Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2011
ReviewClinical trial methodology of pain treatment studies: selection and measurement of self-report primary outcomes for efficacy.
The past century has seen immense progress in the advancement of methodology to evaluate efficacy of treatment interventions for acute and chronic pain. Continuing challenges revolve around how to best select and measure primary efficacy outcomes for a given analgesic trial. ⋯ In the setting of emerging new pain treatment strategies, careful consideration must be given to match current or novel outcome measures to the specific goals of a proposed trial. Future research is needed to directly compare current methods with newer measurement approaches for the critical goal of maximizing validity, reliability, and utility of different outcome measures in clinical trials of pain treatment.
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Reg Anesth Pain Med · Jul 2011
Comparative StudyPatient perceptions of regional anesthesia: influence of gender, recent anesthesia experience, and perioperative concerns.
Anesthesiologists often find that patients would prefer a general anesthetic (GA) to a regional anesthetic (RA) for surgery. We surveyed patients' attitudes to RA in an Australian tertiary-care hospital, hoping to understand the reasons for acceptance or refusal. We explored how 3 main factors influence the patient's choice for subsequent RA: gender, type of anesthetic on the day of surgery, and perioperative concerns. ⋯ More patients, especially females, may accept RA if reassured appropriately about not hearing or seeing the surgery. Once patients have experienced RA, they are more likely to choose it in future. Modification of our discussion and consent process may increase the uptake of RA techniques.
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Reg Anesth Pain Med · Jul 2011
Comparative StudyAnatomy and clinical implications of the ultrasound-guided subsartorial saphenous nerve block.
We evaluated the anatomic basis and the clinical results of an ultrasound-guided saphenous nerve block close to the level of the nerve's exit from the inferior foramina of the adductor canal. ⋯ Ultrasound-guided injection directly caudally from the inferior foramina of the adductor canal, between the sartorius muscle and the femoral artery, seems to be an effective approach for saphenous nerve block.