Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Jan 2010
Randomized Controlled Trial Comparative StudyA prospective, randomized comparison between single- and double-injection ultrasound-guided infraclavicular brachial plexus block.
This prospective, randomized, observer-blinded study compared single- and double-injection ultrasound-guided infraclavicular brachial plexus block for upper extremity surgery. ⋯ The double-injection ultrasound-guided infraclavicular block provides no significant advantages compared with its single-injection counterpart.
-
Reg Anesth Pain Med · Jan 2010
Comparative StudyNeedle-induced paresthesiae during single-shot spinal anesthesia: a comparison of sitting versus lateral decubitus position.
Paresthesiae occasionally occur during spinal puncture or injection of local anesthetic for spinal anesthesia. No information is currently available regarding the effects of the patient's position on the incidence of needle-induced paresthesiae. The purpose of this prospective, observational study was to compare the occurrence of needle-induced paresthesiae in patients who received single-shot spinal anesthesia in the sitting position or in the lateral decubitus position. ⋯ Patient's position may influence the occurrence of needle-induced paresthesiae during spinal anesthesia. Lateral decubitus position resulted in a higher incidence of paresthesiae than the sitting position. However, there is no position-related difference noted if a single-needle puncture is sufficient to perform the block.
-
Reg Anesth Pain Med · Jan 2010
Randomized Controlled TrialLong-lasting analgesic effects of intraoperative thoracic epidural with bupivacaine for liver resection.
Continuous epidural analgesia may be considered in liver resection but is often avoided because of possible coagulopathies and the risk of epidural hematoma in the postoperative period. On the other hand, there is no coagulation defect during the surgery. Effective prevention of postoperative pain may require continuous sensory ablation throughout the surgery event. ⋯ Intraoperative thoracic epidural infusion of bupivacaine, added to intrathecal morphine, decreased postoperative morphine consumption with better pain relief compared with the placebo.
-
Reg Anesth Pain Med · Jan 2010
Randomized Controlled Trial Comparative StudyAxillary block by "selective" injections at the nerves involved in surgery using a peripheral nerve stimulator: a comparison with a "standard" triple-injection technique.
A triple-injection technique (injections at the median, musculocutaneous, and radial nerves) for axillary block affords a high incidence of complete block (all the nerves below the elbow). However, in certain surgeries, only 1 or 2 nerves are involved in the surgical field. The aim of this prospective randomized study was to test the effectiveness of surgical anesthesia of a "selective" approach in which only the nerves involved in surgery were electrically located and injected. ⋯ A standard triple-nerve stimulation technique seems to be preferable to the selective approach even when a limited number of nerves are involved in the surgical field.