Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2011
Comparative StudyInterventional pain physicians' experiences of and attitudes toward surgical privileging.
No consensus guidelines exist on surgical privilege credentialing for nonsurgeons. We queried a group of academic interventional pain physicians about their experiences acquiring such credentials after training, how this process reflected their training, and their current attitudes toward both processes. ⋯ Experience doing implantation procedures during fellowship training and subsequent experience with hospital surgical credentialing seems to vary widely, even among interventional pain physicians associated with academic training programs.
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Reg Anesth Pain Med · Sep 2011
Case ReportsRetained stimulating perineural catheters: a report of four cases.
As the use of ambulatory continuous peripheral nerve blocks continues to grow, new management issues will inevitably arise. Previous descriptions of difficult catheter removal due to cutting, knotting, or kinking of the catheter have involved inpatients. A series of retained ambulatory interscalene catheters has recently been reported. ⋯ Stimulating perineural catheters may be difficult to remove. This may be particularly problematic for outpatients removing the catheters at home.
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Reg Anesth Pain Med · Sep 2011
Review Comparative StudyIs sciatic nerve block advantageous when combined with femoral nerve block for postoperative analgesia following total knee arthroplasty? A systematic review.
Sciatic nerve block (SNB) is commonly performed in combination with femoral nerve block (FNB) for postoperative analgesia following total knee arthroplasty (TKA). This systematic review examines the effects of adding SNB to FNB for TKA compared with FNB alone on acute pain and related outcomes. Four intermediate-quality randomized and 3 observational trials, including a total of 391 patients, were identified. ⋯ Only 2 trials specifically assessed posterior knee pain. We were unable to uncover any clinically important analgesic advantages for SNB beyond 24 hours postoperatively. At present, there is inconclusive evidence in the literature to define the effect of adding SNB to FNB on acute pain and related outcomes compared with FNB alone for TKA.