Existing users Log In New users Sign up


Regional Anesthesia in Neuroanesthesia Practice

DISCOVERIES (ISSN 2359-7232), 2020, April-June issue

CITATION: 

Kaushal A, Haldar  R. Regional Anesthesia in Neuroanesthesia Practice. Discoveries 2020, 8(2): e111. DOI: 10.15190/d.2020.8


Submitted: May 29, 2020; Revision: June 08, 2020; Accepted: June 08, 2020; Published: June 29, 2020; 

 GO BACK to 2020, April-June issue

 GO BACK to DISCOVERIES

Regional Anesthesia in Neuroanesthesia Practice

Ashutosh Kaushal (1), Rudrashish Haldar (2, *)

(1) Department of Anaesthesiology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India

(2) Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGI), Lucknow, India


*Corresponding author: Dr. Rudrashish Haldar, Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGI), Lucknow, India; email: rudrashish@yahoo.com

Abstract

Regional anesthesia has been an undervalued entity in neuroanesthetic practice. However, in the past few years, owing to the development of more advanced techniques, drugs and the prolific use of ultrasound guidance, the unrecognised potential of these modalities have been highlighted. These techniques confer the advantages of reduced requirements for local anesthetics, improved hemodynamic stability in the intraoperative period, better pain score postoperatively and reduced analgesic requirements in the postoperative period. Reduced analgesic requirement translates into lesser side effects associated with analgesic use. Furthermore, the transition from the traditional blind landmark-based techniques to the ultrasound guidance has increased the reliability and the safety profile. In this review, we highlight the commonly practised blocks in the neuroanesthesiologist’s armamentarium and describe their characteristics, along with their individual particularities.


Access full text of the manuscript here: 

References

1. Osborn I, SebeoJ. Scalp block during craniotomy: a classic technique revisited. J Neurosurg Anesthesiol 2010;22(3): 187-94.
2. Dinsmore J. Anaesthesia for elective neurosurgery, Br J Anaes. 2007;99:68-74.
3. Bajwa SJ, Haldar R. Pain management following spinal surgeries: An appraisal of the available options. J Craniovertebr Junction Spine. 2015;6:105‐110. 
4. Papangelou A, Radzik B R, Smith T, Gottschalk A. A review of scalp blockade for cranial surgery. Journal of Clinical Anesthesia .2013; 25: 150–159.
5. Gazoni FM, Pouratian N, Nemergut EC. Effect of ropivacaine skull block on perioperative outcomes in patients with supratentorial brain tumors and comparison with remifentanil: a pilot study. J Neurosurg 2008; 109:44-9.
6. Pinosky ML, Fishman RL, Reeves ST, et al. The effect of bupivacaine skull block on the hemodynamic response to craniotomy. Anesth Analg 1996; 83:1256-61.
7. Geze S, Yilmaz AA, Tuzuner F. The effect of scalp block and local infiltration on the haemodynamic and stress response to skull-pin placement for craniotomy. Eur J Anaesthesiol 2009;26:298-303.
8. Lee EJ, Lee MY, Shyr MH, et al. Adjuvant bupivacaine scalp block facilitates stabilization of hemodynamics in patients undergoing craniotomy with general anesthesia: a preliminary report. J Clin Anesth 2006; 18:490-4.
9. Bala I, Gupta B, Bhardwaj N, Ghai B, Khosla VK. Effect of scalp block on postoperative pain relief in craniotomy patients. Anaesth Intensive Care 2006; 34:224-7.   
10. Nguyen A, Girard F, Boudreault D, et al. Scalp nerve blocks decrease the severity of pain after craniotomy. Anesth Analg 2001; 93:1272-6.
11. Migliore M, Spagnoli, D, Lorenzetti D. Perioperative pain management following neurosurgery. Journal of Neurosurgery. 2005; 101: 356–370.
12. Jose R, Chakravarthy K, Nair S, Joseph M, Jeyaseelan V, Korula G. A Randomized Controlled Trial Studying the Role of Dexamethasone in Scalp Nerve Blocks for Supratentorial Craniotomy. J Neurosurg Anesthesiol. 2017;29(2):150‐156.
13. Nasr Yasser M., Waly Salwa H., Morsy Ahmed A. Scalp block for awake craniotomy: Lidocaine-bupivacaine versus lidocaine-bupivacaine with adjuvants, Egyptian Journal of Anaesthesia. 2020;36:1, 7-15.
14. Guilfoyle MR, Helmy A, Duane D, Hutchinson PJA. Regional scalp block for post craniotomy analgesia: A systematic review and meta-analysis. Anesth Analg 2013;116:1093-102.
15. Wardhana A, Sudadi S. Scalp block for analgesia after craniotomy: A meta-analysis. Indian J Anaesth 2019;63:886-94
16. Ayoub C, Girard F, Boudreault D, Chouinard P, Ruel M, Moumdjian R. A comparison between scalp nerve block and morphine for transitional analgesia after remifentanil-based anesthesia in neurosurgery. Anesth Analg 2006;103:1237-40
17. Williams PL. Gray's Anatomy. 38th (eight) edition. New York, NY: Churchill Livingstone; 1995
18. Jonnavithula N, Padmaja D, Abhishek K, Dilipkumar K, Gopinath R, Manas M. Bilateral infraorbital nerve block for post operative analgesia following transsphenoidal pituitary surgery, BJA: British Journal of Anaesthesia, 2011; 107: eLetters Supplement. https://doi.org/10.1093/bja/el_7758.
19. Mariano ER, Watson D, Loland VJ et al. Bilateral infraorbital nerve blocks decrease postoperative pain but do not reduce time to discharge following outpatient nasal surgery. Can J Anaesth 2009; 56:584 – 589.
20. Molliex S, Navez M, Baylot D, Prades JM, Elkhoury Z, Auboyer C. Regional anaesthesia for outpatient nasal surgery. Br J Anaesth 1996;76:151-153
21. Takechi K, Konishi A, Kikuchi K, Fujioka S, Fujii T, Yorozuya T, Nagaro T. Real-time ultrasound-guided infraorbital nerve block to treat trigeminal neuralgia using a high concentration of tetracaine dissolved in bupivacaine. Scand J Pain. 2015 Jan 1;6:51-54.
22. De M, Mohan VK, Bhoi D, Talawar P. Utility of real-time ultrasound-guided infraorbital nerve block in trigeminal neuralgia. Indian J Pain. 2019;33:45.
23. McAdam D, Muro K, Suresh S. The Use of Infraorbital Nerve Block for Postoperative Pain Control after Transsphenoidal. HypophysectomyRegional Anesthesia & Pain Medicine 2005;30:572-573.
24. Ali AR, Sakr SA, Rahman, SAMA. Bilateral sphenopalatine ganglion block as adjuvant to general anaesthesia during endoscopic trans-nasal resection of pituitary adenoma. Eg J A. 2010; 26:273-280.
25. Chadha R, Padmanabhan V , Rout A, Waikar HD, Mohandas K. Prevention of hypertension during trans-sphenoidal surgery – the effect of bilateral maxillary nerve block with local anaesthetics. Acta Anaesthesiol Scand. 1997;41:35-40.
26. Haridas A, Mathewson C, Eljamel S. Long term results of 405 refractory trigeminal neuralgia surgeries in 256 patients. Zentralbl Neurochir 2008; 69:170-174. 9.
27. Nader A, Kendall MC, De Oliveria GS, et al. Ultrasound-guided trigeminal nerve block via the pterygopalatine fossa: an effective treatment for trigeminal neuralgia and atypical facial pain. Pain Physician. 2013;16(5):E537‐E545.
28. Nader A, Schittek H, Kendall MC. Lateral pterygoid muscle and maxillary artery are key anatomical landmarks for ultrasound-guided trigeminal nerve block. Anesthesiology 2013; 118:957.
29. Stoneham MD, Doyle AR, Knighton JD, Dorje P, Stanley JC. Prospective, randomized comparison of deep or superficial cervical plexus block for carotid endarterectomy surgery. Anesthesiology 1998; 89: 907–12.
30. Pandit JJ, Bree S, Dillon P, Elcock D, McLaren ID, Crider B. A comparison of superficial versus combined (superficial and deep) cervical plexus block for carotid endarterectomy: a prospective, randomized study. Anesth Analg 2000; 91: 781–6.
31. Seidel R, Zukowski K, Wree A, Schulze M. Ultrasound-guided intermediate cervical plexus block and perivascular local anesthetic infiltration for carotid endarterectomy: a randomized controlled trial. Anaesthesist 2016; 65: 917–24.
32. de Sousa AA, Filho MA, Faglione W Jr, Carvalho GT. Superficial vs combined cervical plexus block for carotid endarterectomy: a prospective, randomized study. Surg Neurol 2005; 63 Suppl 1: S22–5.
33. Kim JS, Ko JS, Bang S, Kim H, Lee SY. Cervical plexus block, Korean Journal of Anesthesiology 2018;71(4):274-288.
34. Wang H, Ma L, Yang D, Wang T, Wang Q, Zhang L, Ding W. Cervical plexus anesthesia versus general anesthesia for anterior cervical discectomy and fusion surgery: A randomized clinical trial. Medicine 2017;96: e 6119.
35. GALA Trial Collaborative Group, Lewis SC, Warlow CP, Bodenham AR, Colam B, Rothwell PM, et al. General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial. The Lancet .2008; 372: 2132–42.
36. Mariappan R, Mehta J, Massicotte E, Nagappa M, Manninen P, Venkatraghavan L. Effect of superficial cervical plexus block on postoperative quality of recovery after anterior cervical discectomy and fusion: a randomized controlled trial. Can J Anaesth. 2015; 62:883‐890.
37. De Rojas JO, Syre P, Welch WC. Regional anesthesia versus general anesthesia for surgery on the lumbar spine: a review of the modern literature. Clin Neurol Neurosurg 2014;119:39-43.
38. Bianconi M, Ferraro L, Ricci R et al. The Pharmacokinetics and Efficacy of Ropivacaine Continuous Wound Instillation After Spine Fusion Surgery. Anesth Analg. 2004;98(1):166–172. 
39. Tetzlaff JE, Dilger JA, Kodsy M et al. Spinal anesthesia for elective lumbar spine surgery. J Clin Anesth 1998;10:666-9.
40. Singh S, Chaudhary NK. Bilateral Ultasound Guided Erector Spinae Plane Block for Postoperative Pain Management in Lumbar Spine Surgery: A Case Series. J Neurosurg Anesthesiol. 2019;31(3):354.
41. Ueshima H, Otake H. Clinical experiences of ultrasound-guided erector spinae plane block for thoracic vertebra surgery. J Clin Anesth. 2017; 38:137. 
42. Rodgers A, Walker N, Schug S et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ. 2000; 321:1493.
43. Cohen BE, Hartman MB, Wade JT et al. Postoperative pain control after lumbar spine fusion. Patient-controlled analgesia versus continuous epidural analgesia. Spine. 1997;22:1892–1897. 
44. Gottschalk A, Freitag M, Tank S et al. Quality of postoperative pain using an intraoperatively placed epidural catheter after major lumbar surgery. Anesthesiology. 2004;101:175–180.
45. Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The Erector Spinae Plane Block: A Novel Analgesic Technique in Thoracic Neuropathic Pain. Reg Anesth Pain Med. 2016;41:621‐627.
46. Chin KJ, Malhas L, Perlas A. The erector spinae plane block provides visceral abdominal analgesia in bariatric surgery: a report of 3 cases. Reg Anesth Pain Med. 2017; 42:372-376.
47. Kumar A, Hulsey A, Martinez-Wilson H, Kim J, Gadsden J. The use of liposomal bupivacaine in erector spinae plane block to minimize opioid consumption for breast surgery: a case report. A A Pract. 2018; 10:239-241.
48. Cesur S, Ay AN, Yayik AM, Naldan ME, Gurkan Y. Ultrasound-guided erector spinae plane block provides effective perioperative analgesia and anaesthesia for thoracic mass excision: a report of two cases. Anaesth Crit Care Pain Med. 2019;38: 189-190.
49. Melvin JP, Schrot RJ, Chu GM, Chin KJ. Low thoracic erector spinae plane block for perioperative analgesia in lumbosacral spine surgery: a case series. Can J Anaesth. 2018;65:1057-1065.
50. Ivanusic J, Konishi Y, Barrington MJ. A cadaveric study investigating the mechanism of action of erector spinae blockade. Reg Anesth Pain Med 2018;43:567-71.
51. Dunn LK, Durieux ME, Nemergut EC. Non-opioid analgesics: novel approaches to perioperative analgesia for major spine surgery. Best Pract Res Clin Anaesthesiol. 2016; 30:79-89.
52. Yayik AM, Cesur S, Ozturk F, Ahiskalioglu A, Ay AN, Celik EC, Karaavci NC. Postoperative Analgesic Efficacy of the Ultrasound-Guided Erector Spinae Plane Block in Patients Undergoing Lumbar Spinal Decompression Surgery: A Randomized Controlled Study.World Neurosurg. 2019 Jun;126:e779-e785.
53. Ueshima H, Inagaki M, Toyone T, Otake H. Efficacy of the Erector Spinae Plane Block for Lumbar Spinal Surgery: A Retrospective Study. Asian Spine J. 2019;13(2):254‐257.
54. Singh S, Choudhary NK, Lalin D, Verma VK. Bilateral Ultrasound-guided Erector Spinae Plane Block for Postoperative Analgesia in Lumbar Spine Surgery. Journal of Neurosurgical Anesthesiology. 2019. Online ahead of print. doi:10.1097/ana.0000000000000603.

News & Events Latest news from Discoveries

  • 2022, April| AWARDS!

    2022 Discoveries Award winning articles!

    - Kinal Bhatt et al. 2021 (Larking Health System, FL, USA); Bhatt K, Agolli A, Patel MH, et al. High mortality co-infections of COVID-19 patients: mucormycosis and other fungal infections. Discoveries. 2021;9(1):e126. 
    27 citations in the past 1 year - $1000 prize

    - Hasnain Jan et al. 2020 (Quaid-i-Azam University, Pakistan); Jan H, Faisal S, Khan A, et al. COVID-19: Review of Epidemiology and Potential Treatments Against 2019 Novel Coronavirus. Discoveries. 2020;8(2):e108. 
    23 citations in the past 2 years - $400 prize

    Congratulations! Prizes will be received by the awardees in July 2022!

  • 2021, July| 2021, Jul-September

    Due to the high volume of the submitted articles, both Discoveries and Discoveries Reports are experiencing processing and publication delays during the months of July-September 2021. We will get back to the normal processing and publication times starting in October 2021. Note that our editorial and administrativ work is fully funded by our publishing house at this time and we are striving to KEEP THE NO FEE/NO CHARGE strategy in place as long as possible. 

  • 2021, January| AWARDS!

    2022 DISCOVERIES AWARDS! Discoveries will offer $1000 and $400 awards in early 2022, for the most cited (2021 ISI Citations) and visible articles published in 2018-2021.

  • 2020, November| Follow us on Twitter!

    You can now follow the latest Discoveries news and updates on Twitter! (@DiscoveriesNews) 

  • 2020, August| For Authors!

    Due to a high volume of article submissions, our peer-review process takes more than usual. The pre-screening decision is released in 1-2 days, while the peer-review process lasts between 10 and 20 days.  

  • 2020, April | For Authors!

    WE DO NOT TOLERATE ANY MISCONDUCT! Please be aware that we are testing all received articles with specialized software for PLAGIARISM and WE WILL TAKE MEASURES if your article is already published or in consideration for publication by other journals! This may result in serious professional consequences for the authors. The latest striking case is the following article which is already published and was re-submitted here.  

  • 2020, April | For Authors!

    We are happy to let you know that all articles published in Discoveries are now included in PubMedCentral (PMC). New accepted articles will be included in PMC and PubMed within 1-2 weeks after their publication.

  • 2020, January | For Authors!

    Starting in January 2020, Discoveries will also consider articles submitted by Discoveries' Editorial Board members. However, only a small number of such articles (maximum 4 articles/year) will be considered for publication after the peer-review process, and the authors who are also our editors will be clearly disclosed on our website.  

  • 2019, September | Indexed by PMC

    Discoveries is now indexed by PubMedCentral and Pubmed. The agreement with US National Library of Medicine was signed on September 10, 2019. Our next step is ISI Web of Science indexing. NOTE: previously published articles will be included on PubMed in early 2020.

  • 2019, September | PubMed inclusion!

    We are happy to let you know that Discoveries successfuly passed the last step (Technical Review) required for PubMedCentral and PubMed inclusion!

  • 2019, July | PubMed inclusion News!

    We are happy to receive positive comments from PMC/NLM-NIH regarding Discoveries' last step (Technical Review) required for PubMedCentral and PubMed inclusion. We will let you know once whole indexing process is completed. 

  • 2019| Sharing and Distribution!

    All articles published in Discoveries are Open Access articles distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited and it is not used for commercial purposes.

  • 2018-2019 | For Authors!

    From now on and for at least 1 year, we will only accept articles from authors that are NOT members of Discoveries' Editorial Board. All articles submitted by our editors will be immediately rejected until further notice (one accepted article was already rejected). 

  • 2018 | PubMed inclusion News!

    Discoveries successfully passed the Scientific Quality Review by NLM-NIH for PubMedCentral and PubMed indexing. This is the first and the most important step towards PubMedCentral and PubMed indexing! The second (last) step is the Technical Review.

  • 2016, April | Faster Peer-Review

    Starting on April 13th 2016, all articles selected for a peer-review will receive the post peer-review decision within ~10 days. The initial pre-screening time will remain the same (48h from the submission of the manuscript). This decision will significantly accelerate the publication, with no effect on the quality of the peer-review process.

  • 2016, February | Manuscript submission

    Discoveries is commited to excellence, quality and high editorial standards. We are receiving an increasing number of manuscripts for which the identity of the authors/corresponding author can't be verified. Please NOTE that ALL these articles were and will be immediately REJECTED. Indicating an institutional email address is the easiest way to overcome this problem! Moreover, we do not accept any pressure on our editorial board to accept a manuscript. This results in a prompt rejection of the article.

    Editorial Policies
  • 2016, January | Main Objective

    After reaching all proposed milestones until now (including being indexed by Google Scholar in 2014), Discoveries' next Aim is PubMed indexing of all its articles (already published and upcoming). There will be no charge for the submission or publication of articles before Discoveries is indexed.

  • 2015, August | Discoveries - on PubMed

    We are happy to announce that our first Discoveries articles were included in PMC and PubMed. More articles (submitted by NIH funded authors) are now processed for being included.

    Discoveries articles now on PubMed
  • 2015, April | Special Issue

    DISCOVERIES published the SPECIAL ISSUE entitled "INFLAMMATION BETWEEN DEFENSE AND DISEASE: Impact on Tissue Repair and Chronic Sickness".

    Special Issue on "Inflammation"
  • 2015 | Ischemia Collection

    DISCOVERIES launched a call for papers for a Collection of Articles with focus on "ISCHEMIA". If you are interested to submit a manuscript, please contact us at info@discoveriesjournals.org

  • 2014, September | Special Issue

    DISCOVERIES just publish the SPECIAL ISSUE entitled "CELL SECRETION & MEMBRANE FUSION" in September 2014. Initially scheduled for publication between October 2014-March 2015, this issue was successfully published earlier than scheduled. 

    Special Issue
  • 2014, April | Indexed by Google Scholar

    All our published articles are now indexed by Google Scholar! First citations to Discoveries articles are included! Search for the article's title (recommended) or the authors:

    Google Scholar Search
  • 2014 | DISCOVERIES

    DOIs (Digital Object Identifiers) are now assigned to all our published manuscripts in Discoveries. DOI uniquely identifies an article and is provided by CrossRef.

    CrossRef
  • 2013, July | Manuscript Submission

    Submit your manuscript FREE, FAST and EASY ! (in less than 1 minute)! There are NO fees for the manuscript submission or publishing of the accepted manuscripts.
    read more

  • 2013, July | DISCOVERIES

    We are now ACCEPTING MANUSCRIPTS for publishing in DISCOVERIES. We aim publishing a small number of high impact experimental articles & reviews (around 40/year) to maintain a high impact factor. Domains of interest: all areas related to Medicine, Biology and Chemistry ...

    read more
Member Login
Free Registration Click here to sign up
Copyright © 2013 Applied Systems. All Rights Reserved.