Abstract:
BACKGROUND:Cervical erector spinae plane (ESP) block has been described to anesthetize the brachial plexus (BP), however, the mechanism of its clinical effect remains unknown. As the prevertebral fascia encloses the phrenic nerves, BP and erector spinae muscles to form a prevertebral compartment, a local anesthetic injected in the cervical ESP could potentially spread throughout the prevertebral compartment. This study utilizes cadaveric models to evaluate the spread of ESP injections at the C6 and C7 levels to determine whether the injection can reach the BP and its surrounding structures. METHODS:For each of the five cadavers, an ESP injection posterior to the transverse process of C6 was performed on one side, and an ESP injection posterior to the transverse process of C7 was performed on the contralateral side. Injections were performed under ultrasound guidance and consisted of a 20 mL mixture of 18 mL water and 2 mL India ink. After cadaver dissection, craniocaudal and medial-lateral extent of the dye spread in relation to musculoskeletal anatomy as well as direct staining relevant nerves was recorded. The degree of dye staining was categorized as "deep," "faint," or "no." RESULTS:The phrenic nerve was deeply stained in 1 injection and faintly stained in 2 injections. Caudally, variable staining of C8 (100%) and T1 (50%) roots were seen. Faintly staining at C4 root was only seen in one sample (10%). There was variable staining of the anterior scalene muscles (40%) anterior to the BP and the rhomboid intercostal plane caudally (30%). CONCLUSIONS:Ultrasound-guided cervical (C6 and C7) ESP injections consistently stain the roots of the BP and dorsal rami. This study supports the notion that the cervical ESP block has the potential to provide analgesia for patients undergoing shoulder and cervical spine surgeries.
journal_name
Reg Anesth Pain Medjournal_title
Regional anesthesia and pain medicineauthors
Elsharkawy H,Ince I,Hamadnalla H,Drake RL,Tsui BCHdoi
10.1136/rapm-2019-101154subject
Has Abstractpub_date
2020-07-01 00:00:00pages
552-556issue
7eissn
1098-7339issn
1532-8651pii
rapm-2019-101154journal_volume
45pub_type
杂志文章abstract:OBJECTIVE:We present a case of intense herpes zoster-related pain and itching in the ophthalmic division of the trigeminal nerve (V1). Successful pain and itch management was achieved after insertion of a high thoracic epidural catheter with a continuous infusion of bupivacaine and clonidine. CASE REPORT:A 73-year-old...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/s1098-7339(03)00182-2
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Hematoma is typically cited as one mechanism of nerve injury following axillary block. However, documented cases of this are lacking. METHODS:A healthy 38-year-old man was scheduled for surgical removal of a tumor of the hand. A transarterial axillary block was performed with a 22-gauge short...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Peripheral nerve and spinal cord stimulation techniques have been used for many years. However, electrical stimulation methods rarely have been used to confirm epidural catheter placement. This study examines the practicality of this technique to confirm epidural catheter placement in obstetri...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章
doi:10.1016/s1098-7339(99)90160-8
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The aim of this study was to determine whether an intrabursal morphine and bupivacaine mixed infusion provides useful analgesia for prolonged pain relief after subacromial arthroscopic operation. METHODS:A continuous intrabursal infusion catheter was inserted at the conclusion of the subacrom...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/rapm.2002.31209
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Multimodal analgesic clinical pathways for joint replacement patients often include perineural catheters, but long-term adherence to these pathways has not yet been investigated. Our primary aim was to determine adherence rate to a knee arthroplasty clinical pathway for patients undergoing sta...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000588
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:In ambulatory lower limb surgery, spinal anesthesia with rapid onset and a short duration of block is preferable. We hypothesized that the use of 2-chloroprocaine would be associated with a faster motor block recovery compared with prilocaine in knee arthroscopy. A difference of 15 min was considered clinica...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-100673
更新日期:2019-08-21 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The transversus abdominis plane (TAP) block can be used as part of a multimodal analgesia protocol after abdominal surgery. This study investigated whether a pneumoperitoneum during abdominal surgery influences the spread of local anesthetics. METHODS:Nine fresh frozen cadavers were used for ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000260
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:A growing body of evidence indicates that the use of regional anesthesia offers advantages over general anesthesia, not only in terms of reducing complications but also regarding resource utilization and patient satisfaction. Because of the paucity of data on the nationwide adoption of regional anesthesia te...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000342
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Paresthesia occasionally occurs during dural puncture or injection of local anesthetic for spinal anesthesia. Although the incidence of neurologic complications after spinal anesthesia is extremely low, the significance of paresthesia is unknown. The influence of known lumbar spine pathology o...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/s1098-7339(98)90081-5
更新日期:1998-11-01 00:00:00
abstract:INTRODUCTION:The posterior lumbar plexus block (LPB) has been used for decades to provide acute pain management after hip surgery. Unfamiliarity with the technique and its perceived difficulty, potential risks, and possible adverse effects such as quadriceps weakness have limited broader use. The quadratus lumborum blo...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2020-101915
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The posterior approach to performing a continuous brachial plexus block at the level of the nerve roots has been described using traditional superficial landmarks. We describe an ultrasound-guided approach for the placement of a continuous interscalene brachial plexus catheter at the level of ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/AAP.0b013e3181933a53
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:This prospective randomized trial compared ultrasound-guided single-injection (SI) and triple-injection (TI) subparaneural popliteal sciatic nerve block. We hypothesized that multiple injections are not required when local anesthetic (LA) is deposited under the paraneurium because the latter e...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/AAP.0000000000000253
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:Postdural puncture headache (PDPH) is an uncommon sequel of lumbar puncture in children. When conservative treatment with bed rest, hydration, and caffeine are ineffective, epidural blood patches are recommended and are generally effective. The purpose of this report was to highlight that when lumbar epidural...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000562
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Stellate ganglion block (SGB) is one treatment option for human trigeminal nerve injury. The aim of this study was to evaluate the effectiveness of cervical sympathetic ganglia blocks (SB) by comparing the recovery of severed nerves in 2 rat models, treated or not treated by SB. METHODS:The i...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1053/rapm.2002.31206
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The incidence of postdural puncture headache (PDPH) after epidural wet tap for obstetric patients may be as high as 75%. We have studied how subsequent placement of a subarachnoid catheter immediately after confirmation of a wet tap, and leaving the catheter in place for 24 hours affects the i...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/s1098-7339(03)00393-6
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:A variety of brachial plexus block techniques via the interscalene approach have been proposed. We describe here a new middle interscalene perivascular approach to the brachial plexus. To verify its effectiveness, we studied 719 patients scheduled for shoulder arthroscopy. Furthermore, to veri...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章
doi:10.1016/j.rapm.2006.05.015
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The aim of this study was to compare the antinociceptive and motor-blocking effects of epidurally administered IQB-9302 (C18H26N2O.HCl) and bupivacaine in the dog. METHODS:Twelve adult female Beagle dogs were used. Each animal received 3 concentrations (0.25%, 0.50%, and 0.75%) of either IQB-...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Peripheral nerve blocks can be successfully utilized in infants for neurosurgical procedures. Our objective was utilizing a series of peripheral nerve blocks for a neurosurgical procedure in a very low-birth-weight neonate. CASE REPORT:We report the use of supraorbital, great auricular, and g...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2003.09.008
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:The term "Wrong-Site Surgery (WSS)" is commonly associated with surgical procedures; however, The Joint Commission (TJC) considers any invasive procedure, not just a surgical procedure, performed on the wrong side, at the wrong site, or on the wrong patient to be a WSS. For anesthesia providers, this means t...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-000033
更新日期:2019-01-13 00:00:00
abstract::Contemporary nonmalignant pain treatment algorithms commence with conservative non-invasive strategies, later progressing from minimally invasive interventions to invasive techniques or implantable devices. The most commonly used implantable devices are spinal cord stimulation (SCS) systems or targeted drug delivery (...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-100859
更新日期:2020-01-12 00:00:00
abstract:OBJECTIVES:The majority of intrathecal pumps are implanted by anesthesiologists. Despite a recent increase in case reports involving intrathecal catheter-tip inflammatory masses, this complication is rarely reported in the anesthesiology literature. The present case report describes a patient with spinal cord compressi...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1016/j.rapm.2004.01.012
更新日期:2004-05-01 00:00:00
abstract::Conventional opioids are widely used for acute pain management in the postoperative setting. However, a primary concern with conventional opioids is their therapeutic window-the range between doses that produce the desired therapeutic effect (analgesia) and doses that produce unwanted opioid-related adverse events (OR...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1136/rapm-2018-000010
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The aim of this study was to compare the potency of bupivacaine, ropivacaine, and levobupivacaine in an equal dose and concentration for sympathetic block. METHODS:We measured mean arterial pressure, heart rate (HR), and right and left brachial artery blood flow (BABF) before and after cervic...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e3181e6acf1
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Ultrasound-guided infiltration of the interspace between the popliteal artery and capsule of the knee (iPACK) block, a new regional analgesic technique, is believed to relieve posterior knee pain, after total knee arthroplasty, by targeting the articular branches innervating posterior aspect o...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-100355
更新日期:2019-05-06 00:00:00
abstract::The COVID-19 outbreak is on the world. While many countries have imposed general lockdown, emergency services are continuing. Healthcare professionals have been infected with the virulent severe acute respiratory syndrome coronavirus-2 (SARS), which spreads by close contact and aerosols. The anesthesiologist is partic...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1136/rapm-2020-101541
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Approximately 15% of patients report persistent knee pain despite surgical success following total knee arthroplasty (TKA). The purpose of this study was to determine the association of acute-postsurgical pain (APSP) with chronic postsurgical pain (CPSP) 6 months after TKA controlling for patient, surgical a...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-100036
更新日期:2019-02-15 00:00:00
abstract:INTRODUCTION:Diabetes may affect the duration of nerve block after regional anesthesia. This study aimed to compare the durations of sensory and motor block in diabetes versus non-diabetes patients after lower limb nerve block and delineate any sex-based differences in the duration of sensory and motor blocks of both d...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-100609
更新日期:2019-07-12 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Gabapentin is an anticonvulsant that has been shown to be effective in the treatment of neuropathic and inflammatory pain in animal and human studies. The analgesic effect of its perioperative use has not been fully elucidated. METHODS:This systematic review (meta-analysis) included 12 random...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,meta分析
doi:10.1016/j.rapm.2006.01.005
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Transversus abdominis plane (TAP) blocks have been shown to reduce postoperative pain after various abdominal surgical procedures in several studies. The motor nerves of the abdominal wall are located in the same plane as the sensory nerves affected by the TAP block. The aim of this study was ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e3182330b95
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Many patients experience moderate to severe postoperative pain. Nitrous oxide (N₂O) exerts analgesia by inhibition of N-methyl-D-aspartate receptors. Ketamine, another N-methyl-D-aspartate receptor antagonist, reduces postoperative opioid consumption and pain. A similar effect of N₂O is plausi...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000039
更新日期:2014-01-01 00:00:00