Block of the Articular Branches of the Femoral Nerve improves Early Pain Control Following Total Hip Arthroplasty
|
|
- Austin Boone
- 6 years ago
- Views:
Transcription
1 /jp-journals Michael Tanzer et al ORIGINAL ARTICLE Block of the Articular Branches of the Femoral Nerve improves Early Pain Control Following Total Hip Arthroplasty Michael Tanzer, Riccardo Taddei, Erik Arbeid, Cedrick Zaouter, Thomas M Hemmerling ABSTRACT We assessed the effectiveness of a continuous local anaesthesia block of the articular branches of the femoral nerve (ABFN) for the treatment of early postoperative pain in 74 patients undergoing total hip anthroplasty (THA). Postoperative analgesia was provided by patient-controlled analgesia (PCA) in 20 patients (PCA group), or by continuous block of ABFN in addition to PCA in 54 patients (PCA + ABFN group). Combining standard PCA morphine and ABFN block decreased the morphine consumption in the postanaesthesia care unit (PACU) by 56% and reduced the time in the PACU by 31%. Twenty-four hours after surgery, continuous block of the ABFN decreased morphine consumption by 44% and pain scores by 32% at rest and 19% with activities. The addition of a block of the ABFN is an effective method of pain treatment immediately following THA because it provides excellent pain control while enabling early mobilisation without impairing motor function. Keywords: Hip arthroplasty, Pain, Anaesthesia, Nerve block. How to cite this article: Tanzer M, Taddei R, Arbeid E, Zaouter C, Hemmerling TM. Block of the Articular Branches of the Femoral Nerve improves Early Pain Control Following Total Hip Arthroplasty. Int J Periop Ultrasound Appl Technol 2012; 1(3): Source of support: Nil Conflict of interest: None declared INTRODUCTION In the United States alone, 16% of the US population will be 65 years of age or older. 1 In a general population with increased demands on mobility at old age, total hip arthroplasty (THA) has become a common surgery in the elderly with low-risk of mortality. 1 Almost 300,000 patients undergo hip replacement per year in the United States. 2 Hip arthroplasty can be associated with significant postoperative pain. 21 Whereas intraoperative anaesthesia using spinal anaesthesia is preferred in the elderly and patients with comorbidities, analgesia following THA is commonly based on opioids in various forms of administration, such as patient-controlled analgesia (PCA), or epidural analgesia. Unfortunately, both techniques are prone to significant side effects. 8 Opioid-based analgesia is associated with the risk of sedation, vomiting, nausea or constipation impairing postoperative recovery and mobilisation. The use of epidural analgesia is limited by increasingly aggressive thromboprophylaxis protocols and its negative effect on early mobilisation Pain after THA comes from superficial and deep structures. Whereas the superficial pain can easily be treated using local infiltration with local anaesthetics, blockage of deep pain, particularly from the hip capsule, is more difficult. Isolated nerve blocks, such as the femoral nerve or combined blocks, such as femoral, obturator and lateral cutaneous nerve, might theoretically provide pain relief, but they also limit muscular force in the respective motor areas, thus limiting early mobilisation and increasing the risk of patients falling. In a cadaveric anatomic study, Birnbaum et al determined that the sensory innervation of the anterior hip capsule was mainly articular branches from the femoral nerve (ABFN). 4 We previously reported on a technique to block the ABFN and our preliminary clinical results suggested further evaluation was warranted. 13 The aim of this study was to update our understanding of the effectiveness of the ABFN block on early pain control following THA by comparing post-operative pain and morphine consumption in the first 24 hours following THA in patients using either standard opioid-based analgesia (PCA) or PCA with the addition of a continuous block of the ABFN. MATERIALS AND METHODS Seventy-four patients were included in this prospective audit after having obtained approval by the institutional review board. All patients underwent a cementless THA by a single orthopaedic surgeon using a posterior approach to the hip. There were no changes in surgical technique or THA patient care protocols during the study period. All postoperative nerve blocks were carried out by a single anaesthesiologist, with extensive experience in peripheral nerve block techniques using ultrasound guidance. Routine anaesthetic monitoring was conducted in the operating room using noninvasive blood pressure, peripheral oxygen saturation and continuous 5-lead electrocardiography. All patients received spinal anaesthesia performed in standard fashion (L2-L3) using 10 to 15 mg of isobaric bupivacaine 0.5%. In the postanaesthesia care unit (PACU), pain management was provided either using PCA, using morphine (bolus: 1 mg; lockout: 7 minutes) (PCA group) or PCA and a continuous block of the ABFN (PCA + ABFN group). The PCA group consisted of 20 consecutive patients that underwent THA immediately prior to July 2009 and the PCA + ABFN
2 IJPUT Block of the Articular Branches of the Femoral Nerve improves Early Pain Control Following Total Hip Arthroplasty group consisted of 54 consecutive patients that had their THA after July 2009, when the technique for ABFN was developed. For those patients in the PCA + ABFN group, imaging of the inguinal region was performed by using a linear 10 to 5 MHz ultrasound probe (SonoSite Inc, Seattle, USA). First, the femoral artery was visualized in short axis, the probe was then moved laterally for 3 to 4 cm along the sartorius muscle, 3 to 4 cm inferior to the inguinal ligament. The ABFN was then identified as a white triangular to ovalshaped area, usually an area of 0.5 to 1 cm between the sartorius muscle and the rectus femoris muscle (Figs 1A and B). After sterile preparation, a 4 cm long 18 gauge Tuohy needle was placed under ultrasound guidance (outof-plane technique) targeting the nerve and 10 ml of lidocaine 2% injected through the needle visualising the ABFN surrounded by the local anaesthetic and lifting the sartorius muscle. A 20 G catheter was placed, inserting 2 to 3 cm within the nerve sheath, tunneled and secured via transparent adhesive tape. Ropivacaine 2% was continuously administered at 6 to 8 ml/h for 24 hours. On average, the ABFN was found to be located 3 ± 0.6 cm deep to the skin surface, 3.6 ± 0.7 cm lateral to the femoral artery and 3.5 ± 0.7 cm distal to the lower border of the inguinal ligament. Fig. 1A: Schematic of the proximal thigh demonstrating the location of the ABFN relative to the surrounding muscles and femoral neurovascular structures Fig. 1B: Ultrasound image of the ABFN and adjacent muscles After the placement of the catheter, the patients were monitored in the PACU until complete return of motor and sensory function in the upper thigh. Pain scores were assessed using a visual pain score (VAS) (0 to 10, with 0 being no pain at all and 10 being the worst imaginable pain) and recorded at the time of discharge from the PACU, and at 24 hours after surgery. Morphine consumption was recorded at 2 hour intervals until 24 hours after surgery. Discharge criteria from the PACU were a return of normal motor and sensory function and VAS < 4. Patient data including gender, age, weight, height and the pre-operative classification of the American Society of Anaesthesiologists were compared using Mann-Whitney rank sum test for continuous and Fisher test for categorical data. Pain assessment using visual analogue score (VAS, 0 = no pain, 10 = maximum imaginable pain) was evaluated at rest at the time of discharge from the PACU and at rest and at mobilisation 24 hours after surgery and compared via Mann- Whitney rank sum test. The total morphine consumption within 12 and 24 hours were compared using Mann-Whitney rank sum test. A value p < 0.05 was considered as showing a statistically significant difference between the two groups. RESULTS Patient characteristics were not different between the two groups (Table 1). At the time of discharge from PACU, motor and sensory functions were completely restored in all patients. There was a significant difference in the time patients required to stay in the PACU with the PCA + ABFN group requiring on average 97 minutes less time meeting the discharge criteria than the PCA group (Table 2). While in the PACU, the PCA group required significantly more morphine to control their pain than the patients with an ABFN block (Table 2). The PCA patients used an average of 4.9 mg of morphine more than the PCA + ABFN group. Morphine consumption 12 and 24 hours after the surgery was significantly lower in the PCA + ABFN group than in the patients who only had a PCA (Graph 1). The PCA patients used an average of 15 mg of morphine more than the PCA + ABFN group at 24 hours postoperatively. When tested 24 hours after surgery, all patients could mobilise the leg of the surgical site, with evidence of sensory or motor impairment from the ABFN block was noted. The patients in the PCA + ABFN group were found to have significantly less pain both at rest and with movement than the patients who had only a PCA (Graph 2). DISCUSSION Patients undergoing hip arthroplasty are pre-dominantly elderly patients and post-operative analgesia is based on intravenous opioids or epidural analgesia. 22,23 Although patient controlled administration of opioids produces better International Journal of Perioperative Ultrasound and Applied Technologies, September-December 2012;1(3):
3 Michael Tanzer et al pain relief than conventional intramuscular opioid therapy, 16,24 it is less efficient for pain due to movement and ineffective in preventing reflex spasms of the quadriceps muscle, which are frequent after hip arthroplasty. 5 Epidural analgesia decreases pain with very little sedation but is associated with a greater incidence of urinary retention, pruritus and hypotension. 8 A common problem of lower lumbar epidural analgesia is also the significant concomitant motor blockade and the significant risk of epidural haematoma. 6 The aim of this study was to compare postoperative pain control and morphine consumption in the first 24 hours following THA in patients using either standard opioid-based analgesia (PCA) or PCA with the addition of a continuous block of the ABFN. Blocking the sensory innervation of the anterior hip capsule, by blocking the ABFN is an effective method of pain treatment Table 1: Patient data and preoperative risk assessment according to classification by the American Society of Anaesthesiologists (ASA) PCA group PCA + ABFN p- (n = 20) group (n = 54) value Gender (female/male) 12/8 26/28 NS Age (years) 63 (14) 69 (11) NS Weight (kg) 81 (15) 78 (11) NS Height (cm) 168 (10) 165 (10) NS ASA I/II/III 6/10/04 14/23/17 NS NS: Nonsignificant; Data as mean (standard deviation) immediately following THA. We found that combining standard PCA morphine and ABFN block decreased the morphine consumption in the PACU by 56% and reduced the time in the PACU by 31%. Continuous block of the ABFN resulted in a decrease in pain scores of 32% at rest, 19% with activities and morphine consumption by 44% at 24 hours after THA surgery. The ABFN block combines excellent pain control without impairment of motor function enabling early mobilisation. There are some limitations to this study, none of which have substantive impact on the results or conclusions. Firstly, this is a cohort study with only time-related randomisation. However, there was no change in operating technique or technique in spinal analgesia throughout the study period. The pain assessment and assessment of morphine consumption relied on standard chart review. However, the nurses who took care of pain assessment and morphine administration in the PACU were not involved in this study but performed their routine duties. Whether or not these small but significant decrease in the visual analogue assessment of pain at 24 hours is clinically relevant is unknown. Several authors have advocated that the use of lumbar plexus block with or without sciatic nerve block, 7,14 femoral lateral nerve block 18 and fascia iliaca block 25 following hip Graph 1: The morphine consumption used by the PCA group (black) and the ABFN and PCA group (grey) during their stay in the PACU, and at 12 and 24 hours after surgery. Data presented as means with standard deviation (bars) Graph 2: The VAS in the PCA group (black) and the ABFN and PCA group (grey) 24 hours postoperatively, both at rest and with movement Table 2: Time, morphine consumption and pain scores VAS in post-operative care unit (PACU) PCA group (n = 20) PCA + ABFN group (n = 54) p-value Time in PACU (min) 315 (250) 218 (87) 0.014* First VAS score (before the block) 1.6 (2.7) 1.0 (2.0) NS Maximum VAS 5.3 (2.4) 4.6 (2.8) NS VAS score at discharge 2.7 (2.1) 2.1 (1.5) NS Morphine consumption (mg) 9.0 (6.8) 4.1 (6.0) 0.004* p < 0.05 showing significant difference; Data presented as means (standard deviation); NS: Nonsignificant 96
4 IJPUT Block of the Articular Branches of the Femoral Nerve improves Early Pain Control Following Total Hip Arthroplasty arthroplasty. Two studies showed that posterior lumbar plexus block did cause significantly better analgesia than placebo, 3,26 whereas femoral nerve block was not able to provide any significant pain relief. 3,10 Despite these advantages, the placement of lumbar plexus or sciatic nerve blocks requires advanced regional anaesthesia skills. They can have serious potential side effects, including patients falls and injury, 15 nerve injury, 21 neuraxial block, systemic absorption of local anaesthetic and retroperitoneal haematoma. 19,20 The combination of spinal local anaesthetic and spinal opioid is also used 2,9,11,12,17 to improve pain treatment after hip arthroplasty. However, the administration of opioids, especially morphine, is associated with the significant risk for complications in the increasingly elderly patient population, such as pruritus, vomiting, failure to void or respiratory depression. It was long believed that the ventral hip joint was innervated by articular branches of the obturator nerve. However, Birnbaum et al showed 4 that the anterior hip joint capsule is mainly innervated by articular branches of the femoral nerve. It is therefore appropriate to search for local anaesthesia treatment of these articular branches, the reasoning behind our approach. The ABFN can be located between the sartorius muscle and the rectus femoris muscle; its localisation via ultrasound can be regarded as of similar difficulty as locating the sciatic nerve in the gluteal area. This study clearly demonstrates the effectiveness of a continuous block of the ABFN following THA. Overall, ABFN and PCA significantly reduced post-operative pain and morphine consumption for the first 24 hours following THA as compared to opioid-based analgesia alone. REFERENCES 1. Health services research on aging: Building on biomedical and clinical research. Publication No 00-P012, Available from: Accesed January 11, OrthoInfo AAOS, Total hip replacement. Last reviewed December Available from: topic.cfm?topic=a Accessed January 15, Biboulet P, Morau D, Aubas P, Bringuier-Branchereau S, Capdevila X. Postoperative analgesia after total-hip arthroplasty: Comparison of intravenous patient-controlled analgesia with morphine and single injection of femoral nerve or psoas compartment block. A prospective, randomized, double-blind study. Reg Anesth Pain Med 2004;29: Birnbaum K, Prescher A, Hessler S, Heller KD. The sensory innervation of the hip joint an anatomical study. Surg Radiol Anat 1997;19: Bonica J. Painful disorders of the thigh and knee. In: Bonica J, (Ed). The management of pain (2nd ed). Philadelphia, PA: Lea and Febiger 1990; Bracco D, Hemmerling T. Epidural analgesia in cardiac surgery: An updated risk assessment. Heart Surg Forum 2007;10:E Buckenmaier CC, 3rd, Xenos JS, Nilsen SM. Lumbar plexus block with perineural catheter and sciatic nerve block for total hip arthroplasty. J Arthroplasty 2002;17: Choi PT, Bhandari M, Scott J, Douketis J. Epidural analgesia for pain relief following hip or knee replacement. Cochrane Database Syst Rev 2003;3CD Fogarty DJ, Milligan KR. Postoperative analgesia following total hip replacement: A comparison of intrathecal morphine and diamorphine. JR Soc Med 1995;88: Fournier R, Van Gessel E, Gaggero G, Boccovi S, Forster A, Gamulin Z. Postoperative analgesia with 3-in-1 femoral nerve block after prosthetic hip surgery. Can J Anaesth 1998;45: Fournier R, Van Gessel E, Macksay M, Gamulin Z. Onset and offset of intrathecal morphine versus nalbuphine for postoperative pain relief after total hip replacement. Acta Anaesthesiol Scand 2000;44: Grace D, Fee JP. A comparison of intrathecal morphine-6- glucuronide and intrathecal morphine sulfate as analgesics for total hip replacement. Anesth Analg 1996;83: Hemmerling TM, Minardi C, Bevilacqua L, Zaouter C, Sinha, A, Tanzer M. Continuous block of the articular branches of the femoral nerve as a novel technique for pain control after hip arthroplasty. Int J Ultrasound Appl Technol Periop Care, Jan- Apr 2010;1(1): Horlocker TT, Kopp SL, Pagnano MW, Hebl JR. Analgesia for total hip and knee arthroplasty: A multimodal pathway featuring peripheral nerve block. J Am Acad Orthop Surg 2006;14: Ilfeld BM, Ball ST, Gearen PF, Le LT, Mariano ER, Vandenborne K, et al. Ambulatory continuous posterior lumbar plexus nerve blocks after hip arthroplasty: A dual-center, randomized, triple-masked, placebo-controlled trial. Anesthesiology 2008;109: Keita H, Geachan N, Dahmani S, Couderc E, Armand C, Quazza M, et al. Comparison between patient-controlled analgesia and subcutaneous morphine in elderly patients after total hip replacement. Br J Anaesth 2003;90: Murphy PM, Stack D, Kinirons B, Laffey JG. Optimizing the dose of intrathecal morphine in older patients undergoing hip arthroplasty. Anesth Analg 2003;97: Ng I, Vaghadia H, Choi PT, Helmy N. Ultrasound imaging accurately identifies the lateral femoral cutaneous nerve. Anesth Analg 2008;107: Niemi L, Pitkanen M, Tuominen M, Rosenberg PH. Technical problems and side effects associated with continuous intrathecal or epidural post-operative analgesia in patients undergoing hip arthroplasty. Eur J Anaesthesiol 1994;11: Peters CL, Shirley B, Erickson J. The effect of a new multimodal perioperative anesthetic regimen on postoperative pain, side effects, rehabilitation, and length of hospital stay after total joint arthroplasty. J Arthroplasty 2006;21: Siddiqui ZI, Cepeda MS, Denman W, Schumann R, Carr DB. Continuous lumbar plexus block provides improved analgesia with fewer side effects compared with systemic opioids after hip arthroplasty: A randomized controlled trial. Reg Anesth Pain Med 2007;32: Singh JA, Lewallen D. Age, gender, obesity, and depression are associated with patient-related pain and function outcome after revision total hip arthroplasty. Clin Rheumatol 2009;28: Slappendel R, Weber EW, Dirksen R, Gielen MJ, van Limbeek J. Optimization of the dose of intrathecal morphine in total hip surgery: A dose-finding study. Anesth Analg 1999;88: Spetzler B, Anderson L. Patient-controlled analgesia in the total joint arthroplasty patient. Clin Orthop Relat Res 1987;215: International Journal of Perioperative Ultrasound and Applied Technologies, September-December 2012;1(3):
5 Michael Tanzer et al 25. Stevens M, Harrison G, McGrail M. A modified fascia iliaca compartment block has significant morphine-sparing effect after total hip arthroplasty. Anaesth Intensive Care 2007;35: Stevens RD, Van Gessel E, Flory N, Fournier R, Gamulin Z. Lumbar plexus block reduces pain and blood loss associated with total hip arthroplasty. Anesthesiology 2000 Jul;93: ABOUT THE AUTHORS Michael Tanzer Department of Surgery, Division of Orthopaedic Surgery, McGill University, Montreal, Canada Correspondence Address: McGill University Health Centre, 1650 Cedar, Avenue No. B5159, Montreal, Quebec, H3G 1A4, Canada michael.tanzer@mcgill.ca Riccardo Taddei Erik Arbeid Department of Anaesthesiology, McGill University, Montreal Canada Cedrick Zaouter Thomas M Hemmerling 98
Continuous Block of the Articular Branches of the Femoral Nerve as a Novel Technique for Pain Control after Hip Arthroplasty
IJUTPC Continuous Block of the Articular Branches of the Femoral Nerve as a Novel Technique for Pain Control after Hip Arthroplasty ORIGINAL ARTICLE Continuous Block of the Articular Branches of the Femoral
More informationAndrew B. Wolff, MD a Geoffrey Hogan, BA a James Capon, BS, MS a Hayden Smith, BA a Alexandra Napoli, BS a Patrick Gaspar, MD b
Pre-operative Lumbar Plexus Block Provides Superior Post-operative Analgesia when compared with Fascia Iliaca Block or General Anesthesia alone in Hip Arthroscopy Andrew B. Wolff, MD a Geoffrey Hogan,
More informationNon-commercial use only
Comparison of continuous femoral nerve block, caudal epidural block, and intravenous patient-controlled analgesia in pain control after total hip arthroplasty: a prospective randomized study Shoji Nishio,
More informationMaroun Badwi Ghabach 1, Jamil Marwan Elmawieh 2, May Semaan Matta 3 and May Rady Helou 4*
COMBINED BLOCK OF THE FEMORAL AND LATERAL FEMORAL CUTANEOUS NERVES UNDER ULTRASOUND FOR POST- OPERATIVE ANALGESIA IN PATIENTS UNDERGOING HIP SURGERY: A DOUBLE BLIND RANDOMIZED TRIAL Maroun Badwi Ghabach
More informationAnatomy and principles of the fascia iliaca block
Anatomy and principles of the fascia iliaca block Dr Ganesh Kumar 23 rd November 2016 Courtesy Dr Fred Sage Objectives Why do peripheral nerves blocks work? Why choose FIB over FNB? How does it work? How
More informationA Staged Approach to Analgesia After Hip Arthroscopy Using Multimodal Analgesia & Elective Ultrasound Guided Fascia Iliaca Block
A Staged Approach to Analgesia After Hip Arthroscopy Using Multimodal Analgesia & Elective Ultrasound Guided Fascia Iliaca Block James T. Beckmann MD Stephen K. Aoki MD Stephen Guyette MD Jeffrey Swenson
More informationCurrent evidence in acute pain management. Jeremy Cashman
Current evidence in acute pain management Jeremy Cashman Optimal analgesia Best possible pain relief Lowest incidence of side effects Optimal analgesia Best possible pain relief Lowest incidence of side
More informationAnesthesia for Total Hip and Knee Arthroplasty
Anesthesia for Total Hip and Knee Arthroplasty Typical approach Describe anesthesia technique Rather Describe issues with THA and TKA How anesthesia can modify Issues Total Hip Total Knee Blood Loss ++
More informationThe intensity of preoperative pain is directly correlated with the amount of morphine needed for postoperative analgesia
The intensity of preoperative pain is directly correlated with the amount of morphine needed for postoperative analgesia This study has been published: The intensity of preoperative pain is directly correlated
More informationLower Extremity Ultrasound-Guided Regional Anesthesia. Stephanie Duffy, CRNA Regional Anesthesia Faculty Acute Pain Service NMCSD
Lower Extremity Ultrasound-Guided Regional Anesthesia Stephanie Duffy, CRNA Regional Anesthesia Faculty Acute Pain Service NMCSD Objectives Review anatomy of lumbosacral plexus Lumbar plexus blocks Psoas
More informationMalaysian Orthopaedic Journal 2008 Vol 2 No 2
Randomized Clinical Trial of Periarticular Drug Injection used in combination Patient-Controlled Analgesia versus Patient-Controlled Analgesia Alone in Total Knee Arthroplasty MN Sabran, MBBS, AJM Talha*,
More informationPsoas compartment block
Stephen Mannion MRCPI FCARCSI MD Key points Psoas compartment block consistently blocks the femoral, lateral femoral cutaneous, and obturator nerves (the true 3-in-1 block). It provides excellent postoperative
More informationMr David A McDonald Service Improvement Manager Whole System patient Flow Improvement Programme Scottish Government
Mr David A McDonald Service Improvement Manager Whole System patient Flow Improvement Programme Scottish Government Introduction Brief update Two main topics Use of Gabapentin Local Infiltration Analgesia
More informationInvestigation performed at the University of Rochester, Department of Orthopaedics and Rehabilitation, Rochester, NY USA
Intra-articular cocktail offers clinical advantages over femoral nerve block for postoperative analgesia in patients undergoing arthroscopic hip surgery Sean Childs, MD; Sonia Pyne, MD; Kiritpaul Nandra,
More informationShow Me the Evidence: Epidurals, PVBs, TAP Blocks Christopher L. Wu, MD Professor of Anesthesiology The Johns Hopkins Hospital
Show Me the Evidence: Epidurals, PVBs, TAP Blocks Christopher L. Wu, MD Professor of Anesthesiology The Johns Hopkins Hospital Overview Review overall (ERAS and non-eras) data for EA, PVB, TAP Examine
More informationCHAPTER 5 Femoral Nerve Block. Arun Nagdev, MD Mike Mallin, MD, RDCS, RDMS
CHAPTER 5 Femoral Nerve Block Arun Nagdev, MD Mike Mallin, MD, RDCS, RDMS SECTION 1 Introduction An ultrasound-guided femoral nerve block (USFNB) can be a rapid and definitive tool for pain control for
More informationDORIS DUKE MEDICAL STUDENTS JOURNAL Volume V,
Continuous Femoral Perineural Infusion (CFPI) Using Ropivacaine after Total Knee Arthroplasty and its Effect on Postoperative Pain and Early Functional Outcomes Eric Lloyd Scientific abstract Total Knee
More informationUltrasound Guided Lower Extremity Blocks
Ultrasound Guided Lower Extremity Blocks CONTENTS: 1. Femoral Nerve Block 2. Popliteal Nerve Block Updated December 2017 1 1. Femoral Nerve Block Indications Surgery involving the knee, anterior thigh,
More informationNerve Blocks of the Lumbar Plexus
27th ESRA Regional Anaesthesia Cadaver Workshop Innsbruck, Austria, February 23 24, 2018 Nerve Blocks of the Lumbar Plexus Paul Kessler Department of Anaesthesiology and Intensive Care Medicine Orthopaedic
More informationENHANCED RECOVERY PROTOCOLS FOR KNEE REPLACEMENT
ENHANCED RECOVERY PROTOCOLS FOR KNEE REPLACEMENT Jeff Gadsden, MD, FRCPC, FANZCA Associate Professor Duke University Department of Anesthesiology Regional Anesthesia and Acute Pain Medicine DISCLOSURES
More informationIs There an Ideal Regimen for CPNB?
Is There an Ideal Regimen for CPNB? Dr Eric Albrecht, MD, DESA Department of Anesthesiology, CHUV 2nd SARA Annual Symposium June 2013 Manuel pratique d ALR échoguidé, Elsevier Masson, Paris, 2013 Albrecht
More informationPAIN. Editor s key points. Methods. J. Kuchálik 1,3, B. Granath 2,3, A. Ljunggren 1, A. Magnuson 4, A. Lundin 2,3 and A.
British Journal of Anaesthesia 111 (5): 793 9 (2013) Advance Access publication 19 July 2013. doi:10.1093/bja/aet248 PAIN Postoperative pain relief after total hip arthroplasty: a randomized, double-blind
More informationWITH ISOBARIC BUPIVACAINE (5 MG/ML)
, 49, 2013, 3 63 (5 MG/ML) (5 MG/ML).,.,.,..,..,, SPINAL ANESTHESIA: COMPARISON OF ISOBARIC ROPIVACAINE (5 MG/ML) WITH ISOBARIC BUPIVACAINE (5 MG/ML) D. Tzoneva, Vl. Miladinov, Al. Todorov, M. P. Atanasova,
More informationIs Local Infiltration Analgesia (LIA) a Safe and Effective Method for Post-Operative Pain Management After a Unilateral Total Knee Arthroplasty (TKA)?
Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Physician Assistant Studies Student Scholarship Student Dissertations, Theses and Papers 2013 Is Local Infiltration Analgesia (LIA)
More informationMULTIMODAL ANALGESIA AFTER TOTAL KNEE ARTHROPLASTY: ROLE OF PERIPHERAL NERVE BLOCKS AND SMALL DOSE KETAMINE
1. 4. MULTIMODAL ANALGESIA AFTER TOTAL KNEE ARTHROPLASTY: ROLE OF PERIPHERAL NERVE BLOCKS AND SMALL DOSE KETAMINE Maher A. Doghiem, MD and Doaa Aboalia MD. Anaesthesia Department, Faculty of Medicine,
More informationDipartimento di Emergenza e Accettazione, Catholic University of Sacred Heart, A. Gemelli Hospital Rome (Italy)
European Review for Medical and Pharmacological Sciences 2008; 12: 117-122 The efficacy of the psoas compartment block versus the intrathecal combination of morphine, fentanyl and bupivacaine for postoperative
More informationPeripheral regional anaesthesia and outcome: lessons learned from the last 10 years
British Journal of Anaesthesia 114 (5): 728 45 (2015) Advance Access publication 17 February 2015. doi:10.1093/bja/aeu559 REVIEW ARTICLES Peripheral regional anaesthesia and outcome: lessons learned from
More informationAnalgesia for ERAS programs. Dr Igor Lemech VMO Anaesthetist Wagga Wagga Base Hospital
Analgesia for ERAS programs Dr Igor Lemech VMO Anaesthetist Wagga Wagga Base Hospital Disclosure I have received honoraria from Mundipharma and MSD The new Wagga Wagga Rural Referral Centre Scope Analgesic
More informationRole and safety of epidural analgesia
Anaesthesia for Liver Resection Surgery The Association of Anaesthetists Seminars 21 Portland Place, London Thursday 15 th December 2005 Role and safety of epidural analgesia Lennart Christiansson MD,
More informationSenior Visceral Surgery Fast-Track in Colorectal Surgery The anesthetist s point of view
Senior Visceral Surgery Fast-Track in Colorectal Surgery The anesthetist s point of view 1st Geneva International SCIENTIFIC DAY February 3 rd 2010 E. Schiffer Dept APSI, HUG 1 Fast-Track in colorectal
More informationSufentanil Sublingual Tablet System 15mcg vs IV PCA Morphine: A Comparative Analysis of Patient Satisfaction and Drug Utilization by Surgery Type
Sufentanil Sublingual Tablet System 15mcg vs IV PCA Morphine: A Comparative Analysis of Patient Satisfaction and Drug Utilization by Surgery Type 2016 European Society of Regional Anesthesia Congress Maastricht,
More informationUltrasound-guided Sciatic Nerve Blocks: Higher and Popliteal Approaches
10.5005/jp-journals-10027-1026 K Kondov, S Fransis REVIEW ARTICLE Ultrasound-guided Sciatic Nerve Blocks: Higher and Popliteal Approaches K Kondov, S Fransis ABSTRACT Background and objective: In modern
More informationEpidural infusion or combined femoral and sciatic nerve blocks as perioperative analgesia for knee arthroplasty {
British Journal of Anaesthesia 93 (3): 368 74 (2004) DOI: 10.1093/bja/aeh224 Advance Access publication July 9, 2004 Epidural infusion or combined femoral and sciatic nerve blocks as perioperative analgesia
More informationIntravenous lidocaine infusions. Dr Ian McConachie FRCA FRCPC
Intravenous lidocaine infusions Dr Ian McConachie FRCA FRCPC Thank the organisers for inviting me. No conflicts or disclosures Lidocaine 1 st amide local anesthetic Synthesized in 1943 by Lofgren in Sweden.
More informationCase Report Use of Peripheral Nerve Blocks with Sedation for Total Knee Arthroplasty in a Patient with Contraindication for General Anesthesia
Case Reports in Anesthesiology Volume 2015, Article ID 950872, 4 pages http://dx.doi.org/10.1155/2015/950872 Case Report Use of Peripheral Nerve Blocks with Sedation for Total Knee Arthroplasty in a Patient
More informationULTRASOUND GUIDED TECHNIQUES FOR PERIOPERATIVE PAIN MANAGEMENT IN TOTAL KNEE ARTHOPLASTY
No. 11 28 July 2017 ULTRASOUND GUIDED TECHNIQUES FOR PERIOPERATIVE PAIN MANAGEMENT IN TOTAL KNEE ARTHOPLASTY S Bobaker Moderator: Dr Y Hookamchand School of Clinical Medicine Discipline of Anaesthesiology
More informationPerioperative Pain Management
Perioperative Pain Management Overview and Update As defined by the Anesthesiologist's Task Force on Acute Pain Management are from the practice guidelines from the American Society of Anesthesiologists
More informationUSRA OF THE LOWER EXTREMITY
USRA OF THE LOWER EXTREMITY Christian R. Falyar, CRNA, DNAP Department of Nurse Anesthesia Virginia Commonwealth University Disclosure Statement of Financial Interest I, Christian Falyar, DO NOT have a
More informationRegional Anaesthesia: Minimizing risk and complications. Mafeitzeral Mamat Anaesthesiology & Critical Care Faculty of Medicine UiTM Sg Buloh
Regional Anaesthesia: Minimizing risk and complications Mafeitzeral Mamat Anaesthesiology & Critical Care Faculty of Medicine UiTM Sg Buloh Regional anesthesia is an art. Remembering that even experts
More informationLasse Østergaard Andersen. Departments of Anesthesia and Orthopedic Surgery, Hvidovre University Hospital,
U N I V E R S I T Y O F C O P E N H A G E N F A C U L T Y O F H E A L T H A N D M E D I C A L S C I E N C E S High-volume Local Infiltration Analgesia in Hip and Knee Arthroplasty Lasse Østergaard Andersen
More informationPost-operative Analgesia for Caesarean Section
Post-operative Analgesia for Caesarean Section Introduction Good quality analgesia after any surgery leads to earlier mobilisation, fewer pulmonary and cardiac complications, a reduced risk of DVT and
More informationAlessandro Di Filippo Manuela Magherini Peggy Ruggiano Antonio Ciardullo Silvia Falsini
DOI 10.1007/s40520-014-0272-5 ORIGINAL ARTICLE Postoperative analgesia in patients older than 75 years undergoing intervention for per-trochanteric hip fracture: a single centre retrospective cohort study
More informationAustralian and New Zealand Registry of Regional Anaesthesia (AURORA)
Australian and New Zealand Registry of Regional Anaesthesia (AURORA) Overview of Results First 4000 procedures recorded to - www.anaesthesiaregistry.org June 1st 2011 to February 2012 Background Australian
More informationEfficacy of postoperative epidural analgesia Block B M, Liu S S, Rowlingson A J, Cowan A R, Cowan J A, Wu C L
Efficacy of postoperative epidural analgesia Block B M, Liu S S, Rowlingson A J, Cowan A R, Cowan J A, Wu C L CRD summary This review evaluated the efficacy of post-operative epidural analgesia. The authors
More informationCAESAREAN SECTION Brian Fredman
CHAPTER 3 GYNAECOLOGICAL SURGERY CAESAREAN SECTION Brian Fredman Review of evidence: surgical site infusion Of the seven studies on surgical site local anaesthetic infusion after Caesarean section performed
More informationEUROANESTHESIA 2008 Copenhagen, Denmark, 31 May - 3 June RC2
PERIPHERAL NERVE BLOCKS FOR LOWER LIMB SURGERY: PRACTICAL GUIDELINES EUROANESTHESIA 2008 Copenhagen, Denmark, 31 May - 3 June 2008 08RC2 XAVIER CAPDEVILA, MATTHIEU PONROUCH Lapeyronie University Hospital
More informationIntrathecal 0.75% Isobaric Ropivacaine Versus 0.5% Heavy Bupivacaine for Elective Cesarean Delivery: A Randomized Controlled Trial
Intrathecal 0.75% Isobaric Ropivacaine Versus 0.5% Heavy Bupivacaine for Elective Cesarean Delivery: A Randomized Controlled Trial Surjeet Singh, 1 V.P. Singh, 2 Manish Jain, 3 Kumkum Gupta, 3 Bhavna Rastogi,
More informationManagement of Acute Pain in the Chronic Pain Patient. Eric Cannon, MD Mountain West Anesthesia December 1, 2017
Management of Acute Pain in the Chronic Pain Patient Eric Cannon, MD Mountain West Anesthesia December 1, 2017 Objectives 1. Describe the unique challenges of managing acute pain episodes in patients being
More informationA randomised controlled study of epidural fentanyl analgesia following lumbar laminectomy
A randomised controlled study of epidural fentanyl analgesia following lumbar laminectomy Mr. S Thomson 1 Mr. P Mitchell 3 Mr. PT van Hille 2 Dr. B Gregson 3 1. Department of Neurosurgery, Cambridge University
More informationSurgery Under Regional Anesthesia
Surgery Under Regional Anesthesia Jean Daniel Eloy, MD Assistant Professor Residency Program Director Rutgers-New Jersey Medical School Rutgers The State University of New Jersey Peripheral Nerve Block
More informationTAP blocks vs wound infiltration in laparoscopic colectomies Results of a Randomised Controlled Clinical Trial
TAP blocks vs wound infiltration in laparoscopic colectomies Results of a Randomised Controlled Clinical Trial Kim Gorissen Frederic Ris Martijn Gosselink Ian Lindsey Dept of Colorectal Surgery Dept of
More informationREVIEW ARTICLE. Molecular Orthopaedics, Beijing Institute of Traumatology and Orthopaedics, Beijing, China
294 2016 THE AUTHORS. PUBLISHED BY JOHN WILEY &SONS AUSTRALIA, LTD AND CHINESE ORTHOPAEDIC ASSOCIATION REVIEW ARTICLE Analgesic Efficacy of Adductor Canal Block in Total Knee Arthroplasty: A Meta-analysis
More informationON-Q * Pain Relief System ORTHOPEDIC SURGERY TECHNIQUES & CLINICAL EVIDENCE
ON-Q * Pain Relief System ORTHOPEDIC SURGERY TECHNIQUES & CLINICAL EVIDENCE BETTER OUTCOMES. SATISFIED PATIENTS. DISCLAIMERS The disclaimers contained herein pertain to all information included in this
More informationBrachial plexus blockade within the interscalene groove involves local anesthetic
Interscalene Brachial Plexus Block- How I do it. Part 1 of a 2 part discussion on technique. Stuart Grant Professor of Anesthesiology Duke University Medical Center Durham NC Brachial plexus blockade within
More informationFASCIAL PLANE BLOCKS TOM BARIBEAULT MSN, CRNA
FASCIAL PLANE BLOCKS TOM BARIBEAULT MSN, CRNA TECHNIQUES Abdominal Wall TAP Rectus Sheath Quadratus Lumborum Erector Spinae Chest PECS I & II Erector Spinae TECHNIQUES Knee Ipack/LIA Hip Fascia Iliaca
More informationRegional anaesthesia in paediatric day case surgery. PA Lönnqvist Karolinska Institutet Karolinska University Hospital Stockholm, Sweden
Regional anaesthesia in paediatric day case surgery PA Lönnqvist Karolinska Institutet Karolinska University Hospital Stockholm, Sweden Ambulatory surgery in children Out-patient surgery in children did
More informationmusculoskeletal system anatomy nerves of the lower limb 1 done by: dina sawadha & mohammad abukabeer
musculoskeletal system anatomy nerves of the lower limb 1 done by: dina sawadha & mohammad abukabeer What is the importance of plexuses? plexuses provides us the advantage of a phenomenon called convergence
More informationABSTRACT TITLE: Near-OR Perioperative Interventions to Decrease Hospital Length
ABSTRACT NUMBER: 020-0094 ABSTRACT TITLE: Near-OR Perioperative Interventions to Decrease Hospital Length of Stay AUTHORS: Mark J. Lenart, MD Vanderbilt University 1301 Medical Center Drive Nashville,
More informationEfficacy of single-shot fascia iliaca compartment blocks. Tom Brink Promotor: Dr. Ph. van Loon
Efficacy of single-shot fascia iliaca compartment blocks Tom Brink Promotor: Dr. Ph. van Loon Index Introduction About the FICB Methods Results o o o o o Search results Study characteristics Techniques
More informationPerspectives on Modern Orthopaedics
Perspectives on Modern Orthopaedics Analgesia for Total Hip and Knee Arthroplasty: A Multimodal Pathway Featuring Peripheral Nerve Block Terese T. Horlocker, MD Sandra L. Kopp, MD Mark W. Pagnano, MD James
More informationComparison of fentanyl versus fentanyl plus magnesium as post-operative epidural analgesia in orthopedic hip surgeries
Original Research Article Comparison of fentanyl versus fentanyl plus magnesium as post-operative epidural analgesia in orthopedic hip surgeries P V Praveen Kumar 1*, Sreemanth 2 1 Associate Professor,
More informationAnesthetic Techniques for Rapid Recovery in Total Knee Arthroplasty
Anesthetic Techniques for Rapid Recovery in Total Knee Arthroplasty Scott T. Ball, MD Chief, Adult Joint Reconstruction Department of Orthopaedic Surgery University of California, San Diego Disclosures
More informationResearch and Reviews: Journal of Medical and Health Sciences
Research and Reviews: Journal of Medical and Health Sciences Evaluation of Epidural Clonidine for Postoperative Pain Relief. Mukesh I Shukla, Ajay Rathod, Swathi N*, Jayesh Kamat, Pramod Sarwa, and Vishal
More informationAnaesthesia and Pain Management for Endo Exo Femoral Prosthesis (EEFP) Bridging the Gap from Surgery to Rehabilitation
Anaesthesia and Pain Management for Endo Exo Femoral Prosthesis (EEFP) Bridging the Gap from Surgery to Rehabilitation Dr Ajay Kumar Senior Lecturer Macquarie and Melbourne University Introduction Amputee
More informationThe effect of liposomal bupivacaine injection during total hip arthroplasty: a controlled cohort study
Domb et al. BMC Musculoskeletal Disorders 2014, 15:310 RESEARCH ARTICLE Open Access The effect of liposomal bupivacaine injection during total hip arthroplasty: a controlled cohort study Benjamin G Domb
More informationProfessor Narinder Rawal, MD, PhD, FRCA (Hon), EDRA Department of Anaesthesiology and Intensive Care University Hospital Örebro, Sweden
Professor Narinder Rawal, MD, PhD, FRCA (Hon), EDRA Department of Anaesthesiology and Intensive Care University Hospital Örebro, Sweden Infiltrative techniques in perioperative pain lecture outline Why
More informationEfficacy Of Ropivacaine - Fentanyl In Comparison To Bupivacaine - Fentanyl In Epidural Anaesthesia
ISPUB.COM The Internet Journal of Anesthesiology Volume 33 Number 1 Efficacy Of Ropivacaine - Fentanyl In Comparison To Bupivacaine - Fentanyl In Epidural Anaesthesia S Gautam, S Singh, R Verma, S Kumar,
More informationPeripheral Nerve Blocks
Peripheral Nerve Blocks N U R S I N G E D U C A T I O N JPS Acute Pain Service Peripheral nerve blocks are used as part of a multimodal analgesic program which provides the patient with safe and effective
More informationThe use of Pudendal Nerve Block in Hemorrhoidectomy Operations: A Prospective Double Blind Placebo Control Study
Kasr El Aini Journal of Surgery VOL., 10, NO 3 September 2009 97 The use of Pudendal Nerve Block in Hemorrhoidectomy Operations: A Prospective Double Blind Placebo Control Study Sherif Adly and Mohamed
More informationRole of PNB in Postoperative Pain Management
27th ESRA Regional Anaesthesia Cadaver Workshop Innsbruck, Austria, February 23 24, 2018 Role of PNB in Postoperative Pain Management Paul Kessler Department of Anaesthesiology and Intensive Care Medicine
More informationComparison Of 0.5%Bupivacaine And 0.5% Bupivacaine Plus Buprenorphine in Brachial Plexus Block
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 15, Issue 1 Ver. VIII (Jan. 2016), PP 01-08 www.iosrjournals.org Comparison Of 0.5%Bupivacaine And 0.5%
More informationContinuous Wound Infusion and Postoperative Pain Current status?
Continuous Wound Infusion and Postoperative Pain Current status? Pr Patricia Lavand homme Department of Anesthesiology St Luc Hospital University Catholic of Louvain Medical School Brussels, Belgium Severe
More informationMD (Anaesthesiology) Title (Plan of Thesis) (Session )
S.No. 1. To study the occurrence of postoperative hyponatremia in paediatric patients under 2 years of age 2. Influence of timing of intravenous fluid therapy on maternal hemodynamics in patients undergoing
More informationIntrathecal morphine versus epidural bupivacaine
Original Research Article Spinal Anaesthesia with Bupivacaine and Intrathecal Morphine Versus Combined Spinal-Epidural Anaesthesia using Bupivacaine and Epidural Infusion of Bupivacaine Plus Fentanyl for
More informationNurse administered fascia iliaca compartment block for pre-operative pain relief in adult fractured neck of femur
Acute Pain (2008) 10, 145 149 Nurse administered fascia iliaca compartment block for pre-operative pain relief in adult fractured neck of femur Ayodele Obideyi a,, Indra Srikantharajah b, Lynn Grigg b,
More informationParaspinal Blocks a new paradigm in truncal analgesia
Paraspinal Blocks a new paradigm in truncal analgesia Ki Jinn Chin, MBBS (Hons), MMed, FRCPC Associate Professor Toronto Western Hospital University of Toronto Online Resources https://youtu.be/lockhd
More informationMulti-Modal Pain Management
Multi-Modal Pain Management July 14th, 2017 Todd Edmiston, MD Disclosures None Fellowship training in Sports and Adult Reconstruction Director of Orthopaedic Center, South Baldwin Regional Medical Center,
More informationCombination of Ultra-low Dose Bupivacaine and Fentanyl for Spinal Anaesthesia in Out-patient Anorectal Surgery
The Journal of International Medical Research 2008; 36: 964 970 Combination of Ultra-low Dose Bupivacaine and Fentanyl for Spinal Anaesthesia in Out-patient Anorectal Surgery A GURBET, G TURKER, NK GIRGIN,
More informationInterscalene brachial plexus blockade - indications, anatomy, practical performance
08RC2 Interscalene brachial plexus blockade - indications, anatomy, practical performance Urs Eichenberger Department of Anaesthesiology and Pain Therapy, University Hospital of Bern, Switzerland Saturday,
More informationBritish Journal of Anaesthesia 100 (2): (2008) doi: /bja/aem373
REVIEW ARTICLES Epidural analgesia compared with peripheral nerve blockade after major knee surgery: a systematic review and meta-analysis of randomized trials S. J. Fowler 1, J. Symons 1, S. Sabato 1
More informationOriginal Article INTRODUCTION. Abstract
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2018/147 Comparing Two Different Doses of Clonidine as an Adjuvant to Bupivacaine in Blind Fascia Iliaca Compartment Block
More informationprilocaine hydrochloride 2% hyperbaric solution for injection (Prilotekal ) SMC No. (665/10) Goldshield Group
prilocaine hydrochloride 2% hyperbaric solution for injection (Prilotekal ) SMC No. (665/10) Goldshield Group 17 December 2010 The Scottish Medicines Consortium (SMC) has completed its assessment of the
More informationOpen Access. M. Dauri*, S. Faria, L. Celidonio, P. David, A. Bianco, E. Fabbi and M.B. Silvi
Send Orders of Reprints at reprints@benthamscience.net The Open Anesthesiology Journal, 2013, 7, 19-25 19 Open Access The Comparing of Ultrasound-guided Techniques: Sciatic Block with Continuous Lumbar
More informationNEW KIDS ON THE BLOCK: THE NEW ERA OF REGIONAL ANESTHESIA PLANE BLOCKS
2017 CSA Fall Anesthesia Conference NEW KIDS ON THE BLOCK: THE NEW ERA OF REGIONAL ANESTHESIA PLANE BLOCKS Michael Barrington, MB BS, FANZCA, PhD Senior Staff Anaesthetist, St Vincent s Hospital, Melbourne.
More informationrotation of the hip Flexion of the knee Iliac fossa of iliac Lesser trochanter Femoral nerve Flexion of the thigh at the hip shaft of tibia
Anatomy of the lower limb Anterior & medial compartments of the thigh Dr. Hayder The fascia lata encloses the entire thigh like a sleeve/stocking. Three intramuscular fascial septa (lateral, medial, and
More informationOptimizing dose infusion of 0.125% bupivacaine for continuous femoral nerve block after total knee replacement
Clinical Research Article Korean J Anesthesiol 2010 May; 58(5): 468476 DOI: 10.4097/kjae.2010.58.5.468 Optimizing dose infusion of 0.125% bupivacaine for continuous femoral nerve block after total knee
More informationSign up to receive ATOTW weekly -
ULTRASOUND GUIDED ADDUCTOR CANAL BLOCK (SAPHENOUS NERVE BLOCK) ANAESTHESIA TUTORIAL OF THE WEEK 301 13 TH JANUARY 2014 Dr Daniel Quemby, Specialist Trainee Anaesthesia Dr Andrew McEwen, Consultant Anaesthetist
More informationREGIONAL/LOCAL ANESTHESIA and OBESITY
REGIONAL/LOCAL ANESTHESIA and OBESITY Jay B. Brodsky, MD Stanford University School of Medicine Jbrodsky@stanford.edu Potential Advantages Regional compared to General Anesthesia Minimal intra-operative
More informationEvaluation of the Effect of Magnesium Sulphate as Adjunct to Epidural Bupivacaine: An Institutional Based Study
Original article: Evaluation of the Effect of Magnesium Sulphate as Adjunct to Epidural Bupivacaine: An Institutional Based Study RajulSubhash Karmakar 1, ShishirRamachandra Sonkusale 1* 1Associate Professor,
More informationPAIN Postoperative pain after hip fracture is procedure specific
British Journal of Anaesthesia 2 (1): 111 16 (29) doi:.93/bja/aen345 PAIN Postoperative pain after hip fracture is procedure specific N. B. Foss 12 *, M. T. Kristensen 23, H. Palm 2 and H. Kehlet 4 1 Department
More informationANATYOMY OF The thigh
ANATYOMY OF The thigh 1- Lateral cutaneous nerve of the thigh Ι) Skin of the thigh Anterior view 2- Femoral branch of the genitofemoral nerve 5- Intermediate cutaneous nerve of the thigh 1, 2 and 3 are
More informationREGIONAL ANALGESIA FOR POST-OPERATIVE PAIN MANAGEMENT INITIAL EXPERIENCE IN A LOW RESOURCE SETTING
1 Ea s t Af r i c a n Me d i c a l Jo u r n a l March 212 East African Medical Journal Vol. 89 No. 3 March 212 REGIONAL ANALGESIA FOR POST-OPERATIVE PAIN MANAGEMENT INITIAL EXPERIENCE IN A LOW RESOURCE
More informationAssistant Professor, Anaesthesia Department, Govt. General Hospital / Guntur Medical College, Guntur, Andhra Pradesh, India.
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 15, Issue 8 Ver. I (August. 2016), PP 87-91 www.iosrjournals.org A Comparative Study of 0.25% Ropivacaine
More informationObjectives. Conflict of Interest Disclosure. Neuraxial and Regional Anesthesia in the Pediatric Population
Neuraxial and Regional Anesthesia in the Pediatric Population Lauren Renner, MS, RN-BC, PNP Sharon Wrona, DNP, RN-BC, PNP, PMHS, AP- PMN.... Conflict of Interest Disclosure Conflicts of Interest for ALL
More informationUltrasound Guided Genicular Nerve Block-A Motor Sparing Technique for the Treatment of Acute and Chronic Knee Pain
International Journal of Anesthesiology Research, 2015, 3, 37-43 37 Ultrasound Guided Genicular Nerve Block-A Motor Sparing Technique for the Treatment of Acute and Chronic Knee Pain Michael Meng 1, Reid
More informationLocal infiltration analgesia for total knee arthroplasty: should ketorolac be added?
British Journal of Anaesthesia 111 (2): 242 8 (2013) Advance Access publication 20 March 2013. doi:10.1093/bja/aet030 PAIN Local infiltration analgesia for total knee arthroplasty: should ketorolac be
More informationHyun Chul Jung, Hyo Jung Seo, Deok Hee Lee, Sang-Jin Park
ORIGINAL ARTICLE eissn 2384-0293 Yeungnam Univ J Med 2017;34(1):37-42 https://doi.org/10.12701/yujm.2017.34.1.37 A comparison of 0.075% and 0.15% of ropivacaine with fentanyl for postoperative patient
More informationObjectives 9/7/2012. Optimizing Analgesia to Enhance the Recovery After Surgery CME FACULTY DISCLOSURE
Optimizing Analgesia to Enhance the Recovery After Surgery Francesco Carli, M.D.. McGill University, Montreal, QC, Canada. ASPMN, Baltimore, 2012 CME FACULTY DISCLOSURE Francesco Carli has no affiliation
More informationEffect of Pre-Incisional Continuous Regional Block on Early and Late Postoperative Conditions in Tibial Osteotomy and Total Knee Arthroplasty
22 The Open Orthopaedics Journal, 2009, 3, 22-26 Open Access Effect of Pre-Incisional Continuous Regional Block on Early and Late Postoperative Conditions in Tibial Osteotomy and Total Knee Arthroplasty
More informationPeri operative pain control. Disclosure. Objectives 9/1/2011. No current conflicts of interest
Peri operative pain control Chris Herndon, PharmD, FASHP Southern Illinois University Edwardsville Disclosure No current conflicts of interest Objectives Discuss studies evaluating the transformation of
More information