Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2012
Editorial CommentConnective tissues associated with peripheral nerves.
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Reg Anesth Pain Med · Jul 2012
Real-time evaluation of diffusion of the local anesthetic solution during peribulbar block using ultrasound imaging and clinical correlates of diffusion.
The aims of this prospective observational study were to assess the incidence of intraconal spread during peribulbar (extraconal) anesthesia by real-time ultrasound imaging of the retro-orbital compartment and to determine whether a complete sensory and motor block (with akinesia) of the eye is directly related to the intraconal spread. ⋯ Ultrasound imaging provides information of local anesthetic spread within the retro-orbital space, which might assist in the prediction of block success.
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Reg Anesth Pain Med · Jul 2012
Effect of adjuvant drugs on the action of local anesthetics in isolated rat sciatic nerves.
There is increasing clinical use of adjuvant drugs to prolong the duration of local anesthetic-induced block of peripheral nerves. However, the mechanistic understanding regarding drug interactions between these compounds in the periphery is quite limited. Accordingly, we undertook this study to determine whether selected adjuvant drugs are efficacious in blocking action potential propagation in peripheral nerves at concentrations used clinically and whether these drugs influence peripheral nerve block produced by local anesthetics. ⋯ These results suggest that the reported clinical efficacy of clonidine, buprenorphine, and dexamethasone influences the actions of local anesthetics via indirect mechanisms. Further identification of these indirect mechanisms may enable the development of novel approaches to achieve longer-duration, modality-specific peripheral nerve block.