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Medicina
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General and Regional Anesthesia for Perioperative Analgesia
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General and Regional Anesthesia for Perioperative Analgesia

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Intensive Care/ Anesthesiology".

Deadline for manuscript submissions: closed (31 October 2024) | Viewed by 9870

Special Issue Editor

Dr. Henry Liu

E-Mail Website
Guest Editor
Department of Anesthesiology & Critical Care, Perelman School of Medicine, The University of Pennsylvania, 3400 Spruce Street, Suite 680 Dulles, Philadelphia, PA 19104, USA
Interests: perioperative management; blood management; hemodynamic monitoring
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The Medicina’s special issue “General and Regional Anesthesia for Perioperative Analgesia” will focus on the following topics to cover all aspects of perioperative analgesia:

  • Multimodal perioperative analgesia
  • What is new in neuraxial analgesia for postoperative pain management
  • Ultrasound-guided Paravertebral block
  • Ultrasound-guided Parasternal block
  • Ultrasound-guided TAP block
  • Ultrasound-guided Erector spinae plane block for postoperative analgesia (Adhikary)
  • Non-neuraxial regional technique for post-cesarean section analgesia (Sangkum)
  • PEC block
  • Ultrasound-guided Lumbar plexus nerve blocks
  • Fascia Iliaca Compartment Block (Verbeek)
  • New opioid analgesics
  • New non-opioid analgesics

This special issue will provide a comprehensive coverage of all areas related to perioperative analgesia, especially those newer ultrasound-guided nerve blocks.

Dr. Henry Liu
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • opioid-sparing
  • ERAS
  • hemodynamic monitoring
  • fluid therapy
  • multimodal analgesia
  • novel anesthetic techniques
  • novel anesthetic agents
  • multimodal analgesia
  • controversies in fluid therapy
  • new techniques/equipment in airway management
  • DINE procedure and its anesthetic management
  • perioperative anticoagulation
  • postoperative neurocognitive decline

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

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8 pages, 4528 KiB  
Article
Comparison of Dye Spread Pattern and Nerve Involvement between Suprainguinal and Infrainguinal Fascia Iliaca Blocks with Different Injectate Volumes: A Cadaveric Evaluation
by Tae-Hyeon Cho, Byongnam Jun, Hun-Mu Yang and Shin Hyung Kim
Medicina 2024, 60(9), 1391; https://doi.org/10.3390/medicina60091391 - 25 Aug 2024
Viewed by 1198
Abstract
Background and Objectives: Fascia iliaca compartment block (FICB) is an effective and relatively safe technique in perioperative pain management for hip surgery. However, blockade of the obturator nerve (ON) using this technique remains controversial. This study aimed to compare dye spread patterns [...] Read more.
Background and Objectives: Fascia iliaca compartment block (FICB) is an effective and relatively safe technique in perioperative pain management for hip surgery. However, blockade of the obturator nerve (ON) using this technique remains controversial. This study aimed to compare dye spread patterns and nerve involvement in the suprainguinal FICB (S-FICB) and infrainguinal FICB (I-FICB) approaches using different volumes of dye. Materials and Methods: Following randomization, 6 S-FICBs and 6 I-FICBs were performed on the left or right sides of 6 unembalmed cadavers. For each block, 30 mL or 60 mL of dye solution was injected. The extent of dye spreading and the staining pattern in the lumbar plexus branches were investigated using anatomical dissection. Results: Twelve injections were successfully completed. The lateral femoral cutaneous nerve (LFCN) and femoral nerve (FN) were consistently stained in all injections. Extended dye spread toward lumbar plexus branches was observed volume-dependently in S-FICBs. However, I-FICBs with an increased volume only showed dye spreading in the caudad direction limited to within the fascia iliaca. When 30 mL of dye was used, the ON was not stained with either approach. A stained ON was only observed in S-FICBs when 60 mL of dye was used. Conclusions: In this cadaveric evaluation, the ON was not stained in either FICB approach with the volume of injectate commonly used in clinical practice. The S-FICBs but not I-FICBs using a high volume of injectate resulted in extended spreading to the lumbar plexus branches. Full article
(This article belongs to the Special Issue General and Regional Anesthesia for Perioperative Analgesia)
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10 pages, 477 KiB  
Article
Programmed Intermittent Epidural Bolus Reduces Workloads in Labor Analgesia: A Single Center’s Experience
by Chia-Hung Ou and Wei-Ting Chen
Medicina 2024, 60(6), 993; https://doi.org/10.3390/medicina60060993 - 17 Jun 2024
Viewed by 2136
Abstract
Background and Objectives: Labor epidural analgesia can be maintained through programmed intermittent epidural bolus (PIEB), continuous epidural infusion (CEI), or patient-controlled epidural analgesia (PCEA). Our department changed from CEI+PCEA to PIEB+PCEA as the maintenance method. The higher hourly dose setting in the current [...] Read more.
Background and Objectives: Labor epidural analgesia can be maintained through programmed intermittent epidural bolus (PIEB), continuous epidural infusion (CEI), or patient-controlled epidural analgesia (PCEA). Our department changed from CEI+PCEA to PIEB+PCEA as the maintenance method. The higher hourly dose setting in the current regimen brought to our concern that side effects would increase with proportional staff workloads. This study aimed to investigate the validity of our proposal that PIEB+PCEA may function as a feasible tool in reducing the amount of work in the obstetrics anesthesia units. Materials and methods: This 2-year retrospective review included parturients with vaginal deliveries under epidural analgesia. We compared the staff burden before and after the switch from CEI (6 mL/h, PCEA 6 mL lockout 15 min, group A) to PIEB (8 mL/h, PCEA 8 mL lockout 10 min, group B). The primary outcome was the difference of proportion of parturients requiring unscheduled visits between groups. Side effects and labor and neonatal outcomes were compared. Results: Of the 694 parturients analyzed, the proportion of those requiring unscheduled visits were significantly reduced in group B (20.8% vs. 27.7%, chi-square test, p = 0.033). The multivariate logistic regression showed that PIEB was associated with fewer unscheduled visits than CEI (OR = 0.53, 95% CI [0.36–0.80], p < 0.01). Group B exhibited a significantly lower incidence of asymmetric blockade, as well as motor blockade. In nulliparous subjects, obstetric anal sphincter injury occurred less frequently when PIEB+PCEA was used. Significantly more multiparous women experienced vacuum extraction delivery in group B than in group A, and they had a longer second stage of labor. Conclusions: The PIEB+PCEA protocol in our study reduced workloads in labor epidural analgesia as compared to CEI+PCEA, despite that a higher dose of analgesics was administered. Future studies are warranted to investigate the effect of manipulating the PIEB settings on the labor outcomes. Full article
(This article belongs to the Special Issue General and Regional Anesthesia for Perioperative Analgesia)
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Review

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12 pages, 1321 KiB  
Review
Peripheral Nerve Blocks for Cesarean Delivery Analgesia: A Narrative Review
by Lisa Sangkum, Amornrat Tangjitbampenbun, Theerawat Chalacheewa, Kristin Brennan and Henry Liu
Medicina 2023, 59(11), 1951; https://doi.org/10.3390/medicina59111951 - 4 Nov 2023
Cited by 1 | Viewed by 5852
Abstract
Effective postoperative analgesia using multimodal approach improves maternal and neonatal outcomes after cesarean delivery. The use of neuraxial approach (local anesthetic and opioids) and intravenous adjunctive drugs, such as nonsteroidal anti-inflammatory drugs and acetaminophen, currently represents the standard regimen for post-cesarean delivery analgesia. [...] Read more.
Effective postoperative analgesia using multimodal approach improves maternal and neonatal outcomes after cesarean delivery. The use of neuraxial approach (local anesthetic and opioids) and intravenous adjunctive drugs, such as nonsteroidal anti-inflammatory drugs and acetaminophen, currently represents the standard regimen for post-cesarean delivery analgesia. Peripheral nerve blocks may be considered in patients who are unable to receive neuraxial techniques; these blocks may also be used as a rescue technique in selected patients. This review discusses the relevant anatomy, current evidence, and advantages and disadvantages of the various peripheral nerve block techniques. Further research is warranted to compare the analgesic efficacy of these techniques, especially newer blocks (e.g., quadratus lumborum blocks and erector spinae plane blocks). Moreover, future studies should determine the safety profile of these blocks (e.g., fascial plane blocks) in the obstetric population because of its increased susceptibility to local anesthetic toxicity. Full article
(This article belongs to the Special Issue General and Regional Anesthesia for Perioperative Analgesia)
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