&lt;p&gt;Regional Anesthesia for Pain Management After Orthopedic Procedures for Treatment of Lower Extremity Length Discrepancy&lt;/p&gt;

Villalobos, Mauricio Arce; Veneziano, Giorgio; Iobst, Christopher; Miller, Rebecca; Walch, Ana Gabriela; Roth, Catherine; Argote-Romero, Graciela; Martin, David P.; Beltran, Ralph J; Tobias, Joseph D.

doi:10.2147/jpr.s233617

Cited by 6 publications

(6 citation statements)

References 17 publications

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“…Sample size was calculated using MedCalc Software version 16.8.4 (MedCalc Software bvba, Acacialaan 22, 8400 Ostend, Belgium). Based on minimum mean difference of 25% in morphine consumption [ 13 ] with α = 0.01 and β = 0.20, sample size for each group was estimated as 20. So, we include 30 patients in each group.…”

Section: Methodsmentioning

confidence: 99%

Psoas compartment block efficacy and safety for perioperative analgesia in the elderly with proximal femur fractures: a randomized controlled study

Бєлка

Kuchyn

Токар³

et al. 2021

BMC Anesthesiol

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Background Proximal femur fractures are most common fractures in the elderly and associated with significant mortality and morbidity, with high economic and social impact. Perioperative pain management influence outcomes and mortality after surgery with early mobilization being possible. The goal of the study was to compare the efficacy and safety of the psoas compartment block (PCB) with spinal and general anesthesia. Methods We included 90 patients in this randomized controlled study and divided them into three groups. For patients in group 1 ultrasound-guided PCB with bupivacaine 0.125% 6–8 ml / h was performed. Intraoperative anesthesia was provided with PCB and a sciatic nerve block. Postoperative analgesia include prolonged CPB with bupivacaine 0.125% 6–8 ml / h. In group 2 intraoperative spinal anaesthesia were performed. Group 3 patients underwent general sevoflurane inhalation anaesthesia with fentanyl infusion for analgesia. All patients received paracetamol 3 g/day and dexketoprofen 75 mg/day during hospitalization. On-demand, nalbuphine 5 mg SC was used for analgesia. Efficacy outcomes were the ICU length of stay and the total duration of hospitalization, number of patients who had severe pain after surgery, incidence of on-demand analgesia, sleep quality, postoperative mobilization time. Safety outcomes include complication incidence. Results There were no differences in the duration of ICU stay - gr.1 72 [70–75], gr.2 74 [72–76], gr.3 72 [70–75] hours respectively (p = 0.29), and the total duration of hospitalization - gr.1144 [170–184], gr.2170 [148–188], gr.3178 [144–200] hours respectively. Patients in gr.1 had significantly lower nalbuphine consumption in the first 24 h after surgery and total during hospitalization (0 [0–5] mg versus 15 [10–20] and 20 [15–25] mg in the first 24 h in groups 2 and 3, respectively (p < 0.001). Gr. 1 had lower number of patients with severe pain (10% vs. 47 and 60% in groups 2 and 3, respectively, p < 0.05), lower number of on demand analgesia (0 [0–1] vs. 3 [2–4] and 4 [3, 4] in groups 2 and 3, respectively), better sleep quality (8 [7–9] vs. 6 [5–7] and 4 [3, 4] in groups 2 and 3, respectively, p < 0.001), significantly faster mobilization after surgery – sitting in bed and getting to his feet. MINS was diagnosed significantly more often in gr. 2 and 3 compared with gr. 1 (OR 9 95 CI 1,01–77, p = 0,048 for gr. 2 and OR 11 95 CI 1,2–91, p = 0, 03 for gr. 3). However, none of the patients had symptoms of myocardial ischemia and was not diagnosed with myocardial infarction. There were no difference in the incidence of nosocomial pneumonia and delirium. Conclusion Perioperative PCB in elderly patients with a proximal femur fracture could be an effective analgesia technique, as it decrease the number of patients with severe pain, need for on demand analgesia and opioid consumption. PCB also decrease the incidence of opioid-associated nausea and vomiting, comparing to general anesthesia, and increase the number of patients, who was mobilized in the 1st day (sitting) and 2nd day (getting up) after surgery. PCB may reduce the incidence of MINS, although to assess this outcome more studies are needed. Trial registration Clinicaltrials.gov: NCT04648332, first registration date 1/12/2020.

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Section: Methodsmentioning

confidence: 99%

Psoas compartment block efficacy and safety for perioperative analgesia in the elderly with proximal femur fractures: a randomized controlled study

Бєлка

Kuchyn

Токар³

et al. 2021

BMC Anesthesiol

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“…O uso de BNPs em cirurgias ortopédicas de membros inferiores facilita a mobilização precoce (Kamel;Sethi, 2022). Em estudos como o de Arce Villalobos et al (2020), todos os pacientes começaram a fisioterapia e exercícios de sustentação de peso nas primeiras 24 horas pós-cirurgia. Pesquisas comparando BNPs com raquianestesia e anestesia geral mostram que os BNPs promovem mobilização mais rápida, melhor controle da dor e qualidade de sono.…”

Section: Deambulação Precoceunclassified

“…Complicações que causam danos permanentes variam de 0,015% a 0,09% (Mateen et al, 2021;Nobre et al, 2020;Danninger;Opperer;Memtsoudis, 2014). Arce Villalobos et al (2020) observaram uma maior recorrência de lesões nervosas em procedimentos com BNPs, destacando a necessidade de atenção redobrada a esse aspecto.…”

Section: Lesão Nervosaunclassified

Benefícios E Riscos Dos Bloqueios Periféricos Sobre a Dor Em Cirurgia Ortopédica Do Membro Inferior

Santos,

Paglioli,

Daudt

et al. 2024

Rev. Contemp.

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A relevância dos bloqueios de nervos periféricos (BNPs) tem aumentado progressivamente ao longo do tempo devido à sua crescente aplicação no gerenciamento da dor em pacientes submetidos a cirurgias ortopédicas, sendo preferidos em relação a outras modalidades de anestesia. Este estudo visa realizar uma síntese dos benefícios e riscos associados à utilização de bloqueios de nervos periféricos para o controle da dor em pacientes submetidos a cirurgias ortopédicas nos membros inferiores. A metodologia empregada consiste em uma revisão integrativa da literatura e análise qualitativa de dados, com o intuito de sintetizar o conhecimento existente, abrangendo um total de 18 artigos selecionados. Os benefícios foram categorizados em diversas áreas, incluindo a utilização dos BNPs como alternativa técnica, a redução de internações não programadas, diminuição do tempo de hospitalização, economia de custos hospitalares, redução do consumo de opioides e analgésicos, bem como promoção de mobilização precoce. Por outro lado, os riscos foram categorizados como fraqueza muscular ou quedas, bloqueio motor, infecção, lesão nervosa, reações alérgicas ao anestésico, falha do bloqueio, formação de hematoma, náuseas, vômitos e dor recorrente. Em resumo, os BNPs, comparados à anestesia geral e neuroaxial, demonstram proporcionar mais benefícios e menos riscos associados, embora exijam um maior nível de proficiência técnica para sua realização adequada.

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“…In one pilot study, Alghamdi et al , with the use of acetaminophen, dexmedetomidine, dextromethorphan, and ketamine, were able to show effective pain management, parental satisfaction, and an absent need for perioperative opioid analgesia in children undergoing adenoidectomy [67]. Likewise, other studies have reported effective postoperative pain control achieved through peripheral nerve catheters with continuous infusion of local anesthetic agents, limiting the need for opioid use and the associated complications [68–71].…”

Section: Perioperative Implications Of Pediatric Obesitymentioning

confidence: 99%

Pediatric obesity and perioperative medicine

Mpody

Owusu-Bediako

Raman

et al. 2021

Current Opinion in Anaesthesiology

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Purpose of reviewChildhood obesity is a public health emergency that has reached a pandemic level and imposed a massive economic burden on healthcare systems. Our objective was to provide an update on (1) challenges of obesity definition and classification in the perioperative setting, (2) challenges of perioperative patient positioning and vascular access, (3) perioperative implications of childhood obesity, (3) anesthetic medication dosing and opioid-sparing techniques in obese children, and (4) research gaps in perioperative childhood obesity research including a call to action. Recent findingsDespite the near axiomatic observation that obesity is a pervasive clinical problem with considerable impact on perioperative health, there have only been a handful of research into the many ramifications of childhood obesity in the perioperative setting. A nuanced understanding of the surgical and anesthetic risks associated with obesity is essential to inform patients' perioperative consultation and their parents' counseling, improve preoperative risk mitigation, and improve patients' rescue process when complications occur. SummaryAnesthesiologists and surgeons will continue to be confronted with an unprecedented number of obese or overweight children with a high risk of perioperative complications.

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<p>Regional Anesthesia for Pain Management After Orthopedic Procedures for Treatment of Lower Extremity Length Discrepancy</p>

Cited by 6 publications

References 17 publications

Psoas compartment block efficacy and safety for perioperative analgesia in the elderly with proximal femur fractures: a randomized controlled study

Psoas compartment block efficacy and safety for perioperative analgesia in the elderly with proximal femur fractures: a randomized controlled study

Benefícios E Riscos Dos Bloqueios Periféricos Sobre a Dor Em Cirurgia Ortopédica Do Membro Inferior

Pediatric obesity and perioperative medicine

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