Regional anesthesia and pain medicine
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Progress continues on American Society of Regional Anesthesia (ASRA) AcutePOP. Highlights include selection of data fields and creation of definitions for complications jointly accepted by clinical registries for ASRA, American Society of Anesthesiologists, Regional Anesthesia Surveillance System, Society for Obstetric Anesthesia and Perinatology, and Society for Pediatric Anesthesia. Development of a Web site and applications continues, and a demonstration is planned for the ASRA 2009 meeting.
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Reg Anesth Pain Med · May 2009
Randomized Controlled Trial Comparative StudyUltrasound improves the success rate of a tibial nerve block at the ankle.
The tibial nerve provides the majority of sensation to the foot. Although multiple techniques have been described, there exists little evidence-based medicine evaluating different techniques for blocking the tibial nerve at the ankle. We hypothesized that an ultrasound (US)-guided tibial nerve block at the ankle would prove more successful than a conventional approach based on surface landmarks. ⋯ In healthy volunteers, US guidance results in a more successful tibial nerve block at the ankle than does a traditional approach using surface landmarks.
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Reg Anesth Pain Med · May 2009
Randomized Controlled Trial Comparative StudyThe rectus sheath block: accuracy of local anesthetic placement by trainee anesthesiologists using loss of resistance or ultrasound guidance.
The aim of this study was to compare the accuracy of local anesthetic placement in the rectus sheath block when performed by trainee anesthetists using loss of resistance (LOR) or ultrasound guidance. ⋯ Ultrasound guidance improves the accuracy of local anesthetic placement when undertaking the rectus sheath block. An additional fascial plane above the anterior layer of the rectus sheath may be wrongly perceived as the anterior layer of the rectus sheath when the block is undertaken without the aid of ultrasound.
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Reg Anesth Pain Med · May 2009
Multicenter StudyOutcome predictors for sacroiliac joint (lateral branch) radiofrequency denervation.
Sacroiliac (SI) joint pain is a challenging condition characterized by limited treatment options. Recently, numerous studies have reported excellent intermediate-term outcomes after lateral-branch radiofrequency (RF) denervation, but these studies are characterized by wide variability in technique, selection criteria, and patient characteristics. The purpose of this study was to determine whether any demographic or clinical variables can be used to predict SI joint RF denervation outcome. ⋯ Whereas several factors were found to influence outcome, no single clinical variable reliably predicted treatment results. The use of more stringent selection criteria was not associated with better outcomes.
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Reg Anesth Pain Med · May 2009
Clinical TrialMinimum effective volume of local anesthetic for ultrasound-guided supraclavicular brachial plexus block.
The aim of this study was to determine the minimum effective anesthetic volume required to produce an effective supraclavicular block for surgical anesthesia using an ultrasound (US)-guided technique. ⋯ In this study, the minimum volume required for US-guided supraclavicular block in 50% of patients was 23 mL, and in 95% of patients was 42 mL. Under the present study conditions, the calculated volume of LA required for US-guided supraclavicular block does not seem to differ from the conventionally recommended volume required for supraclavicular blocks using non-US-based nerve localization techniques.