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Regional Techniques (regional + techniques)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Regional anaesthesia and pain management

ANAESTHESIA, Issue 2010
I. Power
Summary Despite recent advances in analgesia delivery techniques and the availability of new analgesic agents with favourable pharmacokinetic profiles, current evidence suggests that postoperative pain continues to be inadequately managed, with the proportion of patients reporting severe or extreme postoperative pain having changed little over the past decade. Regional techniques are superior to systemic opioid agents with regards to analgesia profile and adverse effects in the context of general, thoracic, gynaecological, orthopaedic and laparoscopic surgery. Outcome studies demonstrate that regional analgesic techniques also reduce multisystem co-morbidity and mortality following major surgery in high risk patients. This review will discuss the efficacy of regional anaesthetic techniques for acute postoperative analgesia, the impact of regional block techniques on physiological outcomes, and the implications of acute peri-operative regional anaesthesia on chronic (persistent) postoperative pain. [source]

Analgesia for labour: a survey of Norwegian practice , with a focus on parenteral opioids

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2009
T. O. TVEIT
Background: During the last two decades, epidural analgesia has become ,a gold standard' for labour pain in most Western countries. Newer short-acting opioids given systemically represent an alternative for adequate pain relief without using regional techniques. With this survey, we wish to explore how Norwegian hospitals practice labour analgesia, especially their use of systemic opioids. Methods: A questionnaire was sent to the head of all 46 registered Norwegian labour units in 2005. The questionnaire focused on epidural and the use of systemic opioids. In 2008, the same questionnaire was sent to the 19 largest units reporting >1000 births a year, seeking updated information. Results: Forty-three of the 46 original questionnaires were returned. An epidural frequency of 25.9% was registered. For epidural treatment, bupivacaine was the preferred local anaesthetic, while sufentanil was the opioid of choice for the majority of units. Pethidine was the most commonly used opioid for systemic administration (77%). All units reported nurse administration of systemic opioids. The intramuscular route was most commonly used, either alone (58%) or in combination with an intravenous (i.v.) administration (34%). Only one unit used i.v. fentanyl. There were only minor changes with the repeated survey, except for one large unit, which reported over a 50% increase in the epidural frequency. Conclusion: In Norway, the frequency of epidural for labour analgesia is still relatively low, but seems to be increasing. Systemic opioids are often used instead of or as a supplement. Clinical practice seems to be conservative, and newer short-acting opioids are seldom used systemically. [source]

Alcohol Neurolysis of the Sciatic and Femoral Nerves to Improve Pressure Ulcer Healing

PAIN PRACTICE, Issue 2 2009
Denise Wilkes MD
Abstract Successful pressure ulcer treatment is challenging and is often plagued with prolonged hospitalizations, multiple surgeries, and high recurrence rates. Pressure ulcer secondary to spinal cord injury is further complicated by spasticity, which contributes to both ulcer continuance and healing. This report illustrates the use of neurolytic regional techniques for spasticity control and pressure ulcer healing. Case report: We present our experience with a paraplegic man who suffered from chronic right trochanteric and ischial pressure ulcers that failed to heal despite surgical and conservative treatment. We report the successful treatment of knee and hip flexor spasticity with a femoral and sciatic alcohol neuroablation technique. It was not until the successful control of his lower extremity spasticity that the pressure ulcers showed signs of healing. Neuroablation nay be considered for spasticity control when more conservative approaches fail or are not feasible. [source]

Regional anaesthesia in developing countries

ANAESTHESIA, Issue 2007
T. Schnittger
Summary In modern anaesthesia practice, regional techniques are preferred to general anaesthesia for many types of surgery, particularly in obstetric care. Improved outcomes have been recorded in UK practice, but the techniques remain underutilised in many parts of the world. With encouragement, training and a regular supply of appropriate needles and local anaesthetic agents, the advantages of regional techniques in the developing world could be realised. [source]

1226: Techniques and complications of anaesthesia for vitreoretinal surgery and a new technique of local anaesthesia

ACTA OPHTHALMOLOGICA, Issue 2010
K GOMBOSArticle first published online: 23 SEP 2010
Purpose Since the 1970s, the methods of vitrectomy procedures in ophthalmology have changed due to technical developments. Consequently certain procedures are less painful and less time consuming. On the other hand, due the modern technology more difficult cases can be operated, which may result in increase the time and strain of the operation. Methods General anaesthesia (GA) is one possibility, but it may have lots of side effects, can cause serious life threatening complications, is time consuming, expensive and sometimes to organise general anaesthesia leads to delay of the operation, consequently possibly hindering the proper timing of it. Despite these, the GA seemed to be necessary when a longer procedure planned. Results Using our method we could avoid some of the well-known complications of RBA and PBA. Painless operations were provided and the surgeons were satisfied with the anaesthesia. The serum Lidocain level was lower in cRBA compared with the single dose technique. Moreover the presence of postoperative pain could be reduced by using anaesthesia via cannula. Conclusion The benefits and disadvantages of cRBA will be apparent only by the spread of the new technique, which could also contribute to its improvement. This method means a perspective for postoperative pain relief. Hopefully more widespread use of this method helps continuous regional techniques to find their well deserved place in ophthalmic anaesthesia. [source]