Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2007
Randomized Controlled TrialA randomized controlled trial of the anticatabolic effect of epidural analgesia and hypocaloric glucose.
The goal of the present study was to investigate whether epidural analgesia exerts a protein-sparing effect after colorectal surgery in the presence of hypocaloric glucose supply initiated with surgical skin incision. ⋯ Epidural analgesia inhibits the increase in whole-body protein breakdown in patients receiving perioperative hypocaloric glucose infusion initiated with surgical skin incision. However, oxidative protein loss, protein synthesis, and glucose metabolism are not affected by epidural analgesia.
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Reg Anesth Pain Med · May 2007
Comparative StudyComparison of different injectate volumes for stellate ganglion block: an anatomic and radiologic study.
Volumes from 5 to 20 mL of local anesthetic are used for stellate ganglion block. The variation of practice gave us the impetus to investigate the distribution of 3 different volumes of solution. We documented the regions reached by each volume to assess the possibility to reduce the injectate to 5 mL. ⋯ The use of 5 mL results in an almost ideal vertical distribution in most of the cadavers, whereas high volumes--20 mL more so than 10 mL--are at risk of spreading extensively in both the vertical direction and also uncontrollably to other regions of the neck.
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We aimed to describe the ultrasound appearance of the radial nerve in the lateral aspect of the distal upper arm. This procedure was done to identify potential novel sites for ultrasound-guided radial-nerve block. ⋯ Points B and C may represent convenient, novel sites for ultrasound-guided radial-nerve block. The nerve is clearly visualized and has not yet divided into superficial and deep branches. Point C may be the optimal site for radial-nerve block because of the smaller risk of vessel puncture. Our observations also demonstrate the ability of ultrasound to identify nerves at sites not clearly defined by surface anatomic landmarks.
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Reg Anesth Pain Med · May 2007
Biography Historical ArticleExploring origins: was John Bonica's model of modern-day pain management influenced by John Lundy's earlier work?
Contemporary pain medicine is a multimodality and multidisciplinary field. Many of the current ideas and styles of practice that influence the specialty today can be traced back to John Bonica, M. D., and his model of pain management introduced more than 50 years ago. ⋯ While in the army during World War II, Bonica worked closely with his Chief of Surgery, Joel Deuterman, M. D., a physician who had trained at the Mayo Clinic, where he was exposed to Lundy and his techniques. Deuterman may have influenced Bonica's ideas concerning the treatment of chronic painful conditions.