Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2012
Risk factors for new-onset persistent low-back pain following nonobstetric surgery performed with epidural anesthesia.
The aim of this trial was to identify risk factors for persistent low-back pain (LBP) of new onset following nonobstetric surgery performed with lumbar epidural anesthesia. ⋯ Persistent LBP after nonobstetric surgery performed with lumbar epidural anesthesia is rather rare. Independent risk factors for this untoward outcome are higher body mass index, multiple trials at epidural placement, surgery in the lithotomy position, and operative time exceeding 2½ hrs. These results need to be validated by prospective trials using larger cohorts.
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Reg Anesth Pain Med · Mar 2012
Ultrasound imaging to estimate risk of esophageal and vascular puncture after conventional stellate ganglion block.
The most common techniques to perform stellate ganglion blocks (SGBs) are the blind C6 approach and the fluoroscopic-controlled paratracheal C7 approach, both after manual dislocation of the large vessels. Complications due to vascular or esophageal puncture have been reported. The goal of this ultrasound imaging study was to determine how frequently hazardous structures are located along the needle path of conventional SGB and to determine the influence of the dislocation maneuver on their position. ⋯ The esophagus and relevant arteries were frequently located in the needle path of conventional SGBs. The dislocation maneuver had a partial impact on moving these structures away from the target and may increase left-sided esophageal puncture risk in certain individuals. Ultrasound (US) imaging is expected to improve the safety of SGB, but it will require clinical trials to confirm this expectation.