Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2005
Correlation of postoperative pain to quality of recovery in the immediate postoperative period.
It is unclear whether the severity of postoperative pain may affect patients' quality of recovery in the immediate postoperative period (within 2 weeks of surgery). ⋯ Our findings suggest that an increase in postoperative pain is correlated with a decrease in a patient's quality of recovery in the immediate postoperative period.
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Reg Anesth Pain Med · Nov 2005
Nerve blocks at the wrist for carpal tunnel release revisited: the use of sensory-nerve and motor-nerve stimulation techniques.
Because the median nerve at the wrist has mainly sensory endings, the aim of this study was to assess the response of the median nerve to nerve stimulation at the wrist and to evaluate the quality of median nerve block. A control group of patients who received blinded injections was analyzed and compared post hoc. ⋯ This study describes how infrequently an initial motor response is identified when a nerve stimulator is used on the median nerve at the wrist. A very high success rate of median and ulnar nerve block at the wrist is obtained by use of sensory or sensory-motor-nerve stimulation and less than 10 mL of anesthetic solution.
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Reg Anesth Pain Med · Nov 2005
Randomized Controlled TrialContinuous versus single-injection lumbar plexus blocks: comparison of the effects on morphine use and early recovery after total knee arthroplasty.
Continuous lumbar plexus infusion of local anesthetic after total knee arthroplasty has been shown to improve analgesia and early recovery as compared with patient-controlled analgesia (PCA) morphine. Any benefit of an infusion over a single-injection lumbar plexus block has not been directly shown however. ⋯ Postoperative infusion of local anesthetic around the lumbar plexus reduces morphine requirement and improves early recovery after total knee arthroplasty as compared with a single-injection block.
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Reg Anesth Pain Med · Nov 2005
Clinical TrialA description of the spread of injectate after psoas compartment block using magnetic resonance imaging.
Magnetic resonance imaging (MRI) provides for excellent visualization of spread of solution after peripheral nerve block. The aim of this observational study was to utilize MRI to describe the distribution of injectate (gadopentetate dimeglumine) administered for continuous psoas compartment block (PCB) performed by use of two approaches (Capdevila and modified Winnie) and to describe the spread of injectate to the lumbar plexus. ⋯ The most common pattern of injectate spread seen on MRI with both approaches to PCB was spread within the body of the psoas muscle around the lumbar branches (L2-4), with cephalad spread to the lumbar nerve roots. One catheter resulted in injectate between the psoas and quadratus lumborum muscles.