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Latest & greatest articles for ultrasound
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Ultrasound-Guided Pectoral Nerve Block I and Serratus-Intercostal Plane Block Alleviate Postoperative Pain in Patients Undergoing Modified Radical Mastectomy Simultaneous application of pectoral nerve block and serratus-intercostal plane block (SPB) is one of the most desirable multimodal analgesic strategies, with wide implementation of the enhanced recovery after surgery pathway for modified radical mastectomy (MRM).The aim of the present study was to investigate the efficacy and safety (...) of ultrasound-guided pectoral nerve block I (PECS I) and SPB for postoperative analgesia following MRM.A randomized, prospective study.An academic medical center.A total of 61 women undergoing MRM were randomly divided into 2 groups. The control group (group C, n = 32) received general anesthesia only, whereas the PECS I + SPB treated group (group PS, n = 29) received a combination of pectoral nerve block and SPB in addition to general anesthesia.Pain scores on a visual analog scale, opioid consumption
Hand-held ultrasound devices for cardiac assessment and diagnosis of heart failure Hand-held ultrasound devices - Health Technology Wales > Hand-held ultrasound devices Hand-held ultrasound devices Topic Status Complete Hand-held ultrasound devices for cardiac assessment and diagnosis of heart failure, in the community or primary care setting. Outcome of the appraisal Hand-held ultrasound devices (HUDs) show promise in the diagnosis of heart failure in a primary care or community setting (...) and serious condition that is exerting an increasing burden on cardiology and heart imaging services in Wales. The diagnosis of heart failure can be suspected from clinical assessment and biochemical testing but the use of cardiac ultrasound (echocardiography) is pivotal to either confirming or excluding the diagnosis. Echocardiography is usually done in a hospital setting, but the use of hand-held ultrasound devices means that it can be offered as a quick and portable test to people in a primary care
Recommendations for good practice in Ultrasound: Oocyte retrieval 1 2 Disclaimer The European Society of Human Reproduction and Embryology (hereinafter referred to as 'ESHRE') developed the current good practice recommendations document, to provide clinical recommendations to improve the quality of healthcare delivery within the European field of human reproduction and embryology. This guideline represents the views of ESHRE, which were achieved after careful consideration of the scientific (...) the correctness, completeness, and accuracy of the good practice recommendations in every respect. In any event, these good practice recommendations do not necessarily represent the views of all clinicians that are member of ESHRE. The information provided in this document does not constitute business, medical or other professional advice, and is subject to change. 3 Recommendations for good practice in Ultrasound: oocyte pick-up. Content Authors 4 Introduction 5 Methodology 6 Recommendations 9 Definition: 9
Effect of ultrasound-guided peripheral nerve blocks of the abdominal wall on pain relief after laparoscopic cholecystectomy Purpose: The aim of this study was to compare the effect of an ultrasound-guided transversus abdominis plane block (TAPB) and rectus sheath block (RSB) combination, an ultrasound-guided posterior TAP block combined with the local anesthetic infiltration (LAI) and LAI alone on pain relief after laparoscopic cholecystectomy (LC). Patients and methods: One hundred eighty (...) patients who were American Society of Anesthesiologists class Ι or Π were included in this randomized, double-blind, non-inferiority study. All patients underwent three-port LC and were divided into 3 groups. The LAI group had ropivacaine mixed with dexmedetomidine injected around the trocar entrance site preoperatively. The TL group underwent ultrasound-guided posterior TAPB combined with LAI, and the TR group underwent ultrasound-guided TAPB combined with RSB. Postoperative pain was evaluated
Combined ultrasound-guided Pecs II block and general anesthesia are effective for reducing pain from modified radical mastectomy Purpose: Combined regional and general anesthesia are often used for the management of breast cancer surgery. Thoracic spinal block, thoracic epidural block, thoracic paravertebral block, and multiple intercostal nerve blocks are the regional anesthesia techniques which have been used in breast surgery, but some anesthesiologists are not comfortable because (...) of the complication and side effects. In 2012, Blanco et al introduced pectoralis nerve (Pecs) II block or modified Pecs block as a novel approach to breast surgery. This study aims to determine the effectiveness of combined ultrasound-guided Pecs II block and general anesthesia for reducing intra- and postoperative pain from modified radical mastectomy. Patients and methods: Fifty patients undergoing modified radical mastectomy with general anesthesia were divided into two groups randomly (n=25), to either Pecs
Biochemical tests of placental function versus ultrasound assessment of fetal size for stillbirth and small-for-gestational-age infants. Stillbirth affects 2.6 million pregnancies worldwide each year. Whilst the majority of cases occur in low- and middle-income countries, stillbirth remains an important clinical issue for high-income countries (HICs) - with both the UK and the USA reporting rates above the mean for HICs. In HICs, the most frequently reported association with stillbirth (...) for the identification of SGA infants.The primary objective was to assess and compare the diagnostic accuracy of ultrasound assessment of fetal growth by estimated fetal weight (EFW) and placental biomarkers alone and in any combination used after 24 weeks of pregnancy in the identification of placental dysfunction as evidenced by either stillbirth, or birth of a SGA infant. Secondary objectives were to investigate the effect of clinical and methodological factors on test performance.We developed full search
Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery Patients who undergo surgical procedures that impair the integrity of the chest wall frequently experience extremely severe postoperative pain. Opiates and weaker analgesics, such as nonsteroidal anti-inflammatory drugs (NSAIDs), are not sufficiently effective in achieving control of severe pain and might cause respiratory and gastrointestinal complications. In the past decade, there has been an increased (...) " that was treated by ultrasound-guided serratus anterior plane (SAP) block (a single injection of 0.25% bupivacaine hydrochloride 2 mg/kg plus dexamethasone 8 mg) with standard postoperative pain control regimen. We compared the clinical, laboratory, and postoperative pain assessment data of both groups.Patients in the SAP block Group 2 reported significantly lower levels of pain after thoracic surgery as assessed by their visual analog scale scores, as compared to the patients in the standard pain control
Point-of-care ultrasound before attempting clean-catch urine collection in infants: a randomized controlled trial A new non-invasive bladder stimulation technique has been described to obtain clean-catch urine specimens in infants. This study aimed to evaluate if point-of-care ultrasound (POCUS) guided feeding protocol to measure bladder volume prior to stimulation techniques improves clean-catch urine collection success.A prospective randomized controlled trial study was conducted
The diagnostic accuracy of a point-of-care ultrasound protocol for shock etiology: A systematic review and meta-analysis The aim of this study was to perform a systematic review and meta-analysis of the diagnostic accuracy of a point-of-care ultrasound exam for undifferentiated shock in patients presenting to the emergency department.Ovid MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, and research meeting abstracts were searched from 1966 to June 2018 for relevant studies (...) likelihood ratio values ranged from 0.13 (95% CI 0.04 to 0.48) for obstructive shock to 0.32 (95% CI 0.16 to 0.62) for mixed-etiology shock.The rapid ultrasound for shock and hypotension (RUSH) exam performs better when used to rule in causes of shock, rather than to definitively exclude specific etiologies. The negative likelihood ratios of the exam by subtype suggest that it most accurately rules out obstructive shock.
Ultrasound-guided high-intensity focused ultrasound for malignant neoplasms of the pancreas – second Addendum to Commission H16-02C 1 Translation of the executive summary of the addendum Sonografiegesteuerte hochfokussierte Ultraschallthera- pie bei inoperablen bösartigen Neubildungen des Pankreas – 2. Addendum zum Auftrag H16-02C (Version 1.0; Status: 24 April 2018). Please note: This translation is provided as a service by IQWiG to English-language readers. However, solely the German original (...) text is absolutely authoritative and legally binding. Executive Summary IQWiG Reports – Commission No. H18-01 Ultrasound-guided high- intensity focused ultrasound for unresectable malignant neoplasms of the pancreas Second Addendum to Commission H16-02C 1 Executive summary of addendum H18-01 Version 1.0 USgHIFU for pancreatic tumours 24 April 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic
Preoperative ultrasound-guided multilevel paravertebral blocks reduce the incidence of postmastectomy chronic pain: a double-blind, placebo-controlled randomized trial Chronic postsurgical pain is a challenging problem after breast cancer surgery. This prospective, randomized, double-blinded, parallel-group, placebo-controlled trial was conducted to evaluate the influence of preoperative ultrasound-guided multilevel paravertebral blocks (PVBs) on chronic pain following mastectomy.One hundred (...) eighty-four women were randomized to receive ultrasound-guided multilevel (T1-T5) PVBs with 5 mL of ropivacaine 0.5% or normal saline per level. The primary end point was the incidence of chronic pain at 3 months following mastectomy assessed by the brief pain inventory (BPI), while the secondary end points were the acute postoperative pain, the number of patients requiring rescue analgesia, postoperative nausea and vomiting (PONV), side effects, and chronic pain at 6 months after surgery assessed
The use of ultrasound guidance for perioperative neuraxial and peripheral nerve blocks in children. The use of ultrasound guidance for regional anaesthesia has become popular over the past two decades. However, it is not recognized by all experts as an essential tool, perhaps because it is unclear whether ultrasound reduces the risk of severe neurological complications, and the cost of an ultrasound machine (USD 22,000) is substantially higher than the cost of other tools. This review (...) was published in 2016 and updated in 2019.To determine whether ultrasound guidance offers any clinical advantage when neuraxial and peripheral nerve blocks are performed in children in terms of decreasing failure rate or the rate of complications.We searched CENTRAL, MEDLINE, Embase, and two trial registers up to March 2018 together with reference checking to identify additional studies and contacted study authors to obtain additional trial information.We included all parallel randomized controlled trials
Immediate Effects of Simultaneous Application of Transcutaneous Electrical Nerve Stimulation and Ultrasound Phonophoresis on Active Myofascial Trigger Points: A Randomized Controlled Trial. The aim of the study was to investigate the efficacy of phonophoresis with combined therapy on active myofascial trigger points.One hundred participants with acute mechanical neck pain and at least one active myofascial trigger point in the upper trapezius were randomly assigned into four equal groups.Groups (...) consisted of diclofenac phonophoresis with combined therapy, diclofenac phonophoresis, ultrasound (US) with coupling gel, and sham US and applied for 10 mins over myofascial trigger points.Measurements included pressure pain threshold and active cervical lateral flexion.There were statistically significant improvements in postintervention pressure pain threshold and range of motion values in treatment groups (P < 0.0001). As for the sham US, no significant difference was found between
Translabial ultrasound for diagnosing and assessing complications following vaginal mesh insertion Page 1 of 4 TER007 December 2018 Topic Exploration Report Topic explorations are designed to provide a high-level briefing on new topics submitted for consideration by Health Technology Wales. The main objectives of this report are to: 1. Inform discussions on new topics received by HTW. 2. Determine the quantity and type of evidence available on a topic. 3. Assess the topic against HTW selection (...) criteria. Topic: Translabial ultrasound scanning Topic exploration report number: TER007 Referrer: Jonathan Williams, Welsh Government Topic exploration undertaken by: Health Technology Wales Aim of Search Health Technology Wales searched for evidence on the effectiveness of translabial ultrasound scanning for diagnosing and assessing complications following vaginal mesh insertion, or any UK-based guidelines of commissioning documents on the use of translabial ultrasound for this indication. Summary
Therapeutic Ultrasound for Pain Management in Chronic Low Back Pain and Chronic Neck Pain: A Systematic Review Low back pain (LBP) and neck pain are major causes of pain and disability that are experienced across all ages. The primary goals of treatment are to improve patient function and facilitate a return to the patient's desired level of daily activity. Therapeutic ultrasound is a noninvasive modality widely utilized in the management of musculoskeletal disorders, but there continues (...) to be controversy regarding its use due to insufficient evidence of effectiveness. The objective of this systematic review was to evaluate the effectiveness of therapeutic ultrasound in the management of patients with chronic LBP and neck pain.Using PRISMA guidelines, a search of the PubMed and CENTRAL (The Cochrane Library) databases was performed to retrieve randomized controlled trials (RCTs) that evaluated therapeutic ultrasound in patients with chronic LBP or neck pain.The search strategy identified 10
A multicenter, randomized comparison between 2, 5, and 8 mg of perineural dexamethasone for ultrasound-guided infraclavicular block This multicenter, randomized trial compared 2, 5, and 8 mg of perineural dexamethasone for ultrasound-guided infraclavicular brachial plexus block. Our research hypothesis was that all three doses of dexamethasone would result in equivalent durations of motor block (equivalence margin=3.0 hours).Three hundred and sixty patients undergoing upper limb surgery (...) with ultrasound-guided infraclavicular block were randomly allocated to receive 2, 5, or 8 mg of preservative-free perineural dexamethasone. The local anesthetic agent (35 mL of lidocaine 1%-bupivacaine 0.25% with epinephrine 5 µg/mL) was identical in all subjects. Patients and operators were blinded to the dose of dexamethasone. During the performance of the block, the performance time, number of needle passes, procedural pain, and complications (vascular puncture, paresthesia) were recorded. Subsequently
Guidelines for Cleaning and Preparing External- and Internal-Use Ultrasound Transducers Between Patients, Safe Handling, and Use of Ultrasound Coupling Gel Guidelines for Cleaning and Preparing External- and Internal-Use Ultrasound Transducers Between Patients, Safe Handling, and Use of Ultrasound Coupling Gel Summary Adequate transducer preparation is mandatory. The level of preparation depends on the type of examination performed. Routine high-level disinfection (HLD) of internal transducers (...) Relevant Guidelines Kac et al 1 examined endocavitary transducers and found them persistently contaminated despite the use of transducer covers. They concluded that transducers may carry pathogens, including human papillomavirus (HPV), unless properly disinfected between examination sessions. For disinfection, they recommend an antiseptic-impregnated towel as well as a type C ultraviolet light. Adhikari et al 2 compared infection rates between ultrasound-guided and traditionally placed peripheral