The effect of ultrasound guided rectus sheath block on postoperative pain and opioid consumption. A review and implication for nursing clinical practice

Introduction Abdominal surgeries requiring extended midline incisions are associated with severe postoperative pain (1). Postoperative pain was observed in 59 patients (40%) (95% CI =…

Leggi tutto The effect of ultrasound guided rectus sheath block on postoperative pain and opioid consumption. A review and implication for nursing clinical practice

Ultrasound-guided thoracic pectoral and serratus plane blocks: new approaches to reducing postoperative pain

ABSTRACT

Background: pectoralis nerve and serratus plane blocks (PECS) are newer ultrasound guided regional anesthesia techniques of the thorax. Aim: evaluate and consolidate scientific evidence of ultrasound-guided thoracic PECS or modified PECS block-serratus anterior plane block effect on postoperative pain in comparison with other comparison intervention. Methods: we searched 8 electronic databases: Medline, Cochrane, Scopus, Embase, Web of Science, CINAHL, ESCI and ILISI. Three of the authors independently selected trials, assessed the risk of bias, and extracted data. Results: final analysis included thirteen trials. When the PECS block is effective, an optimal duration of analgesia has been reported in the first 24 hours after surgery. PECS block (or its modifications) has a significant pain effect in the postoperative period. However, paravertebral block (PVB) has slightly better efficacy at 18 h and 24 h (p = 0.008 and <0.001 respectively) compared with PECS block. Conclusions: the PECS block produced excellent analgesia, often if combined with general anesthesia for breast surgery. PECS block could be recommended as an alternative to intravenous normal anesthesia in certain breast surgeries for pain postoperative management.

Key words: thoracic surgery, pectoral blocks, serratus plane block, postoperative pain, regional anesthesia, opioid.

Received: September 10, 2018

Accepted: October 10, 2018

DOI: 10.19190/PNM2018.1_ra10

Leggi tutto Ultrasound-guided thoracic pectoral and serratus plane blocks: new approaches to reducing postoperative pain

Simulated mindfulness meditation: a major breakthrough in the management of chronic pain

ABSTRACT
One of the most important challenges facing nursing today is providing proper pain management for patients suffering from chronic pain (1). According to recent surveys 100 million US adults suffer from chronic pain (2) and one in five people in Europe and developing countries are affected (3). As a result of the strong psychological component of pain perception, supplemental use of non-pharmacological analgesic techniques, such as mindfulness meditation, have proved highly effective (6). This literature review describes mindfulness meditation as an effective and affordable method to alter the pain experience and improve the quality of nursing care.
KEYWORDS: chronic pain, mindful meditation, nursing education, virtual reality

Received on January 11, 2016
Accepted on January 19, 2016
Pain Nursing Magazine 2016; 5: 38-43
DOI: 10.19190/PNM2016.1ra38

RIASSUNTO
Una delle più importanti sfide che oggi coinvolgono l’infermieristica è fornire un appropriato trattamento del dolore cronico (1). Secondo recenti indagini 100 milioni di adulti americani soffrono di dolore cronico (2) e ne è affetta una persona su cinque in Europa e nei Paesi in via di sviluppo (3). La percezione del dolore è legata a una forte componente psicologica; l’utilizzo di tecniche analgesiche non-farmacologiche, come la meditazione, ha dimostrato una elevata efficacia (6). Questa revisione della letteratura descrive la meditazione di consapevolezza quale efficace ed economico metodo per modificare l’esperienza dolore e migliorare la qualità della vita.
PAROLE CHIAVE: dolore cronico, meditazione di consapevolezza, formazione infermieristica, realtà virtuale

Leggi tutto Simulated mindfulness meditation: a major breakthrough in the management of chronic pain