Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2008
Randomized Controlled Trial Comparative StudyUltrasound- or nerve stimulation-guided wrist blocks for carpal tunnel release: a randomized prospective comparative study.
We hypothesized that ultrasound-guided wrist blocks may be faster to perform, and may increase success rate, compared with nerve stimulation-guided wrist blocks. ⋯ This randomized prospective study demonstrates that ultrasound-guided wrist nerve blocks are as efficient as those performed with nerve stimulation.
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Reg Anesth Pain Med · Jul 2008
Randomized Controlled TrialAnalgesic effect of lidocaine patch 5% in the treatment of acute herpes zoster: a double-blind and vehicle-controlled study.
Although lidocaine patch 5% has been widely used for postherpetic neuralgia, its analgesic effect on the intense pain associated with acute herpes zoster has not been investigated because of its potential hazard to damaged skin. ⋯ This study demonstrates that lidocaine patch 5%, applied twice a day, could serve as a well tolerated and effective modality to relieve moderate to severe pain associated with acute herpes zoster presumably through its pharmacological action and physical barrier effect on sensitized skin.
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Reg Anesth Pain Med · Jul 2008
Randomized Controlled TrialOndansetron given intravenously attenuates arterial blood pressure drop due to spinal anesthesia: a double-blind, placebo-controlled study.
Side effects of spinal anesthesia include arterial hypotension and bradycardia. Both of them may be induced by sympathetic nerve blockade as well as by the Bezold-Jarisch reflex, which may be mediated by peripheral serotonin receptors (5-HT(3) type). The aim of this study was to verify the hypothesis that blockade of type 3 serotonin receptors by intravenous ondansetron administration might reduce hypotension and bradycardia induced by spinal anesthesia. ⋯ Ondansetron given intravenously attenuates the fall of systolic and mean blood pressure, but does not have an influence on diastolic blood pressure or heart rate.
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Reg Anesth Pain Med · Jul 2008
Identification of the epidural space using pressure measurement with the compuflo injection pump--a pilot study.
While epidural anesthesia (EA) is frequently used, success rate varies and complications associated with incorrect needle placement can occur. Different methods of objective identification of the epidural space (ES) have been suggested, without receiving widespread popularity. This prospective pilot study evaluated continuous pressure measurement during low speed injection with a computerized injection pump to objectively identify the ES. ⋯ This investigation demonstrates that a computerized injection pump can be used to identify the epidural space and can serve as a base for further comparative research to determine whether this technology can increase the success rate of EA or lower the incidence of side effects.
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Reg Anesth Pain Med · Jul 2008
Evaluation of magnetic resonance imaging following neuraxial steroid administration: does epidural injection produce pathologic findings?
Infection or hematoma following epidural anesthesia is a rare but potentially devastating complication unless diagnosed early. In order to diagnose spinal cord involvement, the currently recommended imaging test is magnetic resonance imaging (MRI). Despite this, no previous studies have been performed to define typical MRI findings following uneventful epidural injection. The purpose of this pilot study was to compare magnetic resonance images before and after epidural injection to define the characteristic appearance of MRI following an uneventful epidural steroid injection. ⋯ The results of this pilot study demonstrated that after uneventful epidural injection in otherwise healthy patients, there were no new pathologic findings on MRI scans. Further MRI studies in large populations and in different clinical situations should be performed to confirm these preliminary findings.