Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 2 de 2
Filtrar
1.
Ann Vasc Surg ; 77: 236-242, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34455047

RESUMEN

OBJECTIVE: The purpose of this study was to determine if single injection erector spinae plane blocks are associated with improved pain control, opioid use, numbness, length of stay, or patient satisfaction compared to intraoperatively placed continuous perineural infusion of local anesthetic after decompression of neurogenic thoracic outlet syndrome. METHODS: This is a retrospective cohort study at a tertiary academic center of eighty patients that underwent supraclavicular decompression for thoracic outlet syndrome between May 2019 and January 2020. Forty consecutive patients treated with single-injection preoperative erector spinae plane blocks were retrospectively compared to 40 age- and gender-matched controls treated with continuous perineural infusion. RESULTS: The primary outcome of mean pain scores was not significantly different between the erector spinae and perineural infusion groups over the three-day study period (4.2-5.3 vs 3.0-5.1 P=0.08). On post-operative day 0, mean pain scores were significantly higher in the erector spinae group (4.2 vs 3.0, P=0.02). While statistically significant, the score was still lower in the erector spinae group on day 0 than on day 1,2, or 3 in either group. Opioid use, nausea, length of stay and patient satisfaction were also similar. Upper extremity numbness was significantly less severe in the erector spinae group (36% vs 73% moderate-extreme, P=0.03) at 6-month follow-up. CONCLUSIONS: Seventy-two-hour perineural local anesthetic infusion did not provide superior analgesia compared to preoperative single-injection erector spinae blocks. Furthermore, there was significantly less long-term postoperative numbness associated with erector spinae blocks compared to perineural local anesthetic infusion.


Asunto(s)
Anestésicos Locales/administración & dosificación , Músculos de la Espalda/inervación , Descompresión Quirúrgica/efectos adversos , Bloqueo Nervioso , Dolor Postoperatorio/prevención & control , Síndrome del Desfiladero Torácico/cirugía , Adulto , Analgésicos Opioides/uso terapéutico , Anestésicos Locales/efectos adversos , Femenino , Humanos , Infusiones Parenterales , Tiempo de Internación , Masculino , Persona de Mediana Edad , Bloqueo Nervioso/efectos adversos , Dimensión del Dolor , Dolor Postoperatorio/diagnóstico , Dolor Postoperatorio/etiología , Satisfacción del Paciente , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento
2.
Pain Med ; 13(10): 1342-6, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22845612

RESUMEN

BACKGROUND AND OBJECTIVES: The purpose of this survey was to determine the current teaching practices of regional anesthesia and the prevalence of ultrasound use in guiding peripheral nerve blocks in the academic institutions across the United States. METHODS: A survey was distributed to all American Board of Anesthesiology-accredited residency programs via email and/or the U.S. postal service. The survey was designed to determine the number of peripheral nerve blocks (PNBs) performed, the role of the ultrasound guidance, the barriers to its use, and the methods by which teaching physicians acquired their ultrasound skills. RESULTS: We received 82 responses (62%) of the 132 programs surveyed. Eighty-eight percent of the responding programs performed more than 20 PNBs/week and 46% performed more than 40 PNBs/week. Three-fourths of the respondents relied on ultrasound to guide the majority of single injection and continuous PNBs. When using ultrasound, most programs (79%) used real-time ultrasound without nerve stimulator. Most teaching physicians supervising ultrasound-guided PNBs received their training via workshops and/or from other colleagues. The three main reasons for using ultrasound were to 1) achieve a higher success rate; 2) improve safety; and 3) teach anesthesia trainees. However, the three main barriers to using ultrasound were 1) lack of training; 2) perceived decreased efficiency; and 3) the lack of immediate availability of equipment. Overall, ultrasound was less utilized to guide lower extremity vs upper extremity PNBs. CONCLUSIONS: Ultrasound-guided PNBs are universally taught across residency programs in the United States. Most teaching physicians believe that ultrasound increases PNB's success and improves safety of regional anesthesia. Barriers to ultrasound use are lack of faculty training and unavailability of ultrasound equipment.


Asunto(s)
Anestesiología/educación , Educación de Postgrado en Medicina , Bloqueo Nervioso , Evaluación de Programas y Proyectos de Salud , Ultrasonografía Intervencional/métodos , Recolección de Datos , Humanos , Internado y Residencia , Estados Unidos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA