Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2013
Investigation of current infection-control practices for ultrasound coupling gel: a survey, microbiological analysis, and examination of practice patterns.
Ultrasound coupling gel may serve as a vector for the spread of bacteria and has been the causative agent for significant health care-associated infections. The purpose of this study was to document existing infection-control procedures and level of contamination present within nonsterile ultrasound gel from several clinical departments at a single institution. A second purpose was to examine the effectiveness of clinician education and manufacturer-based ultrasound additives on ultrasound gel contamination and in vitro bacterial proliferation, respectively. ⋯ The source of contamination for in-use ultrasound gel may be of manufacturer or human origin. Because additives to the ultrasound gel are not bactericidal, sterile ultrasound gel should be used for invasive and high-risk cases, and improving infection-control policies is warranted.
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Reg Anesth Pain Med · Sep 2013
Sonoanatomy Relevant for Lumbar Plexus Block in Volunteers Correlated With Cross-sectional Anatomic and Magnetic Resonance Images.
Ultrasound imaging of the anatomy relevant for lumbar plexus block (LPB) is challenging because of its deep anatomic location and the "acoustic shadow" of the overlying transverse processes. A paramedian transverse scan (PMTS) of the lumbar paravertebral region with the ultrasound beam being insonated through the intertransverse space (ITS) and directed medially toward the intervertebral foramen (PMTS-ITS) may overcome the problem of the "acoustic shadow" and allow clear visualization of the anatomy relevant for LPB. This study assessed the feasibility of using PMTS-ITS for imaging the anatomy relevant for LPB in healthy volunteers. ⋯ A PMTS-ITS can be used to image the sonoanatomy relevant for LPB including the lumbar nerve root, lumbar paravertebral space, lumbar plexus, and the psoas compartment.
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Reg Anesth Pain Med · Sep 2013
Promising effects of intravenous lipid emulsion as an antidote in acute tramadol poisoning.
In recent years, research has provided experimental and subjective evidence that intravenous lipid emulsions (ILEs) reverse some hemodynamically considerable poisonings with various drugs. The aim of this study was to investigate the possible antidotal effect of ILE on acute tramadol poisoning. ⋯ Intravenous lipid emulsion significantly reduced mortality due to acute toxicity with tramadol in rabbits, although increasing the ILE dose may cause reverse effects.