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Introduction: Charcot-Marie-Tooth disease is a group of hereditary peripheral neuropathies with high prevalence that cause distal damage with atrophy and deformities. The use of regional anesthesia has been restricted due to the fear of causing permanent neurological damage or aggravating existing nerve injury. Case report: we present a case of a brachial plexus block performed in a patient with Charcot-Marie-Tooth with no later neurological complications. Conclusion: assessing their use in each case, regional techniques may be an appropriate anesthesia option in Charcot-Marie-Tooth patients, although more case report publications are necessary. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Gastroenterología del Perú is the property of Sociedad de Gastroenterologia del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: comparar la disminución en el dolor en pacientes con terapia con pregabalina frente a bloqueos intervencionistas. Materiales y métodos: estudio de cohorte retrospectiva, se reclutó pacientes mayores de 18 años diagnosticados con dolor de tipo neuropático de centro de referencia de la ciudad de Pereira, Colombia, entre los años 2010 a 2016. Se evaluó la variación en la intensidad del dolor. La comparación entre cohortes y la efectividad de la intervención se evaluó a través del análisis de medias repetidas con la ecuación de estimación generalizada. Resultados: se incluyeron 94 pacientes con dolor neuropático. A 62 (66%) pacientes se les formuló un esquema farmacológico con pregabalina y a 32 (34%) pacientes se les realizó bloqueos. La intensidad del dolor previa al tratamiento con pregabalina fue de 7,3 ± 1,8 y de 8,9 ± 1,2 en el grupo con bloqueos, p=0,005. La intensidad del dolor posterior en el grupo con pregabalina fue de 3,5 ± 2,4, con una mejoría media de 53,9%, mientras que en el grupo con bloqueos fue del 2,5 ± 2 con una mejoría media de 70,7%. El manejo intervencionista logró una reducción 2,09 veces mayor comparada con la pregabalina (p

Introduction: the erector spine plane block (ESPB) is a safe procedure, technically is less demanding than conventional thoracic regional anesthesia techniques. It is used for the treatment of acute and chronic pain. In the literature review, no reports of its use as a single technique in the acute pain of scapula fracture were found. Case presentation: ESPB is reported in a case as an experimental technique for controlling acute postoperative pain in scapula fractures with an application at the T2 level. It was performed postoperatively with a decrease in pain after 10 minutes and a score of zero on the analog pain scale. In this case, the ESPB was performed in the immediate postoperative period, achieving a total decrease in pain at 10 minutes, with subsequent pain control at 36 hours. Conclusion: this case shows the effectiveness of ESPB as an experimental technique for postoperative pain control in scapula fractures. [ABSTRACT FROM AUTHOR]

Introducción: La osteoartritis (OA) es la patología reumatológica más prevalente a nivel mundial, que produce intenso dolor crónico especialmente en las articulaciones de soporte, como es la rodilla. Dentro de las nuevas dianas terapéuticas para la OA de rodilla, se encuentra el bloqueo nervioso junto a sus diversos tipos y técnicas, que ayudan a mejorar significativamente dolor y funcionalidad integral del paciente. Objetivo: Revisar la evidencia actual sobre los tipos y técnicas del bloqueo nervioso en la osteoartritis de rodilla. Métodos: Se realizó una revisión sistemática siguiendo las directrices PRISMA, de distintos estudios según los criterios de inclusión, en la base de datos de: PubMed, MedScape, ScienceDirect, Scopus y ProQuest, desde enero del 2018 a enero del 2023. Resultados: En la búsqueda sistemática se obtuvieron 9034 artículos, tras eliminar duplicados y conforme los criterios de inclusión y exclusión se filtraron un total de 19 artículos, entre ellos 10 eran ensayos aleatorios controlados y 9 estudios observaciones, que cumplian todos los criterios de elegibilidad. Conclusión: De acuerdo a los resultados de los estudios, existe evidencia de la eficacia y seguridad del bloqueo genicular en el alivio del dolor crónico en la OA de rodilla, siendo una opcion recomendable como complemento en el abordaje terapeutico de esta patología. La tecnica que se aplique depende del contexto clínico del paciente y del profesional que realizará el procedimiento, los resultados a largo plazo no tienen diferencia significativa.

The erector spinae plane (ESP) block is an interfascial block described in 2016 by Forero and collaborators, with wide clinical uses and benefits when it comes to analgesic control in different surgeries. This block consists of the application of local anesthetic (LA) in a deep plane over the transverse process, anterior to the erector spinae muscle in the anatomical site where dorsal and ventral branches of the spinal nerve roots are located. This review will cover its clinical uses according to different surgical models, the existing evidence and complications described to date. [ABSTRACT FROM AUTHOR]

Background: Antiaggregant and anticoagulant therapy complicate the management of patients with osteoporotic hip fracture., Objective: To homogenize and improve daily clinical practice with simple recommendations., Methods: The haemostasis section of SEDAR established a working group to define an action plan for the management of antiaggregated or anticoagulated patients with an osteoporotic hip fracture. The suggested recommendations are based on evidence of best practices, and have been validated by a multidisciplinary group formed by 6 specialties., Results: Early surgery reduces complications and mortality and improves patient comfort and functional recovery, with no difference in mortality between intradural and general anaesthesia., Conclusion: Although uncertainties remain, it is recommended to perform surgery within 24-48 h of admission, adapting peripheral nerve blocks and type of anaesthesia (neuraxial or general) an to the haemostatic conditions. A multimodal management of antithrombotics, and the optimisation of haemostasis, haemoglobin and venous thromboprophylaxis since admission are suggested., Competing Interests: Declaration of competing interest The authors have no conflict of interest to declare., (Copyright © 2024 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.)

Copyright of Revista Odontología Vital is the property of Universidad Latina de Costa Rica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of CES Odontología is the property of Universidad CES and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Ankylosing spondylitis is an arthropathy that falls within the group of seronegative arthropathies, being the most common and representative entity of them. It is characterized by chronic inflammation of the axial skeleton, with inflammatory back pain and progressive stiffness. It typically manifests in young patients who begin to show symptoms between 20 and 30 years of age. Progressive ossification in ankylosing spondylitis involves the articular cartilage and discs of the spine, with the development of bony bridges between the vertebrae. This fusion makes the axial approach difficult, if not impossible, to achieve epidural or spinal anesthesia, and even increases the difficulty of airway management due to the fusion of the cervical vertebrae. Case report: This case report presents a 40-year-old female patient, already diagnosed with ankylosing spondylitis, who underwent a total abdominal hysterectomy, where a failed neuraxial approach was first attempted and then general anesthesia with airway management was used. Conclusion: Intubation in awake patients is a subject widely described in the literature which can be performed in different ways, in our case we opted for the use of upper airway blocks with subsequent use of fiberscope to ensure endotracheal intubation. [ABSTRACT FROM AUTHOR]

We present the case of a patient intervened for mechanical mitral replacement, tricuspid annuloplasty, and correction of a total anomalous pulmonary venous return, which required Extracorporeal Membrane Oxygenation (ECMO) in the immediate postoperative period because of refractory cardiogenic shock. After withdrawal of the arterial cannula, the patient developed compartment syndrome of the right lower limb, requiring urgent intervention. Also, the patient went into respiratory failure, requiring support with high flow oxygen cannula. Given the patient's condition, general anesthesia was discarded. An ultrasound-guided popliteal block and sedation with dexmedetomidine and ketamine was performed instead, maintaining the high flow nasal cannula. Regional anesthesia along with dexmedetomidine and ketamine could be an alternative for a surgical procedure in patients with high risk of cardiovascular and respiratory complications. [ABSTRACT FROM AUTHOR]

Post-dural puncture headache is a frequent complication in neuraxial approaches. It may result in disability, healthcare dissatisfaction and potentially serious complications. The traditional initial management includes general and analgesia measures with poor evidence. The treatment approach best supported by the literature is the epidural blood patch for which rates of up 70% improvement have been reported. Regional techniques have been recently described that may be helpful because they are less invasive than the epidural blood patch, under certain clinical circumstances. This article suggests an algorithm that uses such techniques for the management of this complication. [ABSTRACT FROM AUTHOR]

Complications in airway management remain a common cause of anesthesia-associated mortality. When a patient is considered with anticipated difficult airway, the management depends on several variables, however, at present, the standard of management continues to be the patient awake approach. In scenarios of acute upper airway obstruction, the only way to guarantee adequate ventilation is to obtain a translaryngeal or transtracheal access, for which, it is necessary to use local anesthesia and grade I / II sedation, avoiding loss of spontaneous ventilation. For this purpose, we propose ultrasound-guided superior laryngeal nerve block, in order to standardize an ultrasound landmark that is reproduceable, with a high success rate, which allows limiting complications related to regional anatomic techniques and thus facilitating the securing of the airway in these patients. [ABSTRACT FROM AUTHOR]

Copyright of CES Odontología is the property of Universidad CES and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: El bloqueo terapéutico de ganglio estrellado es un procedimiento para aliviar dolores crónicos de miembros superiores, cabeza y cuello. Actualmente se realiza con anestésicos locales más adyuvantes; pero en Cuba sólo se usan anestésicos locales para este bloqueo. Objetivo: Cotejar información reciente sobre la pertinencia del uso de anestésicos locales con adyuvantes, para estimular la actualización de su práctica nacional acorde a las rutinas y los resultados de esta pericia en el contexto internacional. Métodos: Se revisaron más de 150 informes científicos en línea, referentes a esta técnica a nivel mundial, respecto al uso de drogas y resultados terapéuticos, en bases de datos en inglés, español y portugués. Desarrollo: El bloqueo anestésico precisa conocimientos de farmacología y habilidades prácticas para efectuarlo. La necesidad de anestésicos locales y adyuvantes varía, y depende del paciente y tipo de bloqueo. Para tratar el dolor crónico se usan también opioides, solos y con anestésicos locales. Se publican además beneficios razonables con el uso de ketamina y esteroides en combinación con anestésicos locales. Conclusión: Los resultados terapéuticos más intensos y duraderos que se obtienen al aplicar anestésico local más adyuvante, sugieren actualizar estas prácticas a nivel nacional.

Erector spinae plane block is an ultrasound-guided technique who has seen a growing role as a perioperative analgesic technique due to its safety profile and versatility. We describe a case of an elderly female with a history of ischemic heart disease and atrial fibrillation, who underwent segmental colectomy by left subcostal laparotomy under general anesthesia, for removal of a colon tumor. An erector spinae plane catheter was placed at the T7 level under ultrasound guidance, and then used for postoperative analgesia. Ropivacaine 0.2% (initial bolus + infusion at 8 mL/h) was used through the catheter, together with intravenous paracetamol and metamizol. This analgesic regimen was maintained for 72 hours, with excellent pain control, after which the catheter was removed. The patient’s pain remained controlled and rescue analgesia was not required until her discharge at seven days postoperative. Continuous ESP block was an effective technique for postoperative analgesia in this case, allowing excellent pain control with a low risk of complications and avoiding the use of opioids. [ABSTRACT FROM AUTHOR]

Copyright of Colombian Journal of Anesthesiology is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Heart failure represents a public health problem involving high morbidity and mortality. For advanced stages of the disease the use of ventricular assist devices (VADs) has been implemented as destination therapy. The perioperative management of patients with VADs may result in multiple challenges, with optimal pain management being one of those challenges. Objective: To describe the use of erector spinae plain (ESP) block as a rescue analgesia technique in a patient undergoing HeartMate 3 type VAD implantat. Methods: Case report and subject review. Results: The case discussed is a patient with ischemic cardiomyopathy and severe ventricular dysfunction, undergoing a HeartMate 3 type VAD implant as destination therapy, under general anesthesia and postoperative analgesia protocol with fentanyl and acetaminophen. During the postoperative period the patient developed acute pain of severe intensity (visual analogue scale [VAS]: 8-10/10), that led to the use of a regional rescue technique--ESP block--that showed satisfactory results with optimal analgesia control (VAS: 1-3/10). Conclusion: The ESP block was a safe and effective option as part of a postoperative analgesia strategy for a patient with a HeartMate 3 type VAD implant. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The erector spinae plane (ESP) block is a relatively new interfascial block about which several applications have been described, both in abdominal and thoracic surgical procedures. Case presentation: A 17-year old patient programed for removal of a Nuss bar through mini-thoracotomy. Following the induction with anesthesia, a US-guided bilateral ESP block was administered; no pain was reported during the immediate postoperative period and over the 48-hour follow-up. Conclusion: Bilateral ESP block seems to be promising, easy to administer, and an acceptable alternative to the epidural catheter (the gold standard in the management of analgesia for thoracic surgery), providing adequate and opiate-free analgesi. [ABSTRACT FROM AUTHOR]

Copyright of Colombian Journal of Anesthesiology is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article describes the use of the bilateral erector spinae plane block at the level of T7, as an alternative technique outside the operating room to do contrast magnetic resonance images in a patient with chronic metastatic pain in the dorsal region, with a pain score of 10 in the visual analogue scale. Ten minutes after the block, the pain dropped to 2/10 in the visual analogue scale, until it finally disappeared. Two weeks later, the pain came back with a visual analogue scale rating of 5/10--a considerably lower level as compared to the pain before the procedure. [ABSTRACT FROM AUTHOR]

Copyright of Colombian Journal of Anesthesiology is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Interscalene block (ISB) is the brachial plexus approach most frequently used in shoulder surgery, providing better postoperative analgesia and reducing the need for rescue morphine compared to general anesthesia. While it is considered a safe block, it has been associated with a relatively high rate of complications, the most serious of which are postoperative neurologic symptoms, such as paresthesia, dysesthesia, and reduced sensitivity. We present the case of a patient with prolongedneurological deficit lasting 4months following nerve stimulation-guided ISB. Due to the multifactorial nature of postoperative neurological lesions, it can be difficult to determine their etiology. In our case, the brachial plexopathy was probably due to the administration of local anesthetic through the perineurium. We discuss possible causes and argue for the use of ultrasound associated with nerve stimulation when an ISB is performed in order to reduce the incidence of nerve puncture. [ABSTRACT FROM AUTHOR]

Introduction: Spinal anesthesia (SA) and sciatic-femoral nerve block are the most widely used anesthesia techniques for knee arthroscopy; however, there is still some controversy with regard to which anesthetic procedure offers improved safety, better pain control, and higher patient satisfaction. Objective: To assess the effectiveness of exclusive SA with bupivacaine versus sciatic-femoral nerve block, regardless of the drug, during the postoperative period of patients having undergone knee arthroscopy, through a systematic review of the scientific literature. Methods: A search of Randomized Clinical Trials was conducted in a number of databases including Ovid, Cochrane, Embase, Lilacs, Open Grey, ClinicalTrials.gov, and academic Google. The snowball technique was also used to identify additional trials. The design of the search strategy included Boolean operators and considered studies in English, Spanish, and Portuguese, with no date restrictions. The information is presented in narrative form. Results: The search identified 478 studies, of which 3 met the eligibility criteria. The effectiveness was evaluated based on total anesthesia time and rescue analgesia. Safety was evaluated with heart rate monitoring and time to first micturition. Patient satisfaction was identified through surveys to measure the acceptance of the anesthetic technique. Conclusion: SA is effective as assessed based on the motorsensory blockade effect and pain control, but its adverse events shall be taken into consideration when making a decision. The anesthetic techniques of the peripheral sciatic-femoral nerve block present less undesirable side effects than spinal analgesia and provide better postoperative pain control. [ABSTRACT FROM AUTHOR]

Zovawk is newly identified breed of pig of Mizoram approved by breed registration committee of Indian Council of Agricultural Research (ICAR), New Delhi. This study was designed to provide maximum number of morphometrical parameters of skull and some valuable information on clinically important parameters of Zovawk. The skull of the Zovawk was dolichocephalic according to the cephalic index (53.56±0.11). The supraorbital foramina distance, infraorbital foramina distance, skull length, skull width, cranial length and nasal length of the Zovawk were 3.49±0.01 cm, 6.55±0.01 cm, 28.26±0.03 cm, 15.11±0.26 cm, 13.17±0.04 cm and 13.79±0.02 cm, respectively. The orbital margins were found to be incomplete with bilateral variation among the orbits of both the sides. The distance from the process of alveolar socket of canine tooth to the infraorbital canal and from the latter to the root of the fourth upper premolar alveolar tooth directly ventral to it was 4.77±0.04 cm and 1.20±0.01 cm, respectively in Zovawk. The data are of clinical importance as a guide for tracking the infra-orbital nerve, and necessary for its desensitization during the manipulations in the skin of the upper lip, nostril and face at the level of the foramen. The distance between the lateral end of the alveolus of the third incisor tooth to the mental foramen was 3.57±0.04 cm in Zovawk, which is an important landmark for achieving the location of the mental nerve for the regional nerve block Zovawk. The length and height of the mandible were 25.02±0.09 cm and 10.54±0.07 cm, respectively in Zovawk. The morphometric measurements of the skull and applied anatomy of the head region of the Zovawk provide an important baseline data for further research in the field of applied anatomy. [ABSTRACT FROM AUTHOR]

Occipital neuralgia or Arnold's neuralgia is a rare condition that primarily affects women. There are multiple causes that can trigger this disorder, which is clinically characterized by the presence of pain of varying intensity, characteristic radiation of pain and presence of trigger points. Occipital nerve block can be an important element in the diagnosis of the condition. The intensity, frequency and characteristics of pain can considerably limit the perception of quality of life of patients who suffer from it. The case of a 57-year-old patient with a diagnosis of rheumatoid arthritis and symptoms compatible with occipital neuralgia is presented. This case is of interest given the frequent emergency department visits by patients with neck pain and the scarcity of studies on this condition

The ultrasound-guided intercostal nerves (cutaneous branches) block in the mid-axillary line at the level of the 8th rib (modified BRILMA) is an analgesic technique described back in 2015. Four patients undergoing open gastrectomy (who are not candidates for epidural analgesia) are discussed. The patients underwent the above-mentioned bilateral block, with the administration of 15 mL of levobupivacaine 0.5% into the fascial plane, between the serratus anterior muscle and the external intercostal muscle, with the aim of blocking the intercostal nerves T6 to 11. Postoperative pain control was adequate, with low levels of opioids used. There were no complications associated with the technique. [ABSTRACT FROM AUTHOR]

Copyright of Colombian Journal of Anesthesiology is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The prevalence of chronic shoulder pain is 20%, and treatment involves pharmacological and non-pharmacological means, as well as analgesic interventional procedures. The use of intra-articular injections and ultrasound-guided blocks has increased with favorable results, but there are few comparisons to determine their effective use in patients with chronic pain due to shoulder arthrosis refractory to pharmacological treatment. Objective: To compare the clinical efficacy and safety of 2 interventional techniques in patients with chronic shoulder pain secondary to arthrosis. Methods: Retrospective cohort analytical study to compare the clinical efficacy and safety of 2 interventional techniques in terms of pain relief, improvement time, and adverse effects in patients coming to Instituto Colombiano del Dolor (Colombian Pain Institute) between June 2011 and April 2012, followed during a period of at least 16 weeks. Results: The analysis included 62 patients with chronic shoulder pain secondary to osteoarthritis. Suprascapular nerve blocks were performed in 29 patients, and tricompartmental blockade was used in 33 patients, and both procedures were performed under ultrasound guidance. A statistically significant reduction in pain intensity was found during the 16-week period in both groups (P<0.0001), and there were no complications. Conclusion: Both analgesic techniques provided significant pain reduction over the 16-week period, with a superior clinical trend in favor of the suprascapular nerve block, and they were found to be safe therapeutic options because of the low rate of complications. [ABSTRACT FROM AUTHOR]

Copyright of Colombian Journal of Anesthesiology is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Supraclavicular block is usually performed using a lateral to medial approach, although a medial to lateral approach is also feasible. Block onset may be evaluated through the sympathetic effect associated with the sensitive and motor blockade. Objective: To describe the ultrasound-guided supraclavicular block using a medial approach, evaluating the sensitive, motor, and sympathetic block onset. Materials and methods: An ultrasound-guided supraclavicular block was performed in a fresh cadaver with 20 mL volume (2mL of iodine and lmL of methylene blue). A CT scan was performed and sagittal sections were obtained. The clinical phase included 10 patients undergoing a medial approach block; the onset of the block was evaluated based on a motor, sensory and sympathetic assessment (measuring flow changes in the humeral artery, the palmar temperature, and the perfusion index). Results: Adequate distribution of the contrast medium was observed in the cadaver, with complete spread through the brachial plexus, both in terms of the CT-reconstruction as in the anatomical cross sections. A significant change in all the sympathetic block parameters was observed 5minutes after the bock: temperature (32.5±1.8°C to 33.4±1.7°C; P=.047), humeral arterial flow (105±70mL/min to 192±97mL/min; P = .007), and thumb perfusion index (5 ± 3 to 10 ± 3%; P = .002). The block was effective and uneventful in all patients. Conclusions: This supraclavicular approach achieves a homogeneous distribution throughout the brachial plexus, with high anesthetic efficacy. Regional changes secondary to the sympathetic block occur early after the block. [ABSTRACT FROM AUTHOR]

Copyright of Colombian Journal of Anesthesiology is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Pudendal nerve blocks have a wide range of clinical applications for the management of acute post-operative pain in urologic and gynaecologic surgery, in coloproctology, as well as in pain medicine for differential diagnosis, and for the management of pudendal neuropathies. However, despite its benefits, it is infrequently used. Objective: To perform a detailed description of the most recent ultrasound-guided techniques with the aim of encouraging safe and reproducible learning. Materials and methods: We have performed a broad, non-systematic review of the literature through Medline, Embase and Science Direct between 1985 and 2016, to evaluate the most relevant articles, using the following key words: pudendal nerve anatomy; pudendal nerve; pudendal nerve blocks; pudendal nerve ultrasound; pudendal neuralgia; nerve entrapment; chronic pain; Alcock canal and pelvic pain. The search was limited to articles published in Spanish; English and French. Results: Recent descriptions were found of a large number of anatomic variants, which are described in detail and shown in graphic documents in order to facilitate the sonoanatomic correlation of nerve location as a guide for the performance of the pudendal nerve block through the different approaches. Conclusions: The deep and detailed knowledge of the anatomy of the pudendal nerve and its variations is essential for the realization of Regional Anesthesia techniques guided by images. These promising techniques should continue to be evaluated with clinical studies. [ABSTRACT FROM AUTHOR]

Introduction: Around the world, inguinal hernia repair is one of the most frequent surgical interventions and is associated with moderate to severe postoperative pain. TAP (Transversus Abdominis Plane) block appears to be a useful tool to reduce the morbidity associated with pain in inguinal hernia repair. Objective: To evaluate the analgesic effect of a TAP block in patients scheduled for primary inguinal hernia repair, one hour and 24-hour post-surgery. Materials and methods: Randomized controlled trial. Forty five patients were randomized to receive placebo vs TAP block. Clinical, surgical and anesthetic variables were analyzed. The primary outcome was pain in the first hour and the secondary outcome was pain during the first 24 hours, opiate use and side effects. Results: The acute postoperative pain score during the first hour in the control group was 6 with maximum values of 9 in 22% of patients, whereas in the intervention group the pain score was 2 (SD: 1) (p = 0.03). Likewise, pain 24 hours postop and opiate consumption was lower in the intervention group than in the control group. Conclusions: TAP block helps to reduce acute postoperative pain and the use of opiates in inguinal hernia repair. [ABSTRACT FROM AUTHOR]

Copyright of Colombian Journal of Anesthesiology is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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The anesthetic management of an 8-year-old Golden Retriever female canine submitted to surgical excision of a malignant tumor located in the wall of the cranio-ventral abdomen was exposed; for which the T6-T11 bilateral intercostal nerves anesthetic block was performed using anatomical surface marks as neurolocalization technique, and using bupivacaine (0.5%) as local anesthetic. This as part of a multimodal anesthetic protocol that also included acepromazine, meloxicam, tramadol, propofol and isoflurane in 100% O2. The values of arterial pressure and heart rate were evaluated intraoperatively; postoperative pain was evaluated applying the composite Glasgow pain scale. Intraoperative evaluated cardiorespiratory variables remained stable throughout the surgical procedure. Postoperative pain assessment showed adequate analgesic coverage. The intercostal block used in this patient as part of a multimodal anesthesia protocol allowed to minimize the consumption of isoflurane, and avoided the use of rescue analgesia in the intraoperative period, and the need to administer supplemental anesthesia in the postoperative period. The blockade of the intercostal nerves T6-T11 by means of the surface anatomical marks technique, added to the multimodal protocol used, allowed to obtain effective analgesic coverage, economical and safe in the evaluated patient. This technique could be considered as an alternative to the epidural block traditionally performed in surgical procedures involving the abdominal wall. [ABSTRACT FROM AUTHOR]

INTRODUÇÃO E OBJETIVOS: Toracotomia é um procedimento associado à dor pós-operatória de forte intensidade. O bloqueio peridural (BPD) é considerado o padrão-ouro para o seu controle. O bloqueio paravertebral (BPV) é uma opção para o controle da dor pós-operatória. O objetivo deste estudo foi fazer metanálises focadas nas comparações entre as analgesias com bloqueio peridural torácico ou paravertebral contínuos quanto à eficácia relativa no controle da dor pós-toracotomia e à incidência de efeitos adversos. MÉTODOS: O estudo seguiu o protocolo Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Foram analisados desfechos, primário (dor pós-operatória em repouso), e secundários (retenção urinária, náuseas e vômitos e hipotensão arterial). A diferença média ponderada foi estimada para as variáveis contínuas e as razões de chances para as variáveis categóricas. RESULTADOS: Foram incluídos oito estudos prospectivos controlados de alocação aleatória. As metanálises não demonstraram diferenças estatisticamente significantes entre as duas técnicas quanto ao desfecho da dor pós-operatória em repouso nos momentos 4h, 8h, 12h, 16h, 20h, 24h, 36h e 48h. A incidência de retenção urinária foi maior no grupo submetido ao BPD (RC = 7,19; IC95 = 1,87-27,7). A ocorrência de hipotensão foi maior no grupo submetido ao BPD (RC = 10,28; IC95 = 2,95-35,77). Não houve diferença estatisticamente significante entre os dois grupos em relação ao desfecho náuseas/vômitos (RC=3,00; IC95=0,49-18,45). CONCLUSÃO: Não se observaram diferenças estatisticamente significantes quanto ao alívio da dor pós-toracotomia quando comparados os tratamentos BPD e BPV. O tratamento BPV mostrou menor incidência de efeitos colaterais com redução na frequência de retenção urinária e hipotensão.