Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2009
Randomized Controlled Trial Comparative StudyA prospective, randomized comparison between single- and double-injection, ultrasound-guided supraclavicular brachial plexus block.
This prospective, randomized, observer-blinded study compared single- and double-injection, ultrasound-guided supraclavicular brachial plexus block for upper extremity surgery. ⋯ The double-injection, ultrasound-guided supraclavicular block provides no significant advantages compared with its single-injection counterpart.
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Reg Anesth Pain Med · Sep 2009
Randomized Controlled Trial Comparative StudyComparative study of ropivacaine 0.5% and levobupivacaine 0.33% in axillary brachial plexus block.
The aim of this prospective, randomized, double-blind study was to compare the block induced by ropivacaine 0.5% with levobupivacaine 0.33% at the recommended dose range in upper limb surgery. These concentrations have provided equivalent block after epidural analgesia. We hypothesized that the block induced by both local anesthetics at clinical equipotent dose would be similar in axillary block. ⋯ Onset of motor block was significantly faster for ropivacaine than levobupivacaine (P = 0.02), but the time to be ready for surgery was similar with both drugs. Duration of sensory block was prolonged with levobupivacaine (P = 0.01).
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Reg Anesth Pain Med · Sep 2009
Randomized Controlled Trial Multicenter Study Comparative StudyEffect on neurostimulation of injectates used for perineural space expansion before placement of a stimulating catheter: normal saline versus dextrose 5% in water.
We clinically assessed the electrophysiologic effect of dextrose 5% in water (D5W) and of normal saline (NS) used for expansion of the perineural space before placing a stimulating catheter. We questioned if higher current was required with NS but not with D5W, as has been observed experimentally. ⋯ The current needed to electrostimulate the femoral or sciatic nerve was higher after injection of NS than after D5W.
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Reg Anesth Pain Med · Sep 2009
Randomized Controlled Trial Comparative StudyPercutaneous upper thoracic radiofrequency sympathectomy in Raynaud phenomenon: a comparison of T2/T3 procedure versus T2 lesion with phenol application.
Percutaneous radiofrequency (RF) thoracic sympathectomy is an alternative method to surgical procedures for the treatment of acral ischemia in Raynaud phenomenon. The procedure is indicated if conservative therapy fails to provide sufficient relief. The aim of this study was to compare classic T2 and T3 RF thermolesioning with a less invasive procedure at the level of T2 only. ⋯ Thoracic RF upper sympathectomy is an effective method in the treatment of resistant forms of Raynaud phenomenon. A single-shot procedure at the level of T2 may be preferable because of the shorter procedure duration of this technique.
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Reg Anesth Pain Med · Sep 2009
Randomized Controlled Trial Comparative StudyElectrical stimulation versus ultrasound guidance for popliteal-sciatic perineural catheter insertion: a randomized controlled trial.
Sciatic perineural catheters via a popliteal fossa approach and subsequent local anesthetic infusion provide potent analgesia and other benefits after foot and ankle surgery. Electrical stimulation (ES) and, more recently, ultrasound (US)-guided placement techniques have been described. However, because these techniques have not been compared in a randomized fashion, the optimal method remains undetermined. Therefore, we tested the hypotheses that popliteal-sciatic perineural catheters placed via US guidance require less time for placement and produce equivalent results, as compared with catheters placed using ES. ⋯ Placement of popliteal-sciatic perineural catheters takes less time and produces less procedure-related discomfort when using US guidance compared with ES.