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Brazilian Journal of Anesthesiology... 2024
Topics: Humans; Fatigue; Anesthesia; Surveys and Questionnaires
PubMed: 37690608
DOI: 10.1016/j.bjane.2023.09.001 -
Medicina (Kaunas, Lithuania) Jul 2022In the last decades, several new and modern techniques have been developed for the continuous monitoring of vitals for patients undergoing surgery under general...
In the last decades, several new and modern techniques have been developed for the continuous monitoring of vitals for patients undergoing surgery under general anesthesia. These complex methods are meant to come as an adjunct to classical monitoring protocols used in general anesthesia to increase patient safety. The main objectives of multimodal monitoring are avoiding the over- or underdosing of anesthetic drugs, adapting the concentration for the substances in use, reducing post-anesthetic complications, and increasing patient comfort. Recent studies have shown a series of benefits with significant clinical impact such as a reduced incidence of nausea and vomiting, shorter reversal times, a reduction in opioid consumption, shorter hospital stays, and an increase in patient satisfaction.
Topics: Analgesics, Opioid; Anesthesia, General; Humans
PubMed: 35888675
DOI: 10.3390/medicina58070956 -
Die Anaesthesiologie Aug 2022Rebound pain as a side effect of regional anaesthesia is an excessive sensation of pain after the effect of local anaesthesia has subsided. This sensation goes well... (Review)
Review
BACKGROUND
Rebound pain as a side effect of regional anaesthesia is an excessive sensation of pain after the effect of local anaesthesia has subsided. This sensation goes well beyond the normal wound pain following a surgical intervention. This phenomenon has entered focus of research in the past 10 years now, but the specific causes are so far unclear and there are still no targeted treatment recommendations.
OBJECTIVE
This review article is intended to give the readership an overview of the current state of research about rebound pain. The theories of pathophysiology are presented and prophylaxis as well as treatment strategies are explained.
MATERIAL AND METHODS
For this review article, the publications about rebound pain that appeared from 2005 up to May 2021 in PubMed were reviewed and the authors' definitions of rebound pain as well as the assumptions on pathophysiology and treatment recommendations were summarized.
RESULTS AND DISCUSSION
A total of 22 original papers from the years 2005-2021 were evaluated regarding the differences between the definitions of rebound pain, the assumption of its occurrence as well as possible treatment options. It turns out that there is no uniform definition by the professional societies, the pathophysiology has not yet been clearly identified and no clear recommendations for prophylaxis or treatment can be given to date; however, early administration of pain medication (e.g. NSAIDs) before the end of the nerve block has proven to be helpful. Likewise, dexamethasone as an adjuvant to regional anaesthesia shows positive effects regarding the occurrence of rebound pain. In any case, it makes sense to provide patients with comprehensive information about this special side effect of regional anaesthesia so that those affected can correctly classify the excessive pain reaction. Targeted studies to avoid severe pain after regional anaesthesia, e.g. through the addition of adjuvants, are necessary in order to keep side effects as low as possible and thereby improve patient comfort and the acceptance of regional anaesthesia.
Topics: Anesthesia, Conduction; Anesthesia, Local; Anesthetics, Local; Humans; Nerve Block; Pain, Postoperative
PubMed: 35513729
DOI: 10.1007/s00101-022-01120-z -
British Journal of Anaesthesia Apr 2021
Review
Topics: Anesthesia; Humans; Length of Stay; Postoperative Care; Postoperative Complications; Recovery of Function
PubMed: 33516456
DOI: 10.1016/j.bja.2020.12.027 -
Tidsskrift For Den Norske Laegeforening... Oct 2022
Topics: Humans; Anesthesiology; Anesthesia
PubMed: 36286560
DOI: 10.4045/tidsskr.22.0612 -
Anaesthesia Jan 2021Utilisation of regional anaesthesia is increasing globally; however, it remains challenging to determine the overall benefit of individual regional anaesthesia... (Review)
Review
Utilisation of regional anaesthesia is increasing globally; however, it remains challenging to determine the overall benefit of individual regional anaesthesia procedures. Like any peri-operative intervention, the benefit to the patient and healthcare system must outweigh any patient risk or resource implications. This review aims to identify markers of success in regional anaesthesia, categorise these into an objective framework and rationalise suggestions on how measuring outcomes in regional anaesthesia can be used to develop the widespread performance of this evolving subspecialty. This framework of measuring success of regional anaesthesia contains four pillars: patient-centred, population-centred, healthcare-centred and training-centred outcomes. Each pillar of success contains several outcomes which provide a structure for the measurement and development of regional anaesthesia success on a global scale.
Topics: Anesthesia, Conduction; Humans; Risk Assessment; Treatment Outcome
PubMed: 33426663
DOI: 10.1111/anae.15275 -
Anaesthesia May 2022
Topics: Anesthesia, Epidural; Anesthesia, Obstetrical; Humans
PubMed: 35332526
DOI: 10.1111/anae.15723 -
Anaesthesia Aug 2019
Topics: Anesthesia; Anesthesiology; Fatigue; Humans; Models, Theoretical; Problem Solving
PubMed: 30883674
DOI: 10.1111/anae.14633 -
Current Opinion in Anaesthesiology Aug 2023Moderate to severe pain is common and remains a significant problem in the emergency department and regional anesthesia provides optimal and safe pain relief. This... (Review)
Review
PURPOSE OF REVIEW
Moderate to severe pain is common and remains a significant problem in the emergency department and regional anesthesia provides optimal and safe pain relief. This review aims to discuss the benefits, indications of the most common ultrasound-guided regional anesthesia techniques that can be provided by clinicians in the emergency department as part of multimodal analgesia. We will also comment on the education and training for effective and safe ultrasound-guided regional anesthesia in the emergency department.
RECENT FINDINGS
The emergence of multiple new fascial plane blocks that provide easier to learn alternatives, yet effective analgesia for specific patient groups can now safely be taught and utilized in the emergency department.
SUMMARY
Emergency physicians are perfectly placed to utilize the advantages of ultrasound-guided regional anesthesia. Various techniques can now be employed to cover most of the painful injuries presenting to the emergency department, thus modifying the morbidity and outcomes of emergency patients. Some of the new techniques require minimal training, provide safe and effective pain relief with low risk of complications. Ultrasound-guided regional anesthetic techniques should form an integral part of the curriculum of emergency department physicians.
Topics: Humans; Nerve Block; Anesthesia, Conduction; Pain Management; Pain; Emergency Service, Hospital
PubMed: 37314169
DOI: 10.1097/ACO.0000000000001281 -
Anaesthesia Sep 2020
Topics: Anesthesia, Inhalation; Anesthetics, Inhalation
PubMed: 32474913
DOI: 10.1111/anae.15142