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3. Standardizing nomenclature in regional anesthesia: an ASRA-ESRA Delphi consensus study of upper and lower limb nerve blocks.

Author

El-Boghdadly, Kariem, Albrecht, Eric, Wolmarans, Morné, Mariano, Edward R., Kopp, Sandra, Perlas, Anahi, Thottungal, Athmaja, Gadsden, Jeff, Tulgar, Serkan, Adhikary, Sanjib, Aguirre, Jose, Agur, Anne M. R., Altıparmak, Başak, Barrington, Michael J., Bedforth, Nigel, Blanco, Rafael, Bloc, Sébastien, Boretsky, Karen, Bowness, James, and Breebaart, Margaretha

Abstract

Background: Inconsistent nomenclature and anatomical descriptions of regional anesthetic techniques hinder scientific communication and engender confusion; this in turn has implications for research, education and clinical implementation of regional anesthesia. Having produced standardized nomenclature for abdominal wall, paraspinal and chest wall regional anesthetic techniques, we aimed to similarly do so for upper and lower limb peripheral nerve blocks. Methods: We performed a three-round Delphi international consensus study to generate standardized names and anatomical descriptions of upper and lower limb regional anesthetic techniques. A long list of names and anatomical description of blocks of upper and lower extremities was produced by the members of the steering committee. Subsequently, two rounds of anonymized voting and commenting were followed by a third virtual round table to secure consensus for items that remained outstanding after the first and second rounds. As with previous methodology, strong consensus was defined as ≤75% agreement and weak consensus as 50%-74% agreement. Results: A total of 94, 91 and 65 collaborators participated in the first, second and third rounds, respectively. We achieved strong consensus for 38 names and 33 anatomical descriptions, and weak consensus for five anatomical descriptions. We agreed on a template for naming peripheral nerve blocks based on the name of the nerve and the anatomical location of the blockade and identified several areas for future research. Conclusions We achieved consensus on nomenclature and anatomical descriptions of regional anesthetic techniques for upper and lower limb nerve blocks, and committee included a member of the executive committee in addition to three other members selected based on their track record of academic output content expertize in upper and lower limb nerve blocks (JG, APerlas, and AT). A panel of international experts were invited as collaborators, based on previously published criteria, to participate. We replicated a methodology used in a previous study, which is reported in detail elsewhere, and reported in detail in online supplemental appendix 1. In brief, a modified three-round Delphi approach was used, with two rounds of electronic questionnaires and a third round-table discussion round. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Standardizing nomenclature in regional anesthesia: an ASRA-ESRA Delphi consensus study of upper and lower limb nerve blocks

Author

El-Boghdadly, Kariem, primary, Albrecht, Eric, additional, Wolmarans, Morné, additional, Mariano, Edward R, additional, Kopp, Sandra, additional, Perlas, Anahi, additional, Thottungal, Athmaja, additional, Gadsden, Jeff, additional, Tulgar, Serkan, additional, Adhikary, Sanjib, additional, Aguirre, Jose, additional, Agur, Anne M R, additional, Altıparmak, Başak, additional, Barrington, Michael J, additional, Bedforth, Nigel, additional, Blanco, Rafael, additional, Bloc, Sébastien, additional, Boretsky, Karen, additional, Bowness, James, additional, Breebaart, Margaretha, additional, Burckett-St Laurent, David, additional, Carvalho, Brendan, additional, Chelly, Jacques E, additional, Chin, Ki Jinn, additional, Chuan, Alwin, additional, Coppens, Steve, additional, Costache, Ioana, additional, Dam, Mette, additional, Desmet, Matthias, additional, Dhir, Shalini, additional, Egeler, Christian, additional, Elsharkawy, Hesham, additional, Bendtsen, Thomas Fichtner, additional, Fox, Ben, additional, Franco, Carlo D, additional, Gautier, Philippe Emmanuel, additional, Grant, Stuart Alan, additional, Grape, Sina, additional, Guheen, Carrie, additional, Harbell, Monica W, additional, Hebbard, Peter, additional, Hernandez, Nadia, additional, Hogg, Rosemary M G, additional, Holtz, Margaret, additional, Ihnatsenka, Barys, additional, Ilfeld, Brian M, additional, Ip, Vivian H Y, additional, Johnson, Rebecca L, additional, Kalagara, Hari, additional, Kessler, Paul, additional, Kwofie, M Kwesi, additional, Le-Wendling, Linda, additional, Lirk, Philipp, additional, Lobo, Clara, additional, Ludwin, Danielle, additional, Macfarlane, Alan James Robert, additional, Makris, Alexandros, additional, McCartney, Colin, additional, McDonnell, John, additional, McLeod, Graeme A, additional, Memtsoudis, Stavros G, additional, Merjavy, Peter, additional, Moran, E M Louise, additional, Nader, Antoun, additional, Neal, Joseph M, additional, Niazi, Ahtsham U, additional, Njathi-Ori, Catherine, additional, O'Donnell, Brian D, additional, Oldman, Matt, additional, Orebaugh, Steven L, additional, Parras, Teresa, additional, Pawa, Amit, additional, Peng, Philip, additional, Porter, Steven, additional, Pulos, Bridget P, additional, Sala-Blanch, Xavier, additional, Saporito, Andrea, additional, Sauter, Axel R, additional, Schwenk, Eric S, additional, Sebastian, Maria Paz, additional, Sidhu, Navdeep, additional, Sinha, Sanjay Kumar, additional, Soffin, Ellen M, additional, Stimpson, James, additional, Tang, Raymond, additional, Tsui, Ban C H, additional, Turbitt, Lloyd, additional, Uppal, Vishal, additional, van Geffen, Geert J, additional, Vermeylen, Kris, additional, Vlassakov, Kamen, additional, Volk, Thomas, additional, Xu, Jeff L, additional, and Elkassabany, Nabil M, additional

Published
2023
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7. Recommendations for anatomical structures to identify on ultrasound for the performance of intermediate and advanced blocks in ultrasound-guided regional anesthesia

Author

Ashken, Toby, primary, Bowness, James, additional, Macfarlane, Alan James Robert, additional, Turbitt, Lloyd, additional, Bellew, Boyne, additional, Bedforth, Nigel, additional, Burckett-St Laurent, David, additional, Delbos, Alain, additional, El-Boghdadly, Kariem, additional, Elkassabany, Nabil M, additional, Ferry, Jenny, additional, Fox, Ben, additional, French, James L H, additional, Grant, Calum, additional, Gupta, Ashwani, additional, Gupta, Rajnish K, additional, Gürkan, Yavuz, additional, Haslam, Nat, additional, Higham, Helen, additional, Hogg, Rosemary M G, additional, Johnston, David F, additional, Kearns, Rachel Joyce, additional, Lobo, Clara, additional, McKinlay, Sonya, additional, Mariano, Edward R, additional, Memtsoudis, Stavros, additional, Merjavy, Peter, additional, Narayanan, Madan, additional, Noble, J Alison, additional, Phillips, David, additional, Rosenblatt, Meg, additional, Sadler, Amy, additional, Sebastian, Maria Paz, additional, Schwenk, Eric S, additional, Taylor, Alasdair, additional, Thottungal, Athmaja, additional, Valdés-Vilches, Luis Fernando, additional, Volk, Thomas, additional, West, Simeon, additional, Wolmarans, Morné, additional, Womack, Jonathan, additional, and Pawa, Amit, additional

Published
2022
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8. Recommendations for effective documentation in regional anesthesia: an expert panel Delphi consensus project

Author

Ahmed, Hassan M, Atterton, Benjamin P, Crowe, Gillian G, Barratta, Jaime L, Johnson, Mark, Viscusi, Eugene R., Adhikary, Sanjib, Albrecht, Eric, Boretsky, Karen, Boublik, Jan, Breslin, Dara S, Byrne, Kelly, Ch'ng, Alan, Chuan, Alwin, Conroy, Patrick, Daniel, Craig, Daszkiewicz, Andrzej, Delbos, Alain, Dirzu, Dan Sebastian, Dmytriiev, Dmytro, Fennessy, Paul, Fischer, H Barrie J, Frizelle, Henry, Gadsden, Jeff, Gautier, Philippe, Gupta, Rajnish K, Gürkan, Yavuz, Hardman, Harold David, Harrop-Griffiths, William, Hebbard, Peter, Hernandez, Nadia, Hlasny, Jakub, Iohom, Gabriella, Ip, Vivian H Y, Jeng, Christina L, Johnson, Rebecca L, Kalagara, Hari, Kinirons, Brian, Lansdown, Andrew Kenneth, Leng, Jody C, Lim, Yean Chin, Lobo, Clara, Ludwin, Danielle B, Macfarlane, Alan James Robert, Machi, Anthony T, Mahon, Padraig, Mannion, Stephen, McLeod, David H, Merjavy, Peter, Miscuks, Aleksejs, Mitchell, Christopher H, Moka, Eleni, Moran, Peter, Ngui, Ann, Nin, Olga C, O'Donnell, Brian D, Pawa, Amit, Perlas, Anahi, Porter, Steven, Pozek, John-Paul, Rebelo, Humberto C, Roqués, Vicente, Schroeder, Kristopher M, Schwartz, Gary, Schwenk, Eric S., Sermeus, Luc, Shorten, George, Srinivasan, Karthikeyan, Stevens, Markus F, Theodoraki, Kassiani, Turbitt, Lloyd R, Valdés-Vilches, Luis Fernando, Volk, Thomas, Webster, Katrina, Wiesmann, T, Wilson, Sylvia H, Wolmarans, Morné, Woodworth, Glenn, Worek, Andrew K, Moran, E M Louise, Ahmed, Hassan M, Atterton, Benjamin P, Crowe, Gillian G, Barratta, Jaime L, Johnson, Mark, Viscusi, Eugene R., Adhikary, Sanjib, Albrecht, Eric, Boretsky, Karen, Boublik, Jan, Breslin, Dara S, Byrne, Kelly, Ch'ng, Alan, Chuan, Alwin, Conroy, Patrick, Daniel, Craig, Daszkiewicz, Andrzej, Delbos, Alain, Dirzu, Dan Sebastian, Dmytriiev, Dmytro, Fennessy, Paul, Fischer, H Barrie J, Frizelle, Henry, Gadsden, Jeff, Gautier, Philippe, Gupta, Rajnish K, Gürkan, Yavuz, Hardman, Harold David, Harrop-Griffiths, William, Hebbard, Peter, Hernandez, Nadia, Hlasny, Jakub, Iohom, Gabriella, Ip, Vivian H Y, Jeng, Christina L, Johnson, Rebecca L, Kalagara, Hari, Kinirons, Brian, Lansdown, Andrew Kenneth, Leng, Jody C, Lim, Yean Chin, Lobo, Clara, Ludwin, Danielle B, Macfarlane, Alan James Robert, Machi, Anthony T, Mahon, Padraig, Mannion, Stephen, McLeod, David H, Merjavy, Peter, Miscuks, Aleksejs, Mitchell, Christopher H, Moka, Eleni, Moran, Peter, Ngui, Ann, Nin, Olga C, O'Donnell, Brian D, Pawa, Amit, Perlas, Anahi, Porter, Steven, Pozek, John-Paul, Rebelo, Humberto C, Roqués, Vicente, Schroeder, Kristopher M, Schwartz, Gary, Schwenk, Eric S., Sermeus, Luc, Shorten, George, Srinivasan, Karthikeyan, Stevens, Markus F, Theodoraki, Kassiani, Turbitt, Lloyd R, Valdés-Vilches, Luis Fernando, Volk, Thomas, Webster, Katrina, Wiesmann, T, Wilson, Sylvia H, Wolmarans, Morné, Woodworth, Glenn, Worek, Andrew K, and Moran, E M Louise

Abstract

Background and objectives: Documentation is important for quality improvement, education, and research. There is currently a lack of recommendations regarding key aspects of documentation in regional anesthesia. The aim of this study was to establish recommendations for documentation in regional anesthesia. Methods: Following the formation of the executive committee and a directed literature review, a long list of potential documentation components was created. A modified Delphi process was then employed to achieve consensus amongst a group of international experts in regional anesthesia. This consisted of 2 rounds of anonymous electronic voting and a final virtual round table discussion with live polling on items not yet excluded or accepted from previous rounds. Progression or exclusion of potential components through the rounds was based on the achievement of strong consensus. Strong consensus was defined as ≥75% agreement and weak consensus as 50%-74% agreement. Results: Seventy-seven collaborators participated in both rounds 1 and 2, while 50 collaborators took part in round 3. In total, experts voted on 83 items and achieved a strong consensus on 51 items, weak consensus on 3 and rejected 29. Conclusion: By means of a modified Delphi process, we have established expert consensus on documentation in regional anesthesia.

Published
2022

9. Recommendations for effective documentation in regional anesthesia: an expert panel Delphi consensus project.

Author

UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service d'anesthésiologie, Ahmed, Hassan M, Atterton, Benjamin P, Crowe, Gillian G, Barratta, Jaime L, Johnson, Mark, Viscusi, Eugene, Adhikary, Sanjib, Albrecht, Eric, Boretsky, Karen, Boublik, Jan, Breslin, Dara S, Byrne, Kelly, Ch'ng, Alan, Chuan, Alwin, Conroy, Patrick, Daniel, Craig, Daszkiewicz, Andrzej, Delbos, Alain, Dirzu, Dan Sebastian, Dmytriiev, Dmytro, Fennessy, Paul, Fischer, H Barrie J, Frizelle, Henry, Gadsden, Jeff, Gautier, Philippe, Gupta, Rajnish K, Gürkan, Yavuz, Hardman, Harold David, Harrop-Griffiths, William, Hebbard, Peter, Hernandez, Nadia, Hlasny, Jakub, Iohom, Gabriella, Ip, Vivian H Y, Jeng, Christina L, Johnson, Rebecca L, Kalagara, Hari, Kinirons, Brian, Lansdown, Andrew Kenneth, Leng, Jody C, Lim, Yean Chin, Lobo, Clara, Ludwin, Danielle B, Macfarlane, Alan James Robert, Machi, Anthony T, Mahon, Padraig, Mannion, Stephen, McLeod, David H, Merjavy, Peter, Miscuks, Aleksejs, Mitchell, Christopher H, Moka, Eleni, Moran, Peter, Ngui, Ann, Nin, Olga C, O'Donnell, Brian D, Pawa, Amit, Perlas, Anahi, Porter, Steven, Pozek, John-Paul, Rebelo, Humberto C, Roqués, Vicente, Schroeder, Kristopher M, Schwartz, Gary, Schwenk, Eric S, Sermeus, Luc, Shorten, George, Srinivasan, Karthikeyan, Stevens, Markus F, Theodoraki, Kassiani, Turbitt, Lloyd R, Valdés-Vilches, Luis Fernando, Volk, Thomas, Webster, Katrina, Wiesmann, T, Wilson, Sylvia H, Wolmarans, Morné, Woodworth, Glenn, Worek, Andrew K, Moran, E M Louise, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service d'anesthésiologie, Ahmed, Hassan M, Atterton, Benjamin P, Crowe, Gillian G, Barratta, Jaime L, Johnson, Mark, Viscusi, Eugene, Adhikary, Sanjib, Albrecht, Eric, Boretsky, Karen, Boublik, Jan, Breslin, Dara S, Byrne, Kelly, Ch'ng, Alan, Chuan, Alwin, Conroy, Patrick, Daniel, Craig, Daszkiewicz, Andrzej, Delbos, Alain, Dirzu, Dan Sebastian, Dmytriiev, Dmytro, Fennessy, Paul, Fischer, H Barrie J, Frizelle, Henry, Gadsden, Jeff, Gautier, Philippe, Gupta, Rajnish K, Gürkan, Yavuz, Hardman, Harold David, Harrop-Griffiths, William, Hebbard, Peter, Hernandez, Nadia, Hlasny, Jakub, Iohom, Gabriella, Ip, Vivian H Y, Jeng, Christina L, Johnson, Rebecca L, Kalagara, Hari, Kinirons, Brian, Lansdown, Andrew Kenneth, Leng, Jody C, Lim, Yean Chin, Lobo, Clara, Ludwin, Danielle B, Macfarlane, Alan James Robert, Machi, Anthony T, Mahon, Padraig, Mannion, Stephen, McLeod, David H, Merjavy, Peter, Miscuks, Aleksejs, Mitchell, Christopher H, Moka, Eleni, Moran, Peter, Ngui, Ann, Nin, Olga C, O'Donnell, Brian D, Pawa, Amit, Perlas, Anahi, Porter, Steven, Pozek, John-Paul, Rebelo, Humberto C, Roqués, Vicente, Schroeder, Kristopher M, Schwartz, Gary, Schwenk, Eric S, Sermeus, Luc, Shorten, George, Srinivasan, Karthikeyan, Stevens, Markus F, Theodoraki, Kassiani, Turbitt, Lloyd R, Valdés-Vilches, Luis Fernando, Volk, Thomas, Webster, Katrina, Wiesmann, T, Wilson, Sylvia H, Wolmarans, Morné, Woodworth, Glenn, Worek, Andrew K, and Moran, E M Louise

Abstract

Documentation is important for quality improvement, education, and research. There is currently a lack of recommendations regarding key aspects of documentation in regional anesthesia. The aim of this study was to establish recommendations for documentation in regional anesthesia. Following the formation of the executive committee and a directed literature review, a long list of potential documentation components was created. A modified Delphi process was then employed to achieve consensus amongst a group of international experts in regional anesthesia. This consisted of 2 rounds of anonymous electronic voting and a final virtual round table discussion with live polling on items not yet excluded or accepted from previous rounds. Progression or exclusion of potential components through the rounds was based on the achievement of strong consensus. Strong consensus was defined as ≥75% agreement and weak consensus as 50%-74% agreement. Seventy-seven collaborators participated in both rounds 1 and 2, while 50 collaborators took part in round 3. In total, experts voted on 83 items and achieved a strong consensus on 51 items, weak consensus on 3 and rejected 29. By means of a modified Delphi process, we have established expert consensus on documentation in regional anesthesia.

Published
2022

10. Regional anaesthesia in patients on antithrombotic drugs:Joint ESAIC/ESRA guidelines

Author

Kietaibl, Sibylle, Ferrandis, Raquel, Godier, Anne, Llau, Juan, Lobo, Clara, Macfarlane, Alan Jr, Schlimp, Christoph J., Vandermeulen, Erik, Volk, Thomas, von Heymann, Christian, Wolmarans, Morné, Afshari, Arash, Kietaibl, Sibylle, Ferrandis, Raquel, Godier, Anne, Llau, Juan, Lobo, Clara, Macfarlane, Alan Jr, Schlimp, Christoph J., Vandermeulen, Erik, Volk, Thomas, von Heymann, Christian, Wolmarans, Morné, and Afshari, Arash

Abstract

BACKGROUND: Bleeding is a potential complication after neuraxial and peripheral nerve blocks. The risk is increased in patients on antiplatelet and anticoagulant drugs. This joint guideline from the European Society of Anaesthesiology and Intensive Care and the European Society of Regional Anaesthesia aims to provide an evidence-based set of recommendations and suggestions on how to reduce the risk of antithrombotic drug-induced haematoma formation related to the practice of regional anaesthesia and analgesia. DESIGN: A systematic literature search was performed, examining seven drug comparators and 10 types of clinical intervention with the outcome being peripheral and neuraxial haematoma. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used for assessing the methodological quality of the included studies and for formulating recommendations. A Delphi process was used to prepare a clinical practice guideline. RESULTS: Clinical studies were limited in number and quality and the certainty of evidence was assessed to be GRADE C throughout. Forty clinical practice statements were formulated. Using the Delphi-process, strong consensus (>90% agreement) was achieved in 57.5% of recommendations and consensus (75 to 90% agreement) in 42.5%. DISCUSSION: Specific time intervals should be observed concerning the adminstration of antithrombotic drugs both prior to, and after, neuraxial procedures or those peripheral nerve blocks with higher bleeding risk (deep, noncompressible). These time intervals vary according to the type and dose of anticoagulant drugs, renal function and whether a traumatic puncture has occured. Drug measurements may be used to guide certain time intervals, whilst specific reversal for vitamin K antagonists and dabigatran may also influence these. Ultrasound guidance, drug combinations and bleeding risk scores do not modify the time intervals. In peripheral nerve blocks with low bleeding risk (superficial, compressible)

Published
2022

11. PECS2 or PICK2

Author

Elkassabany, Nabil M, primary, Mariano, Edward R, additional, Kopp, Sandra, additional, Albrecht, Eric, additional, Wolmarans, Morné, additional, and El-Boghdadly, Kariem, additional

Published
2022
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12. Recommendations for effective documentation in regional anesthesia: an expert panel Delphi consensus project

Author

Ahmed, Hassan M, primary, Atterton, Benjamin P, additional, Crowe, Gillian G, additional, Barratta, Jaime L, additional, Johnson, Mark, additional, Viscusi, Eugene, additional, Adhikary, Sanjib, additional, Albrecht, Eric, additional, Boretsky, Karen, additional, Boublik, Jan, additional, Breslin, Dara S, additional, Byrne, Kelly, additional, Ch'ng, Alan, additional, Chuan, Alwin, additional, Conroy, Patrick, additional, Daniel, Craig, additional, Daszkiewicz, Andrzej, additional, Delbos, Alain, additional, Dirzu, Dan Sebastian, additional, Dmytriiev, Dmytro, additional, Fennessy, Paul, additional, Fischer, H Barrie J, additional, Frizelle, Henry, additional, Gadsden, Jeff, additional, Gautier, Philippe, additional, Gupta, Rajnish K, additional, Gürkan, Yavuz, additional, Hardman, Harold David, additional, Harrop-Griffiths, William, additional, Hebbard, Peter, additional, Hernandez, Nadia, additional, Hlasny, Jakub, additional, Iohom, Gabriella, additional, Ip, Vivian H Y, additional, Jeng, Christina L, additional, Johnson, Rebecca L, additional, Kalagara, Hari, additional, Kinirons, Brian, additional, Lansdown, Andrew Kenneth, additional, Leng, Jody C, additional, Lim, Yean Chin, additional, Lobo, Clara, additional, Ludwin, Danielle B, additional, Macfarlane, Alan James Robert, additional, Machi, Anthony T, additional, Mahon, Padraig, additional, Mannion, Stephen, additional, McLeod, David H, additional, Merjavy, Peter, additional, Miscuks, Aleksejs, additional, Mitchell, Christopher H, additional, Moka, Eleni, additional, Moran, Peter, additional, Ngui, Ann, additional, Nin, Olga C, additional, O'Donnell, Brian D, additional, Pawa, Amit, additional, Perlas, Anahi, additional, Porter, Steven, additional, Pozek, John-Paul, additional, Rebelo, Humberto C, additional, Roqués, Vicente, additional, Schroeder, Kristopher M, additional, Schwartz, Gary, additional, Schwenk, Eric S, additional, Sermeus, Luc, additional, Shorten, George, additional, Srinivasan, Karthikeyan, additional, Stevens, Markus F, additional, Theodoraki, Kassiani, additional, Turbitt, Lloyd R, additional, Valdés-Vilches, Luis Fernando, additional, Volk, Thomas, additional, Webster, Katrina, additional, Wiesmann, T, additional, Wilson, Sylvia H, additional, Wolmarans, Morné, additional, Woodworth, Glenn, additional, Worek, Andrew K, additional, and Moran, E M Louise, additional

Published
2022
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13. Regional anaesthesia in patients on antithrombotic drugs

Author

Kietaibl, Sibylle, primary, Ferrandis, Raquel, additional, Godier, Anne, additional, Llau, Juan, additional, Lobo, Clara, additional, Macfarlane, Alan JR, additional, Schlimp, Christoph J., additional, Vandermeulen, Erik, additional, Volk, Thomas, additional, von Heymann, Christian, additional, Wolmarans, Morné, additional, and Afshari, Arash, additional

Published
2022
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16. International consensus on anatomical structures to identify on ultrasound for the performance of basic blocks in ultrasound-guided regional anesthesia

Author

Bowness, James Simeon, primary, Pawa, Amit, additional, Turbitt, Lloyd, additional, Bellew, Boyne, additional, Bedforth, Nigel, additional, Burckett-St Laurent, David, additional, Delbos, Alain, additional, Elkassabany, Nabil, additional, Ferry, Jenny, additional, Fox, Ben, additional, French, James L H, additional, Grant, Calum, additional, Gupta, Ashwani, additional, Harrop-Griffiths, William, additional, Haslam, Nat, additional, Higham, Helen, additional, Hogg, Rosemary, additional, Johnston, David F, additional, Kearns, Rachel Joyce, additional, Kopp, Sandra, additional, Lobo, Clara, additional, McKinlay, Sonya, additional, Memtsoudis, Stavros, additional, Merjavy, Peter, additional, Moka, Eleni, additional, Narayanan, Madan, additional, Narouze, Samer, additional, Noble, J Alison, additional, Phillips, David, additional, Rosenblatt, Meg, additional, Sadler, Amy, additional, Sebastian, Maria Paz, additional, Taylor, Alasdair, additional, Thottungal, Athmaja, additional, Valdés-Vilches, Luis Fernando, additional, Volk, Thomas, additional, West, Simeon, additional, Wolmarans, Morné, additional, Womack, Jonathan, additional, and Macfarlane, Alan James Robert, additional

Published
2021
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17. Standardizing nomenclature in regional anesthesia: an ASRA-ESRA Delphi consensus study of abdominal wall, paraspinal, and chest wall blocks

Author

El-Boghdadly, Kariem, primary, Wolmarans, Morné, additional, Stengel, Angela D, additional, Albrecht, Eric, additional, Chin, Ki Jinn, additional, Elsharkawy, Hesham, additional, Kopp, Sandra, additional, Mariano, Edward R, additional, Xu, Jeff L, additional, Adhikary, Sanjib, additional, Altıparmak, Başak, additional, Barrington, Michael J, additional, Bloc, Sébastien, additional, Blanco, Rafael, additional, Boretsky, Karen, additional, Børglum, Jens, additional, Breebaart, Margaretha, additional, Burckett-St Laurent, David, additional, Capdevila, Xavier, additional, Carvalho, Brendan, additional, Chuan, Alwin, additional, Coppens, Steve, additional, Costache, Ioana, additional, Dam, Mette, additional, Egeler, Christian, additional, Fajardo, Mario, additional, Gadsden, Jeff, additional, Gautier, Philippe Emmanuel, additional, Grant, Stuart Alan, additional, Hadzic, Admir, additional, Hebbard, Peter, additional, Hernandez, Nadia, additional, Hogg, Rosemary, additional, Holtz, Margaret, additional, Johnson, Rebecca L, additional, Karmakar, Manoj Kumar, additional, Kessler, Paul, additional, Kwofie, Kwesi, additional, Lobo, Clara, additional, Ludwin, Danielle, additional, MacFarlane, Alan, additional, McDonnell, John, additional, McLeod, Graeme, additional, Merjavy, Peter, additional, Moran, EML, additional, O'Donnell, Brian D, additional, Parras, Teresa, additional, Pawa, Amit, additional, Perlas, Anahi, additional, Rojas Gomez, Maria Fernanda, additional, Sala-Blanch, Xavier, additional, Saporito, Andrea, additional, Sinha, Sanjay Kumar, additional, Soffin, Ellen M, additional, Thottungal, Athmaja, additional, Tsui, Ban C H, additional, Tulgar, Serkan, additional, Turbitt, Lloyd, additional, Uppal, Vishal, additional, van Geffen, Geert J, additional, Volk, Thomas, additional, and Elkassabany, Nabil M, additional

Published
2021
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18. Standardizing nomenclature in regional anesthesia:An ASRA-ESRA Delphi consensus study of abdominal wall, paraspinal, and chest wall blocks

Author

El-Boghdadly, Kariem, Wolmarans, Morné, Stengel, Angela D., Albrecht, Eric, Chin, Ki Jinn, Elsharkawy, Hesham, Kopp, Sandra, Mariano, Edward R., Xu, Jeff L., Adhikary, Sanjib, Altlparmak, Başak, Barrington, Michael J., Bloc, Sébastien, Blanco, Rafael, Boretsky, Karen, Børglum, Jens, Breebaart, Margaretha, Laurent, David Burckett St, Capdevila, Xavier, Carvalho, Brendan, Chuan, Alwin, Coppens, Steve, Costache, Ioana, Dam, Mette, Egeler, Christian, Fajardo, Mario, Gadsden, Jeff, Gautier, Philippe Emmanuel, Grant, Stuart Alan, Hadzic, Admir, Hebbard, Peter, Hernandez, Nadia, Hogg, Rosemary, Holtz, Margaret, Johnson, Rebecca L., Karmakar, Manoj Kumar, Kessler, Paul, Kwofie, Kwesi, Lobo, Clara, Ludwin, Danielle, MacFarlane, Alan, McDonnell, John, McLeod, Graeme, Merjavy, Peter, Moran, E. M.L., O'Donnell, Brian D., Parras, Teresa, Pawa, Amit, Perlas, Anahi, Rojas Gomez, Maria Fernanda, Sala-Blanch, Xavier, Saporito, Andrea, Sinha, Sanjay Kumar, Soffin, Ellen M., Thottungal, Athmaja, Tsui, Ban C.H., Tulgar, Serkan, Turbitt, Lloyd, Uppal, Vishal, Van Geffen, Geert J., Volk, Thomas, Elkassabany, Nabil M., El-Boghdadly, Kariem, Wolmarans, Morné, Stengel, Angela D., Albrecht, Eric, Chin, Ki Jinn, Elsharkawy, Hesham, Kopp, Sandra, Mariano, Edward R., Xu, Jeff L., Adhikary, Sanjib, Altlparmak, Başak, Barrington, Michael J., Bloc, Sébastien, Blanco, Rafael, Boretsky, Karen, Børglum, Jens, Breebaart, Margaretha, Laurent, David Burckett St, Capdevila, Xavier, Carvalho, Brendan, Chuan, Alwin, Coppens, Steve, Costache, Ioana, Dam, Mette, Egeler, Christian, Fajardo, Mario, Gadsden, Jeff, Gautier, Philippe Emmanuel, Grant, Stuart Alan, Hadzic, Admir, Hebbard, Peter, Hernandez, Nadia, Hogg, Rosemary, Holtz, Margaret, Johnson, Rebecca L., Karmakar, Manoj Kumar, Kessler, Paul, Kwofie, Kwesi, Lobo, Clara, Ludwin, Danielle, MacFarlane, Alan, McDonnell, John, McLeod, Graeme, Merjavy, Peter, Moran, E. M.L., O'Donnell, Brian D., Parras, Teresa, Pawa, Amit, Perlas, Anahi, Rojas Gomez, Maria Fernanda, Sala-Blanch, Xavier, Saporito, Andrea, Sinha, Sanjay Kumar, Soffin, Ellen M., Thottungal, Athmaja, Tsui, Ban C.H., Tulgar, Serkan, Turbitt, Lloyd, Uppal, Vishal, Van Geffen, Geert J., Volk, Thomas, and Elkassabany, Nabil M.

Abstract

Background There is heterogeneity in the names and anatomical descriptions of regional anesthetic techniques. This may have adverse consequences on education, research, and implementation into clinical practice. We aimed to produce standardized nomenclature for abdominal wall, paraspinal, and chest wall regional anesthetic techniques. Methods We conducted an international consensus study involving experts using a three-round Delphi method to produce a list of names and corresponding descriptions of anatomical targets. After long-list formulation by a Steering Committee, the first and second rounds involved anonymous electronic voting and commenting, with the third round involving a virtual round table discussion aiming to achieve consensus on items that had yet to achieve it. Novel names were presented where required for anatomical clarity and harmonization. Strong consensus was defined as ≥75% agreement and weak consensus as 50% to 74% agreement. Results Sixty expert Collaborators participated in this study. After three rounds and clarification, harmonization, and introduction of novel nomenclature, strong consensus was achieved for the names of 16 block names and weak consensus for four names. For anatomical descriptions, strong consensus was achieved for 19 blocks and weak consensus was achieved for one approach. Several areas requiring further research were identified. Conclusions Harmonization and standardization of nomenclature may improve education, research, and ultimately patient care. We present the first international consensus on nomenclature and anatomical descriptions of blocks of the abdominal wall, chest wall, and paraspinal blocks. We recommend using the consensus results in academic and clinical practice.

Published
2021

21. Transmuscular quadratus lumborum block reduces opioid consumption and prolongs time to first opioid demand after laparoscopic nephrectomy

Author

Dam, Mette, Hansen, Christian, Poulsen, Troels Dirch, Azawi, Nessn Htum, Laier, Gunnar Hellmund, Wolmarans, Morné, Chan, Vincent, Bendtsen, Thomas Fichtner, Børglum, Jens, Dam, Mette, Hansen, Christian, Poulsen, Troels Dirch, Azawi, Nessn Htum, Laier, Gunnar Hellmund, Wolmarans, Morné, Chan, Vincent, Bendtsen, Thomas Fichtner, and Børglum, Jens

Abstract

Background: Robotic and hand-assisted laparoscopic nephrectomies are often associated with moderate to severe postoperative pain. The aim of the current study was to investigate the analgesic efficacy of the transmuscular quadratus lumborum (TQL) block for patients undergoing robotic or hand-assisted laparoscopic nephrectomy. Methods: Fifty patients were included in this single-center study. All patients were scheduled for elective hand-assisted or robotic laparoscopic nephrectomy under general anesthesia. Preoperatively, patients were randomly allocated to TQL block bilaterally with ropivacaine 60 mL 0.375% or 60 mL saline and all patients received standard multimodal analgesia and intravenous patient-controlled analgesia. Primary outcome was postoperative oral morphine equivalent (OME) consumption 0-12 hours. Secondary outcomes were postoperative OME consumption up to 24 hours, pain scores, time to first opioid, nausea/vomiting, time to first ambulation and hospital length of stay (LOS). Results: Mean (95% CI) OME consumption was significantly lower in the intervention group at 12 hours after surgery 50 (28.5 to 71.5) mg versus control 87.5 (62.7 to 112.3) mg, p=0.02. At 24 hours, 69.4 (43.2 to 95.5) mg versus 127 (96.7 to 158.6) mg, p<0.01. Time to first opioid was significantly prolonged in the intervention group median (IQR) 4.4 (2.8-17.6) hours compared with 0.3 (0.1-1.0) hours in the control group, p<0.001. No significant intergroup differences were recorded for time to first ambulation, pain scores, nausea/vomiting nor for LOS. Conclusion: Preoperative bilateral TQL block significantly reduced postoperative opioid consumption by 43% and significantly prolonged time to first opioid. Trial registration number: NCT03571490.

Published
2020

22. Transmuscular quadratus lumborum block reduces opioid consumption and prolongs time to first opioid demand after laparoscopic nephrectomy.

Author

Dam, Mette, Hansen, Christian, Poulsen, Troels Dirch, Azawi, Nessn Htum, Laier, Gunnar Hellmund, Wolmarans, Morné, Chan, Vincent, Bendtsen, Thomas Fichtner, and Børglum, Jens

Abstract

Background: Robotic and hand-assisted laparoscopic nephrectomies are often associated with moderate to severe postoperative pain. The aim of the current study was to investigate the analgesic efficacy of the transmuscular quadratus lumborum (TQL) block for patients undergoing robotic or hand-assisted laparoscopic nephrectomy.Methods: Fifty patients were included in this single-center study. All patients were scheduled for elective hand-assisted or robotic laparoscopic nephrectomy under general anesthesia. Preoperatively, patients were randomly allocated to TQL block bilaterally with ropivacaine 60 mL 0.375% or 60 mL saline and all patients received standard multimodal analgesia and intravenous patient-controlled analgesia. Primary outcome was postoperative oral morphine equivalent (OME) consumption 0-12 hours. Secondary outcomes were postoperative OME consumption up to 24 hours, pain scores, time to first opioid, nausea/vomiting, time to first ambulation and hospital length of stay (LOS).Results: Mean (95% CI) OME consumption was significantly lower in the intervention group at 12 hours after surgery 50 (28.5 to 71.5) mg versus control 87.5 (62.7 to 112.3) mg, p=0.02. At 24 hours, 69.4 (43.2 to 95.5) mg versus 127 (96.7 to 158.6) mg, p<0.01. Time to first opioid was significantly prolonged in the intervention group median (IQR) 4.4 (2.8-17.6) hours compared with 0.3 (0.1-1.0) hours in the control group, p<0.001. No significant intergroup differences were recorded for time to first ambulation, pain scores, nausea/vomiting nor for LOS.Conclusion: Preoperative bilateral TQL block significantly reduced postoperative opioid consumption by 43% and significantly prolonged time to first opioid.Trial Registration Number: NCT03571490. [ABSTRACT FROM AUTHOR]

Published
2021
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23. Ultrasound-guided transmuscular quadratus lumborum block for elective cesarean section significantly reduces postoperative opioid consumption and prolongs time to first opioid request: a double-blind randomized trial.

Author

Christian, K Hansen, Dam, Mette, Gudny, E Steingrimsdottir, Gunnar, Hellmund Laier, Lebech, Morten, Troels, Dirch Poulsen, Vincent, W S Chan, Wolmarans, Morné, Thomas, Fichtner Bendtsen, Børglum, Jens, Hansen, Christian K, Steingrimsdottir, Gudny E, Laier, Gunnar Hellmund, Poulsen, Troels Dirch, Chan, Vincent W S, and Bendtsen, Thomas Fichtner

Abstract

Background: Elective cesarean section (ECS) can cause moderate to severe pain that often requires opioid administration. To enhance maternal recovery, and promote mother and baby interaction, it is important to reduce postoperative pain and opioid consumption. Various regional anesthesia techniques have been implemented to improve postoperative pain management following ECS. This study aimed to investigate the efficacy of bilateral ultrasound-guided transmuscular quadratus lumborum (TQL) block on reducing postoperative opioid consumption following ECS.Methods: A randomized double-blind trial with concealed allocation was conducted in 72 parturients who received bilateral TQL block with either 30 mL ropivacaine 0.375% or saline. TQL block injectate was deposited in the interfascial plane between the quadratus lumborum and psoas major muscles, posterior to the transversalis fascia. Primary outcome was opioid consumption, which was recorded electronically. Pain scores and time to first opioid request were also evaluated.Results: Opioid consumption (oral morphine equivalents, OME) was significantly reduced in group ropivacaine (GRO) in the first 24 hours compared with group saline (65 mg OME vs 94 mg OME) with a mean difference of 29 mg OME; 95% CI 3 to 55, p<0.03. Time to first opioid request was significantly prolonged in GRO, p<0.003. Numerical rating scale pain scores were significantly lower in GRO in the first 6 hours after surgery, p<0.03.Conclusions: Bilateral TQL block significantly reduced 24 hours' opioid consumption. Further, we observed significant prolongation in time to first opioid, and significant reduction of pain during the first 6 postoperative hours. [ABSTRACT FROM AUTHOR]

Published
2019
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24. International consensus on anatomical structures to identify on ultrasound for the performance of basic blocks in ultrasound-guided regional anesthesia.

Author

Bowness JS, Pawa A, Turbitt L, Bellew B, Bedforth N, Burckett-St Laurent D, Delbos A, Elkassabany N, Ferry J, Fox B, French JLH, Grant C, Gupta A, Harrop-Griffiths W, Haslam N, Higham H, Hogg R, Johnston DF, Kearns RJ, Kopp S, Lobo C, McKinlay S, Memtsoudis S, Merjavy P, Moka E, Narayanan M, Narouze S, Noble JA, Phillips D, Rosenblatt M, Sadler A, Sebastian MP, Taylor A, Thottungal A, Valdés-Vilches LF, Volk T, West S, Wolmarans M, Womack J, and Macfarlane AJR

Subjects
Consensus, Humans, Ultrasonography, Ultrasonography, Interventional methods, Anesthesia, Conduction methods
Abstract

There is no universally agreed set of anatomical structures that must be identified on ultrasound for the performance of ultrasound-guided regional anesthesia (UGRA) techniques. This study aimed to produce standardized recommendations for core (minimum) structures to identify during seven basic blocks. An international consensus was sought through a modified Delphi process. A long-list of anatomical structures was refined through serial review by key opinion leaders in UGRA. All rounds were conducted remotely and anonymously to facilitate equal contribution of each participant. Blocks were considered twice in each round: for "orientation scanning" (the dynamic process of acquiring the final view) and for the "block view" (which visualizes the block site and is maintained for needle insertion/injection). Strong recommendations for inclusion were made if ≥75% of participants rated a structure as "definitely include" in any round. Weak recommendations were made if >50% of participants rated a structure as "definitely include" or "probably include" for all rounds (but the criterion for "strong recommendation" was never met). Thirty-six participants (94.7%) completed all rounds. 128 structures were reviewed; a "strong recommendation" is made for 35 structures on orientation scanning and 28 for the block view. A "weak recommendation" is made for 36 and 20 structures, respectively. This study provides recommendations on the core (minimum) set of anatomical structures to identify during ultrasound scanning for seven basic blocks in UGRA. They are intended to support consistent practice, empower non-experts using basic UGRA techniques, and standardize teaching and research., Competing Interests: Competing interests: AD, CL, EM, LFV-V, TV, and MW are members of the Executive Board of the European Society of Regional Anaesthesia & Pain Therapy (ESRA). NE, SK, SM, SN, and MAR are members of the Board of Directors of the American Society of Regional Anesthesia & Pain Medicine (ASRA). AG, NH, DFJ, RJK, AJRM, AP, MPS, AT, LT, SW, JW are members of the Board of Regional Anaesthesia UK (RAUK). WH-G is the Vice-President of the Royal College of Anaesthetists. JSB, DBSL, AJRM, DP & AT declare honoraria and/or research funding from Intelligent Ultrasound. JAN is a Senior Scientific Advisor for Intelligent Ultrasound Limited. AP declares consultancy fees for B Braun Medical UK and honoraria from GE Healthcare, Butterfly Net Inc, Sintetica UK Ltd, and Pacira., (© American Society of Regional Anesthesia & Pain Medicine 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2022
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