Diaphragm-sparing brachial plexus blocks: a focused review of current evidence and their role during the COVID-19 pandemic / Laura Girón Arango  

Público ISBD Título : Diaphragm-sparing brachial plexus blocks: a focused review of current evidence and their role during the COVID-19 pandemic Tipo de documento : documento electrónico Autores : Laura Girón Arango, Fecha de publicación : 2020 Títulos uniformes : Current Opinion in Anaesthesiology Idioma : Inglés (eng) Palabras clave : brachial plexus  COVID-19  diaphragm-sparing  nerve block  phrenic nerve  regional anesthesia Resumen : Purpose of review: Given that COVID-19 can severely impair lung function, regional anesthesia techniques avoiding phrenic nerve paralysis are relevant in the anesthetic management of suspected/confirmed COVID-19 patients requiring shoulder and clavicle surgical procedures. The objective of this review is to provide an overview of recently published studies examining ultrasound-guided diaphragm-sparing regional anesthesia techniques for the brachial plexus (BP) to favor their preferent use in patients at risk of respiratory function compromise. Recent findings: In the last 18 months, study findings on various diaphragm-sparing regional anesthesia techniques have demonstrated comparable block analgesic effectivity with a variable extent of phrenic nerve paralysis. The impact of hemi-diaphragmatic function impairment on clinical outcomes is yet to be established. Summary: Existing diaphragm-sparing brachial plexus regional anesthesia techniques used for shoulder and clavicle surgery may help minimize pulmonary complications by preserving lung function, especially in patients prone to respiratory compromise. Used as an anesthetic technique, they can reduce the risk of exposure of healthcare teams to aerosol-generating medical procedures (AGMPs), albeit posing an increased risk for hemi-diaphragmatic paralysis. Reducing the incidence of phrenic nerve involvement and obtaining opioid-sparing analgesia without jeopardizing efficacy should be prioritized goals of regional anesthesia practice during the COVID-19 pandemic. Mención de responsabilidad : Cubillos, Javier; Girón-Arango, Laura; Muñoz-Leyva, Felipe Referencia : Curr Opin Anaesthesiol. 2020 Oct;33(5):685-691. DOI (Digital Object Identifier) : 10.1097/ACO.0000000000000911 PMID : 32826625 En línea : https://journals.lww.com/co-anesthesiology/Abstract/2020/10000/Diaphragm_sparing [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5129 Diaphragm-sparing brachial plexus blocks: a focused review of current evidence and their role during the COVID-19 pandemic [documento electrónico] / Laura Girón Arango,  . - 2020. Obra : Current Opinion in Anaesthesiology Idioma : Inglés (eng) Palabras clave : brachial plexus  COVID-19  diaphragm-sparing  nerve block  phrenic nerve  regional anesthesia Resumen : Purpose of review: Given that COVID-19 can severely impair lung function, regional anesthesia techniques avoiding phrenic nerve paralysis are relevant in the anesthetic management of suspected/confirmed COVID-19 patients requiring shoulder and clavicle surgical procedures. The objective of this review is to provide an overview of recently published studies examining ultrasound-guided diaphragm-sparing regional anesthesia techniques for the brachial plexus (BP) to favor their preferent use in patients at risk of respiratory function compromise. Recent findings: In the last 18 months, study findings on various diaphragm-sparing regional anesthesia techniques have demonstrated comparable block analgesic effectivity with a variable extent of phrenic nerve paralysis. The impact of hemi-diaphragmatic function impairment on clinical outcomes is yet to be established. Summary: Existing diaphragm-sparing brachial plexus regional anesthesia techniques used for shoulder and clavicle surgery may help minimize pulmonary complications by preserving lung function, especially in patients prone to respiratory compromise. Used as an anesthetic technique, they can reduce the risk of exposure of healthcare teams to aerosol-generating medical procedures (AGMPs), albeit posing an increased risk for hemi-diaphragmatic paralysis. Reducing the incidence of phrenic nerve involvement and obtaining opioid-sparing analgesia without jeopardizing efficacy should be prioritized goals of regional anesthesia practice during the COVID-19 pandemic. Mención de responsabilidad : Cubillos, Javier; Girón-Arango, Laura; Muñoz-Leyva, Felipe Referencia : Curr Opin Anaesthesiol. 2020 Oct;33(5):685-691. DOI (Digital Object Identifier) : 10.1097/ACO.0000000000000911 PMID : 32826625 En línea : https://journals.lww.com/co-anesthesiology/Abstract/2020/10000/Diaphragm_sparing [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5129

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Can recent chronic pain techniques help with acute perioperative pain? / Laura Girón Arango  

Público ISBD Título : Can recent chronic pain techniques help with acute perioperative pain? Tipo de documento : documento electrónico Autores : Laura Girón Arango, Fecha de publicación : 2019 Títulos uniformes : Current Opinion in Anaesthesiology Idioma : Inglés (eng) Resumen : Purpose of review: This article discussed how the knowledge and technique of a few chronic pain procedures benefited the perioperative clinicians in their care of patients receiving specific orthopaedic surgical procedures. Recent findings: Recent emerging interest in hip and knee denervation for chronic pain management secondary to osteoarthritis stimulates publications on the new understanding of hip and knee joint innervation. The improved understanding of the anatomy allows better precision in targeting the articular branches. The procedures for chronic joint pain such as radiofrequency ablation, chemical neurolysis and neuromodulation procedure have recently been applied to the perioperative care in orthopaedic procedures because of the potential long-lasting analgesia, opioid-sparing effect and consequent improvement in physical function and health-related quality of life after surgery. Summary: Despite the widespread use of regional anaesthesia and multimodal analgesia in the perioperative pain management, more than two-third of the patients reported severe postoperative pain. Therefore, other therapeutic strategies used in chronic pain management such as radiofrequency ablation and neuromodulation have been proposed to optimize acute postsurgical pain. The early experience with those techniques is encouraging, and more studies are required to explore the incorporation of these procedures in the perioperative care. Mención de responsabilidad : Maria Fernanda Arboleda, Laura Girón-Arango, Philip W H Peng Referencia : Curr Opin Anaesthesiol. 2019 Oct;32(5):661-667. DOI (Digital Object Identifier) : 10.1097/ACO.0000000000000772 PMID : 31343464 En línea : https://journals.lww.com/co-anesthesiology/Abstract/2019/10000/Can_recent_chroni [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4240 Can recent chronic pain techniques help with acute perioperative pain? [documento electrónico] / Laura Girón Arango,  . - 2019. Obra : Current Opinion in Anaesthesiology Idioma : Inglés (eng) Resumen : Purpose of review: This article discussed how the knowledge and technique of a few chronic pain procedures benefited the perioperative clinicians in their care of patients receiving specific orthopaedic surgical procedures. Recent findings: Recent emerging interest in hip and knee denervation for chronic pain management secondary to osteoarthritis stimulates publications on the new understanding of hip and knee joint innervation. The improved understanding of the anatomy allows better precision in targeting the articular branches. The procedures for chronic joint pain such as radiofrequency ablation, chemical neurolysis and neuromodulation procedure have recently been applied to the perioperative care in orthopaedic procedures because of the potential long-lasting analgesia, opioid-sparing effect and consequent improvement in physical function and health-related quality of life after surgery. Summary: Despite the widespread use of regional anaesthesia and multimodal analgesia in the perioperative pain management, more than two-third of the patients reported severe postoperative pain. Therefore, other therapeutic strategies used in chronic pain management such as radiofrequency ablation and neuromodulation have been proposed to optimize acute postsurgical pain. The early experience with those techniques is encouraging, and more studies are required to explore the incorporation of these procedures in the perioperative care. Mención de responsabilidad : Maria Fernanda Arboleda, Laura Girón-Arango, Philip W H Peng Referencia : Curr Opin Anaesthesiol. 2019 Oct;32(5):661-667. DOI (Digital Object Identifier) : 10.1097/ACO.0000000000000772 PMID : 31343464 En línea : https://journals.lww.com/co-anesthesiology/Abstract/2019/10000/Can_recent_chroni [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4240

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