scholarly journals Peripheral Nerve Blockade with Combined Standard and Liposomal Bupivacaine in Major Lower‐Extremity Amputation

Pain Practice ◽  
2020 ◽  
Author(s):  
Catalina I. Dumitrascu ◽  
Nafisseh S. Warner ◽  
Thomas M. Stewart ◽  
Adam W. Amundson ◽  
Danette L. Bruns ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Peripheral Nerve ◽  
Lower Extremity Amputation ◽  
Nerve Blockade ◽  
Liposomal Bupivacaine ◽  
Peripheral Nerve Blockade ◽  
Extremity Amputation

Lower-Extremity Sclerotomes

2009 ◽  
Vol 99 (3) ◽  
pp. 232-235 ◽  
Author(s):  
Andrew J. Meyr ◽  
Raymond DiPrimio
Keyword(s):  
Lower Extremity ◽  
Peripheral Nerve ◽  
Spinal Nerve ◽  
Sensory Innervation ◽  
Diagnosis And Treatment ◽  
Deep Fascia ◽  
Nerve Blockade ◽  
Anatomical Knowledge ◽  
Peripheral Nerve Blockade

A sclerotome is an anatomical concept that defines an area of bone supplied by a single spinal nerve. Similar to the familiar dermatomes, sclerotomes provide an element of depth to the sensory innervation of the lower extremity based on the deep fascia as an embryologic boundary. Anatomical knowledge of sclerotomes can be used clinically in the diagnosis and treatment of pain and in the perioperative setting. Specifically, a modified version of the classic Mayo block is presented to highlight an active anatomical approach to peripheral nerve blockade. (J Am Podiatr Med Assoc 99(3): 232–235, 2009)

Lower-Extremity Peripheral Nerve Blockade

2005 ◽  
Vol 30 (1) ◽  
pp. 4-35 ◽  
Author(s):  
Kayser F. Enneking ◽  
Vincent Chan ◽  
Jenny Greger ◽  
Admir Hadžić ◽  
Scott A. Lang ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Peripheral Nerve ◽  
Nerve Blockade ◽  
Peripheral Nerve Blockade

Comparing outcomes after peripheral nerve block versus general anesthesia for lower extremity amputation: a nationwide exploratory retrospective cohort study in Japan

2020 ◽  
Vol 45 (6) ◽  
pp. 399-404 ◽  
Author(s):  
Hiroaki Abe ◽  
Masahiko Sumitani ◽  
Hiroki Matsui ◽  
Shotaro Aso ◽  
Reo Inoue ◽  
...  
Keyword(s):  
Propensity Score ◽  
Lower Extremity ◽  
Peripheral Nerve ◽  
General Anesthesia ◽  
Nerve Block ◽  
Postoperative Delirium ◽  
Peripheral Nerve Block ◽  
Lower Extremity Amputation ◽  
Significant Difference ◽  
Extremity Amputation

Background and objectivesThe health benefits of peripheral nerve block (PNB) on postoperative complications after lower extremity amputation (LEA) compared with general anesthesia (GA) remains controversial. We performed a retrospective propensity score-matched cohort analysis to compare major outcomes after LEA with PNB versus GA.Materials and methodsWe used a nationwide inpatient database in Japan to compare patient outcomes after LEA with PNB versus GA from 2010 to 2016. Our primary outcome was 30-day mortality after LEA. The incidence of composite morbidity from life-threatening complications and of delirium within 30 days after LEA were secondary outcomes. We conducted propensity score-matched analyses of patients who underwent below knee or foot amputation using 36 covariates. Logistic regression analyses fitted with generalized estimating equations were performed to calculate ORs and their 95% CIs.ResultsOf 11 796 patients, 747 received PNB and 11 049 received GA. After one-to-four propensity score matching, 747 patients were included in the PNB group and 2988 in the GA group. The adjusted ORs for postoperative mortality, composite morbidity and delirium within 30 days after LEA were 1.11 (95% CI 0.75 to 1.64), 1.15 (95% CI 0.85 t o1.56) and 0.75 (95% CI 0.57 to 0.98), respectively, for the PNB group with reference to the GA group.ConclusionsThere was no significant difference between groups in 30-day mortality or composite morbidity. The PNB group showed a significantly lower risk of postoperative delirium than the GA group. Our findings suggest that PNB may have advantages over GA in preventing postoperative delirium among patients undergoing LEA.

scholarly journals Use of Liposomal Bupivacaine in Pediatric Peripheral Nerve Blocks after Traumatic Amputation

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Gregory M. Halenda ◽  
Stylianos Voulgarelis
Keyword(s):  
Peripheral Nerve ◽  
Regional Anesthesia ◽  
Phantom Limb ◽  
Leg Pain ◽  
Traumatic Amputation ◽  
Opioid Use ◽  
Nerve Blocks ◽  
Nerve Blockade ◽  
Liposomal Bupivacaine ◽  
Peripheral Nerve Blockade

Liposomal bupivacaine has been explored for indications in regional anesthesia, but little has been reported about its use in pediatric patients. In March 2021, the FDA approved an indication for liposomal bupivacaine as an infiltrated local anesthetic in children older than the age of six. Despite this recently expanded indication, the literature lacks reports of use for peripheral nerve blockade in children. We describe a case where liposomal bupivacaine was used for femoral and sciatic nerve blocks in a 5-year-old child with traumatic amputation of his lower leg. Pain control was excellent, with no pain or opioid use reported during the first 62 hours. After the regional anesthesia subsided, the patient required in total 4 oral doses of oxycodone 0.1 mg/kg prior to discharge. The patient did not develop chronic pain or phantom limb syndrome. While liposomal bupivacaine is not currently FDA-approved for peripheral nerve blockade in children, this case highlights a potentially effective use of this drug and possible area for further investigation.

Continuous peripheral nerve blockade in lower extremity surgery

2005 ◽  
Vol 49 (8) ◽  
pp. 1048-1055 ◽  
Author(s):  
A. M. Navas ◽  
T. V. Gutierrez ◽  
M. E. Moreno
Keyword(s):  
Lower Extremity ◽  
Peripheral Nerve ◽  
Nerve Blockade ◽  
Peripheral Nerve Blockade

Lower-extremity peripheral nerve blockade: Essentials of our current understanding

2005 ◽  
Vol 30 (1) ◽  
pp. 4-35 ◽  
Author(s):  
F ENNEKING ◽  
V CHAN ◽  
J GREGER ◽  
A HADZIC ◽  
S LANG ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Peripheral Nerve ◽  
Current Understanding ◽  
Nerve Blockade ◽  
Peripheral Nerve Blockade

scholarly journals Duration of Upper and Lower Extremity Peripheral Nerve Blockade Is Prolonged with Dexamethasone When Added to Ropivacaine: A Retrospective Database Analysis

Pain Medicine ◽  
2013 ◽  
Vol 14 (8) ◽  
pp. 1239-1247 ◽  
Author(s):  
Stephanie B. Rasmussen ◽  
Nahel N. Saied ◽  
Clifford Bowens ◽  
Nathaniel D. Mercaldo ◽  
Jonathan S. Schildcrout ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Peripheral Nerve ◽  
Database Analysis ◽  
Nerve Blockade ◽  
Peripheral Nerve Blockade ◽  
Retrospective Database Analysis ◽  
Retrospective Database
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