Regional anesthesia and pain medicine
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In the last 2 decades, a growing body of research aimed at investigating the health benefits of Tai Chi in various chronic health conditions has been recognized in the literature. This article reviewed the history, the philosophy, and the evidence for the role of Tai Chi in a few selected chronic pain conditions. The ancient health art of Tai Chi contributes to chronic pain management in 3 major areas: adaptive exercise, mind-body interaction, and meditation. ⋯ Only 5 pain conditions were reviewed: osteoarthritis, fibromyalgia, rheumatoid arthritis, low back pain, and headache. Of these, Tai Chi seems to be an effective intervention in osteoarthritis, low back pain, and fibromyalgia. The limitations of the Tai Chi study design and suggestions for the direction of future research are also discussed.
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Reg Anesth Pain Med · Jul 2012
Meta AnalysisDose-ranging effects of intrathecal epinephrine on anesthesia/analgesia: a meta-analysis and metaregression of randomized controlled trials.
Intrathecal epinephrine has been examined by clinical studies, but its effects on analgesia/anesthesia outcomes as well as on undesirable adverse effects is not clearly defined. The objective of this study was to examine the effects of intrathecal epinephrine on intrathecal anesthesia/analgesia. ⋯ Intrathecal epinephrine has dose-dependent clinical and adverse effects. Doses of 100 µg or less prolonged sensory and motor block duration but were associated with greater incidence of hypotension or PONV. Intrathecal epinephrine doses greater than 100 µg prolonged sensory and motor block and were not associated with greater incidence of hypotension and PONV.
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Reg Anesth Pain Med · Jul 2012
Multicenter StudyA cross-sectional survey on prevalence and risk factors for persistent postsurgical pain 1 year after total hip and knee replacement.
There is a paucity of large multi-institutional surveys to determine the prevalence of and risk factors for persistent pain after total hip (THR) and knee (TKR) replacements. We surveyed a variety of practices and patients and also correlated persistent pain with health-related quality-of-life outcomes. ⋯ Persistent postsurgical pain is common after THR and TKR and is associated with reduced health-related quality of life, although our survey may be biased by the low response rate and retrospective recall bias. Nonmodifiable risk factors may lead to risk stratification. Severity of acute postoperative pain may be a modifiable risk factor.
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Reg Anesth Pain Med · Jul 2012
Randomized Controlled Trial Comparative StudyHemodynamic profile of target-controlled spinal anesthesia compared with 2 target-controlled general anesthesia techniques in elderly patients with cardiac comorbidities.
The impact of anesthesia techniques in patients experiencing hip fracture is controversial. This study compares the effects on blood pressure of 3 anesthesia techniques that are considered safe for the elderly. ⋯ In elderly patients, spinal anesthesia using titrated doses of bupivacaine provided better blood pressure stability than propofol or sevoflurane anesthesia.