Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2011
Randomized Controlled Trial Comparative StudyDecreasing the local anesthetic volume from 20 to 10 mL for ultrasound-guided interscalene block at the cricoid level does not reduce the incidence of hemidiaphragmatic paresis.
This prospective, randomized, double blind study was designed to determine whether reduction in volume from 20 to 10 mL of ropivacaine 0.5% for ultrasound-guided interscalene block might decrease the incidence of diaphragmatic paresis and preserve pulmonary function. ⋯ Decreasing the volume for interscalene block from 20 to 10 mL did not reduce the incidence of hemidiaphragmatic paresis or impairment in pulmonary function, which persisted at discharge from recovery room. No significant differences in quality or duration of analgesia were observed.
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Reg Anesth Pain Med · Jan 2011
Randomized Controlled Trial Comparative StudyA randomized comparison of infraclavicular and supraclavicular continuous peripheral nerve blocks for postoperative analgesia.
Although the efficacy of single-injection supraclavicular nerve blocks is well established, no controlled study of continuous supraclavicular blocks is available, and their relative risks and benefits remain unknown. In contrast, the analgesia provided by continuous infraclavicular nerve blocks has been validated in randomized controlled trials. We therefore compared supraclavicular with infraclavicular perineural local anesthetic infusion following distal upper-extremity surgery. ⋯ A local anesthetic infusion via an infraclavicular perineural catheter provides superior analgesia compared with a supraclavicular perineural catheter.
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Reg Anesth Pain Med · Jan 2011
Postvoid residuals remain unchanged in patients with postoperative thoracic epidural analgesia after thoracotomy.
We found in previous studies that thoracic epidural analgesia (TEA) after open renal surgery via lumbotomy significantly impaired bladder function with decreased detrusor contractility and increased postvoid residuals under urodynamic assessment. Here we evaluated the effect of TEA on bladder emptying in patients undergoing thoracotomy. ⋯ Most patients after thoracotomy had unchanged postvoid residuals under TEA. Our study design does not allow us to determine cause and effect or to make conclusions that are based on comparative, randomized data. However, our observations do yield a hypothesis-generating basis for future clinical trials.
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Reg Anesth Pain Med · Jan 2011
Comment Letter Case ReportsUltrasound-guided peripheral nerve block in a patient with neurofibromatosis.