Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2013
Multicenter Study Comparative StudyUltrasound guidance reduces the risk of local anesthetic systemic toxicity following peripheral nerve blockade.
The use of ultrasound for peripheral nerve blockade reduces the incidence of systemic local anesthetic toxicity by at least 65%, possibly 80%.
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Reg Anesth Pain Med · Jul 2013
The impact of analgesic modality on early ambulation following total knee arthroplasty.
Total knee arthroplasty is associated with moderate to severe pain, and effective analgesia is essential to facilitate postoperative recovery. This retrospective cohort study examined the analgesic and rehabilitation outcomes associated with 48-hour continuous femoral nerve block, local infiltration analgesia, or local infiltration analgesia plus adductor canal nerve block. ⋯ Local infiltration analgesia was associated with improved early analgesia and ambulation. The addition of adductor canal nerve block was associated with further improvements in early ambulation and a higher incidence of home discharge.
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Reg Anesth Pain Med · Jul 2013
Comparative StudySleep apnea and total joint arthroplasty under various types of anesthesia: a population-based study of perioperative outcomes.
The presence of sleep apnea (SA) among surgical patients has been associated with significantly increased risk of perioperative complications. Although regional anesthesia has been suggested as a means to reduce complication rates among SA patients undergoing surgery, no data are available to support this association. We studied the association of the type of anesthesia and perioperative outcomes in patients with SA undergoing joint arthroplasty. ⋯ Barring contraindications, neuraxial anesthesia may convey benefits in the perioperative outcome of SA patients undergoing joint arthroplasty. Further research is needed to enhance an understanding of the mechanisms by which neuraxial anesthesia may exert comparatively beneficial effects.