Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · May 2014
Randomized Controlled Trial Comparative StudyContinuous Versus Single-Injection Sciatic Nerve Block Added to Continuous Femoral Nerve Block for Analgesia After Total Knee Arthroplasty: A Prospective, Randomized, Double-Blind Study.
The benefit of adding sciatic nerve block (SNB) to femoral nerve block to improve analgesia after total knee arthroplasty (TKA) is uncertain. We hypothesized that the effective duration of single-injection SNB is too short to improve postoperative analgesia and that this contributes to conflicting results on the efficacy of SNB after TKA. We evaluated this hypothesis in a prospective double-blind randomized controlled trial. ⋯ The combination of continuous femoral and SNB provides a superior opioid sparing effect and improves analgesia after TKA.
-
Reg Anesth Pain Med · May 2014
Randomized Controlled TrialA Prospective Randomized Observer-Blinded Study to Assess Postoperative Analgesia Provided by an Ultrasound-Guided Bilateral Thoracic Paravertebral Block for Children Undergoing the Nuss Procedure.
This prospective, randomized, single-blinded study evaluates the effectiveness of the ultrasound-guided bilateral thoracic paravertebral (BTPV) block for providing postoperative pain control in children undergoing the Nuss procedure. ⋯ Ultrasound-guided BTPV block provides improved postoperative analgesia for children undergoing the Nuss procedure as compared with intravenous PCA and decreases the incidence of postoperative behavioral disturbance.
-
Reg Anesth Pain Med · May 2014
Correlation Between Altered Central Pain Processing and Concentration of Peritoneal Fluid Inflammatory Cytokines in Endometriosis Patients With Chronic Pelvic Pain.
Translational research has not yet elucidated whether alterations in central pain processes are related to peripheral inflammatory processes in chronic pain patients. We tested the hypothesis that the concentration of cytokines in the peritoneal fluid of endometriosis patients with chronic pain correlate with parameters of hyperexcitability of the nociceptive system. ⋯ Positive correlations between concentration of some cytokines in the peritoneal fluid and amplification of central pain processing were found. The results suggest that inflammatory mechanisms may be important in the pathophysiology of altered central pain processes and that cytokines produced in the environment of endometriosis could act as mediators between the peripheral lesion and changes in central nociceptive processes.