Abdominal Nerve Block Research Articles

Analgesic Effect of Caudal and Abdominal Nerve Blocks among Children Undergoing Inguinal Surgeries: An Original Research.

Pediatric inguinal surgeries sometimes cause considerable post-operative pain that requires effective analgesics. Caudal and abdominal nerve blocks may help this population with pain. It is uncertain how successful they are compared. A randomized controlled trial included 70 pediatric inguinal surgery patients. An abdominal (ANB) or caudal nerve block (CNB) was randomly assigned to participants in addition to usual analgesic treatment. Post-operative pain was measured at various times using a standardized scale. The initial rescue analgesia time and dose were recorded. Statistics were used to compare CNB and ANB results. The CNB and ANB groups were demographically similar. At every time point, the two groups' analgesic usage and post-operative pain were similar. No serious adverse events occurred in either group. CNB and ANB provide equivalent analgesia for pediatric inguinal surgeries. Both approaches alleviate pain well and have similar post-operative effects. Individual nerve block approaches must be chosen based on patient features and clinical considerations. More research is needed to determine each procedure's long-term safety and results.

8954 Abdominal Wall Nerve Blocks

<h3>Study Objective</h3> To demonstrate the nerve block techniques for the ilioinguinal, iliohypogastric, lateral femoral cutaneous, and the genital branch of the genitofemoral nerves. <h3>Design</h3> Procedural video. <h3>Setting</h3> Operating room at an academic medical center. <h3>Patients or Participants</h3> Patients with chronic abdominal pain. <h3>Interventions</h3> This video demonstrates how to perform nerve blocks to the ilioinguinal, iliohypogastric, lateral femoral cutaneous, and genital branch of the genitofemoral nerves. It also highlights the techniques of these nerve blocks and includes general management and follow-up principles for these patients. <h3>Measurements and Main Results</h3> Patients' individual responses to nerve blocks are assessed on a pain scale of 0-10. They are measured prior to and after nerve blocks to gauge response. <h3>Conclusion</h3> Determining the source of chronic abdominal and pelvic pain can be difficult for gynecologists. Nerve blocks can be an effective strategy to help evaluate and possibly treat abdominal wall pain. These blocks can delineate whether pain is originating from the abdominal wall or from another source. Nerve blocks can also potentially be therapeutic in instances of nerve entrapment, muscle spasms, neuralgia, or myofascial pain. These instructional videos on administering abdominal nerve blocks can help gynecologists provide another potential source of therapy for their patients.

Regional abdominal wall nerve block versus epidural anesthesia after hepatectomy: analysis of the ACS NSQIP database.

The aim of this study is to determine whether regional abdominal wall nerve block is a superior to epidural anesthesia (EA) after hepatectomy. Patients undergoing open hepatectomy in the NSQIP targeted file (2014-2016) were identified. Those with INR &gt; 1.5, Platelets &lt; 100, bleeding disorders, undergoing liver ablation without resection, and spinal anesthesia were excluded. Patients with regional abdominal wall nerve block (RAB), mostly transversus abdominis plane (TAP) block, were matched (1:1) to those undergoing EA using propensity scores to adjust for baseline differences. Out of 1727 patients who met our inclusion criteria, 361 (21%) had RAB. Of whom 345 were matched (1:1) to those who underwent EA. The matched cohort was well-balanced regarding preoperative characteristics, extent of hepatectomy, concurrent ablations as well as biliary reconstruction. RAB was associated with shorter hospital stay (median: 6days vs. 5days, p = 0.007). Overall morbidity (44.1% vs. 39.4%, p = 0.217), serious morbidity (27% vs. 25.2%, p = 0.603), and mortality (2.6% vs. 2.3%, p = 0.806) were not different between the two groups. Individual complications, readmission rate, and blood transfusion were not different between the two groups. Regional abdominal nerve block is associated with shorter hospital stay than epidural anesthesia without an increase in overall postoperative morbidity or mortality. RAB is a viable alternative anesthesia adjunct to EA in patients undergoing hepatectomy. However, given the retrospective nature of this study further studies comparing the modalities should be considered to definitively define the utility of RAB.

Effectiveness of bilateral illioinguinal illiohypogastric nerve block and wound site infiltration as a part of post-operative analgesia in patients undergoing elective caesarean section under spinal anesthesia. A prospective cohort study

IntroductionCesarean section is one of the most commonly performed surgical procedures. Postoperative pain after cesarean section is moderate to severe, though it has been neglected due to several reasons. Systemic opoids, local wound infiltration, and abdominal nerve blocks are among popular techniques used for postoperative pain after cesarean section in an area where epidural analgesia is barely practiced. Thus, this study aimed to assess the analgesic effectiveness of II-IH nerve block and wound site infiltration for pain management after cesarean section. MethodAn institutional based prospective cohort study was conducted on 72 parturient scheduled for elective cesarean section. The parturients grouped based on whether they took II-IH, WSI or non-exposed groups. Data collection methods include preoperative chart review, intraoperative observation and postoperative patient interview starting from recovery room for 24 h. Time to first analgesic request, NRS score and total analgesic consumption were used as outcome variables. Continuous data were analyzed using one-way analysis of variance (ANOVA) or kuruska-walih H rank test depending on normality whereas categorical data analyzed by Pearson chi-square test. ResultTime to first analgesic request was significantly prolonged in II-IH groups compared to WSI and Non-exposed groups with p-value 0.01. Similarly, NRS score within 24 h was significantly lower in II-IH groups compared to Non-exposed Group at all follow up periods except at 2 and 24 h. However, WSI reduced NRS score, in a comparison with non-exposed group, only at 4 and 6 h with p-value of 0.04 and 0.02 respectively. In addition, the post hoc comparison of total tramadol consumption revealed significant difference between all the possible three comparisons. Conclusion and RecommendationAlthough II-IH nerve block provides better and prolonged pain relief, WSI was also effective analgesic technique for post cesarean section pain. Therefore, we recommend use of either II-IH or WSI as a part of post-operative pain management for cesarean section. Further Randomized controlled trial studies were also recommended on similar area.

Effects of Abdominal Nerve Block on Postoperative Recovery in Patients Undergoing Gastrointestinal Surgery

Effects of Abdominal Nerve Block on Postoperative Recovery in Patients Undergoing Gastrointestinal Surgery

Ultrasound guided continuous Quadratus Lumborum block hastened recovery in patients undergoing open liver resection: a randomized controlled, open-label trial

BackgroundQuadratus lumborum (QL) block is increasingly being used as a new abdominal nerve block technique. In some studies of mid and lower abdominal and hip analgesia, continuous QL block achieved favorable outcomes as an alternative to continuous intravenous analgesia with opioids. However, the use of continuous QL block for upper abdominal pain is less well characterized. This study aimed to investigate the effects of continuous anterior QL block (CQLB) on postoperative pain and recovery in patients undergoing open liver resection.MethodsSixty-three patients underwent elective open liver resection were randomly divided into continuous anterior QL block (CQLB, n = 32) group and patient-controlled intravenous analgesia (PCIA, n = 31) group. Patients in CQLB group underwent ultrasound-guided anterior QL block at the second lumbar vertebral transverse processes before general anesthesia, followed by postoperative CQLB analgesia. Patients in PCIA group underwent continuous intravenous analgesia postoperatively. Postoperative numerical rating scale (NRS) pain scores upon coughing and at rest, self-administered analgesic counts, rate of rescue analgesic use, time to first out-of-bed activity and anal flatus after surgery, and incidences of analgesic-related adverse effects were recorded.ResultsPostoperative NRS pain scores on coughing in CQLB group at different time points and NRS pain score at rest 48 h after surgery were significantly lower than those in PCIA group (P < 0.05). Time to first out-of-bed activity and anal flatus after surgery in CQLB group were significantly earlier than those in PCIA group (P < 0.05). No significant differences of postoperative self-administered analgesic counts, rate of postoperative rescue analgesic usage, or incidences of analgesic-related adverse effects were found between the two groups (P > 0.05).ConclusionsUltrasound-guided anterior QL block significantly alleviated the pain during coughing after surgery, shortened the time to first out-of-bed activity and anal flatus, promoting postoperative recovery of the patients undergoing open liver resection.Trial registrationThis study has been registered in April 1, 2018 on Chinese Clinical Trail Registry, the registration number is ChiCTR1800015454.

Comparison of ultrasound-guided abdominal nerve blocks and subarachnoid block as an anaesthetic technique for appendectomy: a retrospective study

Background: Ultrasound guided abdominal nerve blocks are increasingly being used for anaesthesia and analgesia for surgeries like appendectomy, hernia repair in our centre. The aim of the study was to compare abdominal nerve blocks and subarachnoid block for appendectomy.Method: Retrospective data of patients that underwent appendectomy either under subarachnoid block (Group-S) or abdominal nerve blocks (Group-A) for three months were collected from hospital records. The groups were compared for conversion to general anaesthesia as a primary end point of study and also for the time taken for the procedure, the first requirement of opioids, total opioid consumption and length of hospital stay.Result: Out of 116 patients studied, 75 surgeries were performed under subarachnoid block and 41 under abdominal plane blocks. Two patients in Group-S and 1 patient in Group-A were converted to general anaesthesia due to inadequate blockade. The time taken to perform the block was around four minutes in Group-S and 12 minutes in Group-A. The mean pethidine consumption in 24 hours was 62.33+16.63 mg and 23.17+15.19 mg in Group-S and Group-A respectively. The time to the first dose of pethidine in Group-S groups was 224.66+43.56 minutes and 813.17+361.80 minutes in Group-A. The mean duration of hospital stay in Group-S was 5.14+0.72 days and Group-A was 2.24+0.58 days.Conclusion: Appendectomy can be safely performed under subarachnoid block as well as the abdominal nerve blocks. The abdominal nerve block technique is found to be advantageous in terms of better postoperative analgesia, less opioid consumption and early hospital discharge.

RECTAL PREOPERATIVE TRAMADOL AND INTRAOPERATIVE BUPIVACAINE WOUND INFILTRATION AT CESAREAN DELIVERY FOR POSTOPERATIVE ANALGESIA

Delivery by CS is increased and is one of the most common great operative procedures done worldwide. Prompt and adequate postoperative pain relief is an important issue of caesarean delivery. Pain relief may cause good psychological and physical effects in patients,lead to better recovery from surgical procedures and early mobilization of patients to prevent complications. Pain after operations is usually mannaged with opioids. These agents exert their analgesic effects through μ-receptors in the CNS. The effect of opioids is limited by the occurance of tolerance or side effects such as vomitin, nausea, sedation, or respiratory depression. Tramadol, is analgesic with weak mu-opioid receptor agonist and activity at serotonergic, noradrenergic and GABAergic systems, is another alternative parenteral ,oral and rectal analgesic for post caesarean pain. The local anesthetic may be used before or after abdominal nerve block, absorbed by systemic route and secreted in breast milk, but their effects on breast fed babies have not yet been demonstrated. This is in contrast to morphine or pethidine, both of which have significant transfer to breast milk and may have a sedative effect on the baby. Objectives: Of our study was to measure the effect of rectal tramadol and bupivacaine infiltration on pain relief after CS and on opioids requirement. Patients and methods: 312 parturient,scheduled for CS under general anashesia ,participated in this study, 156 parturient received placebo rectally and saline infiltration and the other 156 received Tramadol 100mg rectally and Bupivacaine 0.25% infiltration in the wound. Results: Rectal Tramadol and local Bupivacaine infiltration is effective in decreasing intensity of postoperative pain and the amount of the opioids consumption. Conclusion: Combination of the rectal Tramadol suppository and Bupovacaine infiltration of surgery wound cause longer duration of analgesia and decrease consumption of opiods. so can be a good choice for pain relief after cesarean delivery. Key Words: Tramadol, bupivacaine, wound infiltration, cesarean delivery, postoperative analgesia.

Blocs de la paroi abdominale : apport de l’échographie

Although relatively few studies have compared US guidance with established “blind” techniques, the available evidence suggests that the use of US guidance is a safe and effective way to facilitate correct needle placement and adequate spread of LA for abdominal wall nerve blocks. It improves block effectiveness and safety by reducing LA doses and by detecting anatomic variants or unsuspected pathologies. Different techniques are described and discussed: the transverse abdominal nerve blocks, the paraombilical block, the inguinal field block and the fascia transversalis block. Matched with improving technology, the use of US has significant benefits over conventional techniques to perform classic and new abdominal wall nerve blocks in children. However, more studies are required to evaluate the potential of US to support this finding.

Caesarean section wound infiltration with local anaesthesia for postoperative pain relief: any benefit?th lo

Delivery by caesarean section (CS) is becoming more frequent. Childbirth is an emotion-filled event, and the mother needs to bond with her baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation. Local anaesthetics have been employed as an adjunct to other methods of postoperative pain relief, but reports on the effectiveness of this strategy are conflicting. This review attempted to assess the effects of local anaesthetic agent wound infiltration and/or abdominal nerve blocks on pain after CS and the mother's well-being and interaction with her baby. Methods. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (April 2009).The selection criteria were randomised controlled trials of local analgesia during CS to reduce pain afterwards. Twenty studies (1 150 women) were included. Results. Women who had wound infiltration after CS performed under regional analgesia had a decrease in morphine consumption at 24 hours compared with placebo (morphine dose -1.70 mg; 95% confidence interval (CI) -2.75 to -0.94). Women who had wound infiltration and peritoneal spraying with local anaesthetic after CS under general anaesthesia (1 study, 100 participants) had a reduced need for opioid rescue (risk ratio (RR) 0.51; 95% CI 0.38 to 0.69). The numerical pain score (0 -10) within the first hour was also reduced (mean difference (MD) -1.46; 95% CI -2.60 to -0.32). Women with regional analgesia who had local anaesthetic and non-steroidal anti-inflammatory cocktail wound infiltration consumed less morphine (1 study, 60 participants; MD -7.40 mg; 95% CI -9.58 to -5.22) compared with those who had local anaesthetic control. Women who had regional analgesia with abdominal nerve blocks had decreased opioid consumption (4 studies, 175 participants; MD -25.80 mg; 95% CI -50.39 to -5.37). For outcome in terms of the visual analogue pain score (0 - 10) over 24 hours, no advantage was demonstrated in the single study of 50 participants who had wound infiltration with a mixture of local analgesia and narcotics versus local analgesia. Conclusions. Local anaesthetic infiltration and abdominal nerve blocks as adjuncts to regional analgesia and general anaesthesia are of benefit in CS by reducing opioid consumption. Non-steroidal anti-inflammatory drugs may provide additional pain relief.

Abdominal Nerve Block

Abdominal Nerve Block

Abdominal Nerve Block

Abdominal Nerve Block