Local anaesthetic adjuncts for peripheral regional anaesthesia: a narrative review

Anaesthesia ◽  
2021 ◽  
Vol 76 (S1) ◽  
pp. 100-109
Author(s):  
N. Desai ◽  
K. R. Kirkham ◽  
E. Albrecht
Keyword(s):  
Local Anaesthetic ◽  
Regional Anaesthesia ◽  
Narrative Review

scholarly journals 907 Reduction of Nasal Fractures During COVID-19: A Single-Centre Experience

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Crotty ◽  
M Corbett ◽  
T Hussain ◽  
A Diaconescu ◽  
N Patil
Keyword(s):  
Patient Satisfaction ◽  
Prospective Study ◽  
Local Anaesthetic ◽  
Regional Anaesthesia ◽  
Effective Alternative ◽  
General Anaesthetic ◽  
Single Centre ◽  
Pain Scores ◽  
Single Centre Experience ◽  
Nasal Fractures

Abstract Introduction The utilization of local or regional anaesthesia for manipulation of nasal fractures (MNF) avoids the need for general anaesthetic (GA), and the risk associated with instrumentation of the airway during the COVID-19 pandemic. Furthermore, MNF under local anaesthetic (LA) provides similar results with regards to cosmesis and patient satisfaction. We present our experience of performing MNF under LA during the COVID-19 pandemic. Method A single-centre, prospective study of all patients undergoing MNF under LA was conducted (13th July/20–11thSeptember/20). Following reduction, pain scores and patient satisfaction surveys were administered. Results A total of 25 patients (M/F:16/9, median age, 25.6yr (14-52yr)) were enrolled. The majority of patients received either one or two instillations of LA (n = 19, 76%). Pain reported during the MNF procedure was 4.4/10, whilst pain during LA administration was reported as 3.2/10. 80% of patients felt instillation of LA was less painful than expected. 88% of respondents tolerated the LA well, and only 8% would have opted for general anaesthetic. 24 (96%) participants were happy with the cosmetic result. Discussion MNF under LA is a safe and effective alternative to MNF under GA. More literature is needed to define the best method of administering LA prior to performing MNF.

Updates in our understanding of local anaesthetic systemic toxicity: a narrative review

Anaesthesia ◽  
2021 ◽  
Vol 76 (S1) ◽  
pp. 27-39
Author(s):  
A. J. R. Macfarlane ◽  
M. Gitman ◽  
K. J. Bornstein ◽  
K. El‐Boghdadly ◽  
G. Weinberg
Keyword(s):  
Local Anaesthetic ◽  
Systemic Toxicity ◽  
Narrative Review

Regional anaesthesia

2014 ◽  
Author(s):  
Jeremy Prout ◽  
Tanya Jones ◽  
Daniel Martin
Keyword(s):  
Local Anaesthetic ◽  
Lower Limb ◽  
Regional Anaesthesia ◽  
Anatomical Landmarks ◽  
Ultrasound Guided ◽  
Anaesthetic Agents

The regional anaesthesia chapter discusses the pharmacology of local anaesthetic agents, techniques of nerve localisation, practical aspects of ultrasound-guided blocks and the advantages and complications of regional anaesthesia. Common, and clinically useful, blocks for the upper and lower limb are described in detail with pictures of anatomical landmarks and ultrasound appearance to compliment the description. Indications, technique, volumes required and complications are described for each block.

scholarly journals ECMO for Cardiac Rescue after Accidental Intravenous Mepivacaine Application

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Michael Froehle ◽  
Nikolaus A. Haas ◽  
Guenther Kirchner ◽  
Deniz Kececioglu ◽  
Eugen Sandica
Keyword(s):  
Cardiac Arrest ◽  
Local Anaesthetic ◽  
Regional Anaesthesia ◽  
Pediatric Patients ◽  
Rare Complication ◽  
Treatment Options ◽  
Management Strategies ◽  
Lipid Emulsions ◽  
Neurological Damage ◽  
Broad Complex

Mepivacaine is a potent local anaesthetic and used for infiltration and regional anaesthesia in adults and pediatric patients. Intoxications with mepivacaine affect mainly the CNS and the cardiovascular system. We present a case of accidental intravenous mepivacaine application and intoxication of an infant resulting in seizure, broad complex bradyarrhythmia, arterial hypotension and finally cardiac arrest. The patient could be rescued by prolonged resuscitations and a rapid initiation of ECMO and survived without neurological damage. The management strategies of this rare complication including promising other treatment options with lipid emulsions are discussed.

scholarly journals The Role of Interfascial Plane Blocks in Paediatric Regional Anaesthesia: A Narrative Review of Current Perspectives and Updates

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Sujana Dontukurthy ◽  
Roshanak Mofidi
Keyword(s):  
Pain Control ◽  
Regional Anaesthesia ◽  
Early Mobilization ◽  
Perioperative Period ◽  
Multimodal Analgesia ◽  
Narrative Review ◽  
Complication Rates ◽  
Early Recovery ◽  
Nerve Blocks ◽  
Anaesthesia Practice

Regional anaesthesia has been increasingly used for analgesia in the perioperative period in paediatric anaesthesia for better pain control and improved patient outcomes. Interfascial plane blocks are considered as a subgroup of peripheral nerve blocks. The advent of ultrasound in modern regional anaesthesia practice has led to the evolution of various interfascial plane blocks. The ease of their performance and the low complication rates, compared with neuraxial anaesthesia, have led to their increased use in the perioperative period. Interfascial plane blocks are often incorporated in the multimodal analgesia regimen in the early recovery and ambulation after surgery protocols for various chest wall and abdominal surgeries. This achieves better pain control and decreases the requirements of opioids in the perioperative period, thereby facilitating early mobilization and discharge. This narrative review focuses on the relevant anatomic considerations, technique for the performance of each block along with its current applications and limitations, and includes a review of the current literature on various interfascial plane blocks in paediatric regional anaesthesia.

scholarly journals Ultrasound-guided Transversus Abdominis Plane Block for Neonatal Abdominal Surgery

2009 ◽  
Vol 37 (3) ◽  
pp. 469-472 ◽  
Author(s):  
M.J. Fredrickson ◽  
P. Seal
Keyword(s):  
Abdominal Surgery ◽  
Local Anaesthetic ◽  
Regional Anaesthesia ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Wound Infiltration ◽  
Postoperative Ventilation ◽  
Upper Abdominal

This paper describes four neonates having abdominal procedures with intraoperative and early postoperative analgesia provided by a transversus abdominis plane regional block. Analgesia for neonatal upper and midabdominal surgery usually involves regional anaesthesia and/or systemic opioid. All these analgesia techniques have problems specific to the neonatal period. Neonates are sensitive to the respiratory depressant effects of systemic opioid, while the low threshold for local anaesthetic toxicity limits regional anaesthesia/analgesia, which in neonatal upper abdominal surgery is often limited to local anaesthetic infiltration. The transversus abdominis plane block has been shown to provide effective analgesia following a variety of abdominal surgeries in both adults and children. We report four neonates who underwent minor or major abdominal surgery under general anaesthesia supplemented by ultrasound-guided transversus abdominis plane block. Perioperative opioids were administered to one neonate who required postoperative ventilation. Ultrasound-guided transversus abdominis plane bock is a technically feasible alternative to local anaesthetic wound infiltration in the neonate and warrants further evaluation.

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