Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2010
Nerve expansion seen on ultrasound predicts histologic but not functional nerve injury after intraneural injection in pigs.
Intraneural injection can be seen as nerve expansion during ultrasound-guided regional anesthesia. The purpose of this animal study was to determine if nerve expansion seen on ultrasound during intraneural injection results in nerve injury. ⋯ This animal study suggests that nerve expansion seen on ultrasound during intraneural injection of clinically relevant volumes of LA results in histologic but not functional nerve injury.
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Reg Anesth Pain Med · Mar 2010
Practice GuidelineThe American Society of Regional Anesthesia and Pain Medicine and the European Society of Regional Anaesthesia and Pain Therapy joint committee recommendations for education and training in ultrasound-guided regional anesthesia.
Ultrasound-guided regional anesthesia (UGRA) is a growing area of both clinical and research interest. The following document contains the work produced by a joint committee from ASRA and the European Society of Regional Anesthesia and Pain Therapy. This joint committee was established to recommend to members and institutions the scope of practice, the teaching curriculum, and the options for implementing the medical practice of UGRA. ⋯ In both the residency and postgraduate pathways, training, competency, and proficiency requirements include both didactic and experiential components. The Joint Committee recommends that the decision to grant UGRA privileges be based at the individual institution level. Each institution that conducts UGRA is encouraged to support a productive quality improvement process.
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Reg Anesth Pain Med · Mar 2010
Pulsed radiofrequency for the treatment of occipital neuralgia: a prospective study with 6 months of follow-up.
Occipital neuralgia is a paroxysmal nonthrobbing, stabbing pain in the area of the greater or lesser occipital nerve caused by irritation of these nerves. Although several therapies have been reported, no criterion standard has emerged. This study reports on the results of a prospective trial with 6 months of follow-up in which pulsed radiofrequency treatment of the greater and/or lesser occipital nerve was used to treat this neuralgia. ⋯ Pulsed radiofrequency treatment of the greater and/or lesser occipital nerve is a promising treatment of occipital neuralgia. This study warrants further placebo-controlled trials.
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Reg Anesth Pain Med · Mar 2010
In-plane ultrasound-guided thoracic paravertebral block: a preliminary report of 36 cases with radiologic confirmation of catheter position.
Thoracic paravertebral block (TPVB) can be used for unilateral surgical procedures. Modifications of the classic approach have been proposed to minimize the risk of pleural puncture. In this study, we evaluated the feasibility and success rate of a transverse in-plane ultrasound (US)-guided TPVB with radiologic confirmation of catheter position. ⋯ An in-plane transverse US-guided TPVB using the described technique is feasible and has a high success rate. In all patients, correct catheter position in the thoracic paravertebral space was radiologically confirmed.
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This article provides an instructive review of the essential functions universal to modern ultrasound machines in use for regional anesthesia practice. An understanding of machine knobology is integral to performing safe and successful ultrasound-guided regional anesthesia.