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Göteborgs universitets publikationer

Upper extremity nerve block: how can benefit, duration, and safety be improved? An update

Författare och institution:
Metha Brattwall (-); Pether Jildenstål (Institutionen för vårdvetenskap och hälsa); Margareta Warrén Stomberg (Institutionen för vårdvetenskap och hälsa); Jan G Jakobsson (-)
Publicerad i:
F1000Research, 5 ( 907 ) s. 1-9
ISSN:
2046-1402
Publikationstyp:
Artikel, refereegranskad vetenskaplig
Publiceringsår:
2016
Språk:
engelska
Fulltextlänk:
Sammanfattning (abstract):
Upper extremity blocks are useful as both sole anaesthesia and/or a supplement to general anaesthesia and they further provide effective postoperative analgesia, reducing the need for opioid analgesics. There is without doubt a renewed interest among anaesthesiologists in the interscalene, supraclavicular, infraclavicular, and axillary plexus blocks with the increasing use of ultrasound guidance. The ultrasound-guided technique visualising the needle tip and solution injected reduces the risk of side effects, accidental intravascular injection, and possibly also trauma to surrounding tissues. The ultrasound technique has also reduced the volume needed in order to gain effective block. Still, single-shot plexus block, although it produces effective anaesthesia, has a limited duration of postoperative analgesia and a number of adjuncts have been tested in order to prolong analgesia duration. The addition of steroids, midazolam, clonidine, dexmedetomidine, and buprenorphine has been studied, all being off-label when administered by perineural injection, and the potential neurotoxicity needs further study. The use of perineural catheters is an effective option to improve and prolong the postoperative analgesic effect. Upper extremity plexus blocks have an obvious place as a sole anaesthetic technique or as a powerful complement to general anaesthesia, reducing the need for analgesics and hypnotics intraoperatively, and provide effective early postoperative pain relief. Continuous perineural infusion is an effective option to prolong the effects and improve postoperative quality.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
MEDICIN OCH HÄLSOVETENSKAP ->
Klinisk medicin ->
Anestesi och intensivvård
MEDICIN OCH HÄLSOVETENSKAP ->
Klinisk medicin ->
Anestesi och intensivvård ->
Anestesiologi
Nyckelord:
Regional blocks
Postens nummer:
236694
Posten skapad:
2016-05-18 20:43
Posten ändrad:
2016-05-30 15:30

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