoperative pain in older trapeziectomy patients (27). Additionally, the utilization of the "fascial pop" technique for axillary brachial plexus block notably reduced sedation requirements during the procedure, with patients demonstrating greater acceptance of this approach over the electrical nerve stimulation technique (38).…”

Section: Discussionmentioning

confidence: 99%

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The Effects of Anesthesia Methods on the Prognosis of Elderly Patients Undergoing Upper Limb Surgery: A Systematic Review

Yin,

Wally,

OLAGUNJU

et al. 2024

Preprint

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Background The geriatric population presents unique challenges in the perioperative setting due to age-related physiological changes, comorbidities, and altered drug responses. Adapting anesthesia to the particular requirements of elderly patients is crucial for maximizing the success of surgical procedures and reducing the risk of complications and death during the perioperative period; this systematic review aims to assess the selection of anesthetic methods and medications used in upper limb surgeries for elderly patients. By compiling and analyzing data from existing published research, the review seeks to clarify the relative effectiveness, safety, and potential outcomes of various anesthesia techniques used in older individuals undergoing surgeries on the upper extremities. Methods Our study employed a systematic review methodology following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study evaluated anesthesia techniques and drugs for upper limb surgery in older adults. Articles were identified through WEB of SCIENCE, MEDLINE, PUBMED, CINAHL searches, and Hand-Searching from January 2000 to January 2024, with eligibility criteria targeting studies on anesthesia for upper extremity surgeries only in older adults ≥ 65 years. Data extraction included study characteristics and outcomes related to anesthesia techniques and drugs. The methodological quality of included studies was assessed using the Cochrane risk-of-bias tool for randomized trials and the ROBINS-I tool for non-randomized studies of interventions. Results 18 articles met the inclusion criteria for the systematic review. The effectiveness of regional anesthesia is influenced by several factors. The addition of upper-extremity peripheral nerve blocks to general anesthesia during total shoulder arthroplasty has been shown not to increase the risk of complications or resource utilization. In arteriovenous fistula surgery, the application of a brachial plexus block for anesthesia has been shown to increase tissue oxygenation, as indicated by Near-Infrared Spectroscopy. Rotator cuff surgery pain management now favors continuous supraclavicular block, offering comparable pain relief to interscalene block but with fewer side effects Conclusion The review emphasizes the significance of selecting appropriate anesthesia techniques and drugs for upper limb surgery in elderly patients to enhance surgical outcomes and reduce perioperative complications.

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“…98 rodríguez Prieto et al compared distal peripheral nerve blocks (dPnB) with levobupivacaine 0.125% to conventional systemic analgesia after trapeziectomy performed under an axillary block. 99 they found that dPnB provided better postoperative analgesia for the first 48 hours; also, opioid consumption and the incidence of Ponv were lower.…”

Section: Perioperative Medicinementioning

confidence: 93%

A year in review in Minerva Anestesiologica 2018

Cavaliere

Allegri²,

Apan

et al. 2019

Minerva Anestesiol

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Low-concentration distal nerve blocks with 0.125% levobupivacaine versus systemic analgesia for ambulatory trapeziectomy performed under axillary block: a randomized controlled trial

Cited by 3 publications

References 31 publications

Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1)

Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1)

The Effects of Anesthesia Methods on the Prognosis of Elderly Patients Undergoing Upper Limb Surgery: A Systematic Review

A year in review in Minerva Anestesiologica 2018

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