Journal of clinical anesthesia
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Randomized Controlled Trial
Experience of anesthesiologists with percutaneous nonangiographic venous access.
To compare percutaneous nonangiographic insertion of a venous access device with a standard surgical cutdown insertion technique. ⋯ The simplified, percutaneous, nonangiographic technique is as effective as the traditional venous cutdown technique and can be safely done by surgeons as well as by experienced physicians who are not surgeons.
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Randomized Controlled Trial Comparative Study
Comparison of sciatic psoas compartment block and sciatic femoral 3-in-1 block for knee arthroscopy.
To compare the clinical effectiveness of two peripheral nerve block techniques combined with sciatic nerve block: sciatic psoas compartment (SPC) and sciatic femoral 3-in-1 (SF 3-in-1) block. ⋯ Both SPC and SF 3-in-1 provided sufficient anesthetic efficacy for knee arthroscopy. However, SPC may be preferable to SF 3-in-1 block owing to better patient satisfaction and less requirement for opioid analgesics.
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A 61-year-old patient with severe stump pain required hospitalization and intravenous opioids for pain control. After evaluation by our anesthesia pain management service, we concluded that the patient had a neuroma at the site of sciatic nerve transection and that injection of a mixture of local anesthetic and corticosteroid at the site of the neuroma was the most appropriate management. Because the alternative methods of nerve localization (eg, motor stimulation, paresthesia) were unlikely to be successful, we felt that the most reliable way to accomplish this task was to use live ultrasound guidance. After a series of 4 ultrasound-guided blocks with bupivacaine and methylprednisolone acetate, the patient's pain was alleviated to the point at which it was managed with occasional doses of oral opioids.
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A patient who sustained a posterior shoulder subluxation injury after being positioned in the lateral decubitus head-down position during emergence from general anesthesia is presented. It is postulated that the injury occurred as a result of violent retching while in the lateral position.
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Randomized Controlled Trial
The analgesic efficacy of preoperative versus postoperative lornoxicam in varicocele repair.
To determine whether intravenous injection of lornoxicam 30 minutes before skin incision provides better pain relief after varicocelectomy than postoperative administration of lornoxicam. ⋯ Intravenous lornoxicam administered before surgery has a better analgesic effect for varicocelectomy than when administered postoperatively.