Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2007
Multicenter StudyFactors predicting success and failure for cervical facet radiofrequency denervation: a multi-center analysis.
The concept of radiofrequency denervation has recently come under question in light of several studies showing minimal to no benefit. One possibility proposed for these negative outcomes is poor selection criteria. Unlike virtually all other spine interventions, the factors associated with success and failure for cervical facet denervation have yet to be determined. The purpose of this study is to determine which demographic, clinical and treatment factors are associated with cervical facet radiofrequency denervation outcomes. ⋯ Selecting patients based on key clinical variables may increase the chance of treatment success for cervical facet radiofrequency denervation.
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Reg Anesth Pain Med · Nov 2006
Randomized Controlled Trial Multicenter StudyFentanyl iontophoretic transdermal system for acute-pain management after orthopedic surgery: a comparative study with morphine intravenous patient-controlled analgesia.
The fentanyl HCl iontophoretic transdermal system (ITS) has been demonstrated in clinical trials to be safe and effective for acute-pain management after several types of major surgery. The current study compared the efficacy, safety, and convenience of fentanyl ITS with morphine intravenous patient-controlled analgesia (IV PCA) for acute-pain management after unilateral total-hip replacement (THR). ⋯ Results of this study demonstrate fentanyl ITS and a standard regimen of morphine IV PCA were comparable methods of pain control for management of acute postoperative pain after THR, on the basis of the PGA success ratings and pain intensity in the first 24 hours of treatment.
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Reg Anesth Pain Med · Sep 2005
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA prospective crossover comparison study of the single-needle and multiple-needle techniques for facet-joint medial branch block.
Medial branch blocks have been widely described in the literature as a diagnostic tool for facet joint pain. Recently, a new "single-needle' technique was described that is purported to be equally accurate, and in some respects, superior to the standard multiple-needle technique. To date, no studies have been performed that compared these 2 techniques. ⋯ Our results indicate that the single-needle technique takes less time to perform and causes less patient discomfort than does the standard technique but provides the same degree of accuracy. More studies with larger sample sizes are needed to corroborate these results and explore the effect the single-needle approach has on the rate of false-positive medial branch blocks.
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Reg Anesth Pain Med · Jul 2005
Multicenter StudyClinical evaluation of the lateral sagittal infraclavicular block developed by MRI studies.
Lateral sagittal infraclavicular block by single injection has a faster performance time and causes less discomfort than does axillary block by multiple injections. This prospective, descriptive, multicenter study assessed block effectiveness, onset time, and incidence of adverse events and verified the noninvasive measurements from magnetic resonance imaging (MRI). ⋯ Block effectiveness (91%) and onset time (20 minutes) were satisfactory and comparable to the vertical paracoracoid approach. The low rate of axillary vessel punctures (2%) may be the most important advantage of this block. The needle insertion depth measurements confirmed the MRI findings, but the dorsal angle was steeper than predicted.
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Reg Anesth Pain Med · Nov 2002
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialPostoperative analgesia by femoral nerve block with ropivacaine 0.2% after major knee surgery: continuous versus patient-controlled techniques.
This prospective study compared the efficacy and adverse effects after knee surgery of ropivacaine 0.2% administered as patient-controlled femoral analgesia (PCFA), as a continuous femoral infusion (Inf), or as both (PCFA+Inf). ⋯ All 3 strategies provided effective pain relief. PCFA resulted in a lower consumption of ropivacaine (toxic and financial impact). PCFA + Inf does not improve postoperative analgesia.