New peripheral nerve blocks and local anesthetics

Sarı, Sinem; Kumar, Jennifer; Turan, Alparslan

doi:10.1097/mcc.0000000000000873

Cited by 7 publications

(7 citation statements)

References 56 publications

(62 reference statements)

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“…Intermediate chain or linkage facilitates the categorization of local anesthetics and modifies their clearance pattern. The liver bio-transforms amides, while plasma esterases hydrolyze esters in blood [24] .…”

Section: Metabolism and Eliminationmentioning

confidence: 99%

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Continuous Nerve Block

Khalil,

El-Sabagh,

Khashaba

2023

Benha Journal of Applied Sciences

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Background: CPNB known as "perineural infusion of local anesthetic" is the catheter placement next to a peripheral nerve, preceded by local anesthetic administration through catheter, which gives anesthesia/analgesia for many days or even months. CPNBs may be delivered in a hospital setting, but mobile infusion using mobile, lightweight pumps is also a possibility. The most prevalent use of this technique is postoperative pain control. Treating intractable hiccups is considered one of the included other indications; initiating vasodilation to raise blood supply and sympathectomy after catastrophic vascularity, digit transfer/replantation, or limb salvage; relieving Raynaud's disease vasospasm; and treating chronic pain and peripheral embolism, such as complex regional pain syndrome, phantom limb pain, trigeminal neuralgia, and cancer-induced pain. Perineural infusion may give analgesia after trauma while transit to a distant medical facility or while awaiting surgical repair. Catheter installation may be achieved utilizing various different methods, involving nerve stimulation, ultrasound guiding, paresthesia induction, fluoroscopic imaging, and basic tactile sensations ("facial click"). This article provides a review of the existing literature on continuous peripheral nerve blocks supported by evidence.

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Section: Metabolism and Eliminationmentioning

confidence: 99%

“…Notably, both ropivacaine and bupivacaine cause tissue damage, but ropivacaine causes far less harm. Unknowns are the clinical implications of these findings [24] .…”

Section: Infusates Local Anestheticmentioning

confidence: 99%

Continuous Nerve Block

Khalil,

El-Sabagh,

Khashaba

2023

Benha Journal of Applied Sciences

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“…Especially in complex thoracic and abdominal surgery patients, the use of regional blocks combined with epidural anesthesia are emphasized in the literature for better PO pain control 5,50 . Furthermore, there is the emergence of fascial planes blockades, with good evidence in acute pain management and less adverse effects (urinary retention and hypotension), especially in thoraco-abdominal approaches 53,54 , favoring satisfaction, early rehabilitation, and shorter hospital stay. Despite current advances, there is still a large field of ongoing research on the topic, especially in techniques of application and management of infusions directly into more complex wounds, use of anesthetics with longer half-life (16 h x 72 h), and use of intravenous drugs and adjunct perineural to increase analgesic effects 55 .…”

Section: Acute Pain Approach and Multimodal Therapymentioning

confidence: 99%

Acute pain in the critically ill patient: revisiting the literature

Vieira¹,

Prinz²

2022

BrJP

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BACKGROUND AND OBJECTIVES:According to the redefinition, acute pain is a somatic experience, with individual perception of physical or existential threat, comprising affective, cognitive and behavioral components. In critically ill patients, pain is a frequent and poorly controlled symptom, causing worse outcomes. The objective of this study was to explore the topic of acute pain in critically ill adult patients, focusing on some aspects of pathophysiology, in addition to updates regarding diagnosis, multimodal therapy and discussion of its control as a marker of good care practice. CONTENTS: A search strategy was performed with the descriptors previously defined in the Pubmed and Cochrane portals, in the period from 2011 to 2021, without a language restriction filter. Acute pain represents a physiological response to a nociceptive stimulus, with high relevance due to its ability to activate complex pathways (inflammatory, hormonal and immune), with systemic repercussions. Pain assessment is often performed using recognized scales, but with limited validation in patients with traumatic brain injury, burns and patients with severe delirium and/or dementia. Studies considering these patients point to the use of new technologies in an attempt to target this diagnosis, such as bedside pupillometry and the use of platforms capable of integrating multiparametric measurements. Regarding therapy, the concept of analgosedation, aiming at prioritizing analgesia in critically ill patients, presents an approach capable of improving clinical outcomes. In addition, there is a preference for multimodal therapy as a good medical practice through the association of different drugs with different mechanisms of nociceptive blockade as a strategy to achieve pain control and facilitate the reduction of opioid consumption. CONCLUSION: Due to its systemic effects and prevalence, acute pain is still a relevant problem in intensive care units. New diagnostic methods are being marketed with the aim of targeting this evaluation in complex patients. The approach to acute pain Acute pain in the critically ill patient: revisiting the literature Dor aguda no paciente crítico: revisitando a literatura

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“…The possibility of neuroinfections (meningitis or encephalitis) after neuraxial analgesia/anesthesia is an unresolved topic, although it has been mentioned that this possibility is extremely low and there are no published cases with this complication [97]. At present, postdural puncture headache in patients with COVID-19, the epidural blood patch should be avoided [98], instead, regional analgesia can be used with peripheral blocks (greater occipital nerve block, lesser occipital nerve block, sphenopalatine ganglion block, and/or trigger point injections) [99,100].…”

Section: Neuroaxial Anesthesiamentioning

confidence: 99%

Regional Anesthesia in Times of COVID-19

Whizar-Lugo¹,

Iñiguez-López²,

Castorena-Arellano³

2022

Topics in Regional Anesthesia

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The globalized coronavirus pandemic 2019 has kept us on our toes. Although confusion is widespread and there is a trend toward normalization of almost all human activities, outbreaks remain frequent. The majority of patients with COVID-19 have a trivial to moderate clinical course; a small group develops severe pneumonia and other life-threatening complications. Vaccination against this virus has contributed to better control of the pandemic, but there are no antiviral drugs that have demonstrated efficacy; therefore, the management of surgical patients confirmed or suspected of this disease is a challenge for health care workers, including the anesthesiologists, as well as the non-COVID-19 patients who at a given moment could become carriers or sick. General anesthesia produces aerosols and risks medical and technical personnel being infected, especially those who manage the airway. On the other hand, regional anesthesia has advantages over general anesthesia because the airway is not handled; however, its limited duration is the most important concern. It is reasonable that regional anesthesia occupies a preponderant place in the safe management of all patients, as long as the type of surgery allows it, the anesthesiologist has sufficient skills and patients accept the proposed technique. At this time of globalized crisis due to COVID-19, the intrapandemic anesthetic management of patients undergoing surgery continues to be a changing task, a challenge that has been solved as new data based on solid scientific evidence arise, besides the development of drugs, safer vaccines, equipment, and health prophylactic methods. There is a clear tendency to use regional anesthesia whenever this is possible.

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New peripheral nerve blocks and local anesthetics

Cited by 7 publications

References 56 publications

Continuous Nerve Block

Continuous Nerve Block

Acute pain in the critically ill patient: revisiting the literature

Regional Anesthesia in Times of COVID-19

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