Ultrasound-Guided Femoral and Sciatic Nerve Blocks in an Anticoagulated Patient. Case Reports

Ferraro, Leonardo Henrique Cunha; Tardelli, Maria Ângela; Yamashita, Américo Massafuni; Cardone, José Daniel Braz; Kishi, Juliana Midori

doi:10.1016/s0034-7094(10)70052-0

Cited by 8 publications

(3 citation statements)

References 17 publications

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“…Many peer‐reviewed publications support the use of ultrasound suggesting decreased time to perform most blocks, decreased onset of surgical anesthesia, decrease local anesthetic volume, improved patient comfort, enhanced block success rate, and improved the quality of blocks performed [1,4–7]. Ultrasound may also facilitate the placement of PNBs in patients with challenging anatomy (i.e., scarring from previous surgeries and obese patients) and in those for whom PNBs has relative contraindications (i.e., anticoagulation) [8–12]. Based on our survey, most anesthesiologists involved in regional anesthesia education are aware of the major potential advantages of ultrasound.…”

Section: Discussionmentioning

confidence: 93%

The Current Role of Ultrasound Use in Teaching Regional Anesthesia: A Survey of Residency Programs in the United States

et al. 2012

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Section: Discussionmentioning

confidence: 93%

The Current Role of Ultrasound Use in Teaching Regional Anesthesia: A Survey of Residency Programs in the United States

et al. 2012

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“…In rare instances, a hematoma can occur during an axillary brachial plexus block resulting in untoward peripheral nerve sequelae even in otherwise healthy patient not receiving anticoagulation therapy [10]. Although vascular damage could occur from the PNB, an experienced and trained anesthesiologist using a thinner infiltrative needle and higher resolution ultrasound can reduce the risk of hematoma [11]. Continuous PNB was not an option in this patient since there was a potential of significant bleeding and formation of an axillary hematoma.…”

Section: Discussionmentioning

confidence: 94%

Ultrasound-Guided Peri-Lymphatic and Peri-Neural Corticosteroid Injection as an Adjuvant to Pain and Lymphedema Management in Terminal Cancer: Two Case Reports

Choi¹,

Rosenblum²

2012

OJAnes

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We are reporting two patients presented with intractable cancer pain that was treated with a novel application of an ultrasound-guided peripheral nerve block using corticosteroid. This technique offered relief to both patients whom otherwise their cancer pain was difficult to manage. The first patient developed lymphedema to the right axilla from metastatic squamous cell carcinoma. After multiple injections were deposited around the brachial plexus, lymphedema on the right axilla decreased slightly in size; however, range of motion improved post-procedure prior to his discharge one week later. In the second patient with left inguinal lymphadenopathy from metastatic left ureteral transitional cell carcinoma, there was a dramatic reduction in lymphedema in the left groin and leg as well as a considerable decrease in pain score during a two week follow-up after the peri-neural and peri-lymphatic femoral block. A 75% improvement in patient satisfaction was reported in the office visit's questionnaire form. Corticosteroids can be used as an adjuvant to peripheral nerve block to decrease the pain secondary to lymphedema caused by the inflammatory response from metastatic cancer. This application can provide an alternative way to manage severe cancer-related pain caused by lymphedema in both upper and lower limbs.

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“…Moreover, US-guided techniques allow pain physicians to perform neve blocks or injections on deep structures in patients with obesity or regions affected by degenerative conditions/prior surgery. In addition, US-guided procedures can be performed in patients with relative contraindications for other guidance techniques (e.g., anticoagulant use, which increases the risk of excessive bleeding) under careful monitoring [ 11 12 13 ].…”

Section: Discussionmentioning

confidence: 99%

State of education regarding ultrasound-guided interventions during pain fellowships in Korea: a survey of recent fellows

Kim

Byun

et al. 2017

Korean J Pain

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BackgroundRecently, the use of ultrasound (US) techniques in regional anesthesia and pain medicine has increased significantly. However, the current extent of training in the use of US-guided pain management procedures in Korea remains unknown. The purpose of the present study was to assess the current state of US training provided during Korean Pain Society (KPS) pain fellowship programs through the comparative analysis between training hospitals.MethodsWe conducted an anonymous survey of 51 pain physicians who had completed KPS fellowships in 2017. Items pertained to current US practices and education, as well as the types of techniques and amount of experience with US-guided pain management procedures. Responses were compared based on the tier of the training hospital.ResultsAmong the 51 respondents, 14 received training at first- and second-tier hospitals (Group A), while 37 received training at third-tier hospitals (Group B). The mean total duration of pain training during the 1-year fellowship was 7.4 months in Group A and 8.4 months in Group B. Our analysis revealed that 36% and 40% of respondents in Groups A and B received dedicated US training, respectively. Most respondents underwent US training in patient-care settings under the supervision of attending physicians. Cervical root, stellate ganglion, piriformis, and lumbar plexus blocks were more commonly performed by Group B than by Group A (P < 0.05).ConclusionsInstruction regarding US-guided pain management interventions varied among fellowship training hospitals, highlighting the need for the development of educational standards that mandate a minimum number of US-guided nerve blocks or injections during fellowships in interventional pain management.

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Ultrasound-Guided Femoral and Sciatic Nerve Blocks in an Anticoagulated Patient. Case Reports

Cited by 8 publications

References 17 publications

The Current Role of Ultrasound Use in Teaching Regional Anesthesia: A Survey of Residency Programs in the United States

The Current Role of Ultrasound Use in Teaching Regional Anesthesia: A Survey of Residency Programs in the United States

Ultrasound-Guided Peri-Lymphatic and Peri-Neural Corticosteroid Injection as an Adjuvant to Pain and Lymphedema Management in Terminal Cancer: Two Case Reports

State of education regarding ultrasound-guided interventions during pain fellowships in Korea: a survey of recent fellows

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