Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2013
Randomized Controlled Trial Comparative StudyAdductor Canal Block Versus Femoral Nerve Block for Analgesia After Total Knee Arthroplasty: A Randomized, Double-blind Study.
Quadriceps strength is better preserved after adductor canal block for total knee arthroplasty than femoral nerve block with similar analgesic effect.
pearl -
Reg Anesth Pain Med · Nov 2013
Analysis of Inadvertent Intradiscal and Intravascular Injection During Lumbar Transforaminal Epidural Steroid Injections: A Prospective Study.
Inadvertent intradiscal injection during a lumbar transforaminal epidural steroid injection (TFESI) can be critical given the possibility of discitis and disc degeneration. Intravascular steroid injection can result in devastating neurologic complications. We sought to identify the incidence of intradiscal and intravascular injection during lumbar TFESI and determine whether an aspiration test and static fluoroscopic image can be used to predict intravascular needle placement. ⋯ Inadvertent intradiscal injection during TFESI is not rare. Physicians who perform interventional pain procedures should increase their awareness of related potential complications. The aspiration test and static image of fluoroscope often fail to detect the intravascular injection during the TFESI. Real-time fluoroscopy should be the gold standard for confirming intravascular injection.