Anesthesia and analgesia
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Anesthesia and analgesia · Feb 2008
Randomized Controlled Trial Comparative StudyManagement of lower limb complex regional pain syndrome type 1: an evaluation of percutaneous radiofrequency thermal lumbar sympathectomy versus phenol lumbar sympathetic neurolysis--a pilot study.
Complex regional pain syndrome type 1 can be difficult to treat. The purpose of this study was to compare the safety and efficacy of two therapeutic options: percutaneous radiofrequency thermal lumbar sympathectomy and lumbar sympathetic neurolysis. ⋯ Based on this pilot study, radiofrequency lumbar sympathectomy may be comparable to phenol lumbar sympathectomy. A larger trial is required to confirm these findings.
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Anesthesia and analgesia · Feb 2008
Randomized Controlled TrialA prospective evaluation of iodinated contrast flow patterns with fluoroscopically guided lumbar epidural steroid injections: the lateral parasagittal interlaminar epidural approach versus the transforaminal epidural approach.
Lumbar midline interlaminar and transforaminal (TF) epidural steroid injections are treatments for low back pain with radiculopathy secondary to degenerative disk disease. Since pain generators are located anteriorly in the epidural space, ventral epidural spread is the logical target for placement of antiinflammatory medications. In this randomized, prospective, observational study, we compared contrast flow patterns in the epidural space using the parasagittal interlaminar (PIL) and transforaminal approaches with continual fluoroscopic guidance. ⋯ The PIL approach is superior to the TF approach for placing contrast into the anterior epidural space with reduction in fluoroscopy times and an improved spread grade. With increasing attention to neurological injury associated with TF, the PIL approach may be more suitable for routine use.
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Anesthesia and analgesia · Feb 2008
Randomized Controlled Trial Comparative StudyThe effect of motor activity on the onset and progression of brachial plexus block with bupivacaine: a randomized prospective study in patients undergoing arthroscopic shoulder surgery.
A decreased latency of onset of neural blockade has been noted when muscular exercise of the hand was performed after supraclavicular brachial plexus block using lidocaine. In this observational study, we examined the effect of repetitive muscle contraction of the hand on the speed of onset of interscalene brachial plexus block (ISB) using bupivacaine. ⋯ Our results imply that attempting to use a frequency-dependent conduction block with repetitive motor activity as a clinical adjuvant to brachial plexus block with bupivacaine is without merit.
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Anesthesia and analgesia · Feb 2008
Randomized Controlled Trial Comparative StudyAccelerated recovery from sevoflurane anesthesia with isocapnic hyperpnoea.
Isocapnic hyperpnoea (IH) reduces recovery time from isoflurane anesthesia in animals and humans. We studied the effect of IH on the emergence profile of sevoflurane-anesthetized patients by comparing postoperative recovery variables in patients administered IH (IH group) to those recovered in the customary fashion (control group). ⋯ IH accelerates recovery from sevoflurane anesthesia and shortens operating room and postanesthetic care unit stay.