Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Feb 2021
Randomized Controlled TrialClinical effect of normal saline injectate into interscalene nerve block catheters given within one hour of local anesthetic bolus on analgesia and hemidiaphragmatic paralysis.
Previous case reports describe the reversal of phrenic nerve blockade from the interscalene nerve block using normal saline injectate washout. This randomized clinical trial aimed to evaluate whether using normal saline injectate to wash out local anesthetic from an interscalene nerve block catheter would restore phrenic nerve and diaphragm function, while preserving analgesia. ⋯ NCT03677778.
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Reg Anesth Pain Med · Feb 2021
Perioperative cannabis use: a longitudinal study of associated clinical characteristics and surgical outcomes.
Despite increases in cannabis use generally and for pain management, data regarding cannabis use in patients undergoing surgery are lacking. This study examined the prevalence of cannabis use among patients undergoing elective surgery and explored differences in clinical characteristics and surgical outcomes between cannabis users and non-cannabis users. ⋯ Cannabis use is relatively low in this surgical population, yet cannabis users have higher clinical pain, poorer scores on quality of life indicators, and higher opioid use before and after surgery. Cannabis users reported similar surgical outcomes, suggesting that cannabis use did not impede recovery.
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Reg Anesth Pain Med · Feb 2021
Observational StudyInfluence of inpatient opioid consumption on persistent use following total knee arthroplasty.
Total knee arthroplasty (TKA) is associated with a high incidence of continued opioid use beyond the expected period of recovery. The aim of this study was to determine the influence of inpatient opioid consumption on the development of persistent use. ⋯ Larger amounts of opioid consumed in the hospital following uncomplicated, primary TKA may not be associated with an increased risk of persistent use at 6 weeks among opioid-naïve patients. Patients may have unique risk factors for prolonged opioid use that may not necessarily be apparent in the early postoperative period.