Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2017
Clinical Efficacy of an Ultrasound-Guided Greater Occipital Nerve Block at the Level of C2.
The purpose of this prospective open-label study was to investigate the analgesic effects of an ultrasound-guided greater occipital nerve (GON) block at the level of C2, as the nerve courses superficially to the obliquus capitis inferior muscle. ⋯ This prospective open-label study demonstrated successful blockade of the GON at the level of C2 using a novel ultrasound-guided technique. Significant reductions in pain scores were observed over the 4-week study period, and no adverse events were reported. The observations from this study provide important preliminary data for future randomized trials involving patients with occipital neuralgia and cervicogenic headache.
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Reg Anesth Pain Med · Jan 2017
Observational StudyAnesthetic and Obstetrical Factors Associated With the Effectiveness of Epidural Analgesia for Labor Pain Relief: An Observational Population-Based Study.
The effectiveness of labor epidural analgesia is difficult to explore, as it includes the maternal satisfaction with analgesia as well as the overall childbirth experience. In this population-based study, we sought to identify factors associated with the effectiveness of epidural analgesia for labor pain relief. ⋯ At the population level, most women found epidural analgesia effective for labor pain relief, but specific attention should be paid to obese parturients and multiparous women not receiving oxytocin. High epidural effectiveness with patient-controlled analgesia should promote an increased use of this method.
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Reg Anesth Pain Med · Jan 2017
A Cadaveric Study Evaluating the Feasibility of an Ultrasound-Guided Diagnostic Block and Radiofrequency Ablation Technique for Sacroiliac Joint Pain.
Ultrasound (US)-guided diagnostic block/radiofrequency ablation (RFA) along the lateral sacral crest (LSC) has been proposed for managing sacroiliac joint (SIJ) pain. We sought to investigate (1) ease of visualization of bony landmarks using US; (2) consistency of US-guided needle placement along the LSC; and (3) percentage of the posterior sacral network (PSN) innervating the SIJ complex that would be captured if an RFA strip lesion were created between the needles. ⋯ The findings suggest that US-guided needle placement along the LSC is consistent and could capture most or all of the PSN. A clinical study evaluating the outcomes of this technique is in progress.
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Although pediatric regional anesthesia has a demonstrated record of safety, adverse events, especially those related to block performance issues, still may occur. To reduce the frequency of those events, we developed a Regional Anesthesia Time-Out Checklist using expert opinion and the Delphi method. ⋯ The Delphi method and human factors principles enabled the creation of a Regional Anesthesia Time-Out Checklist based on published and experiential knowledge of adverse events. Usability of the checklist was supported through the results of a pilot study.