Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Mar 2011
Comparative StudyMinimum effective volume of lidocaine for ultrasound-guided infraclavicular block.
The aim of this study was to determine the minimum effective volume of lidocaine 1.5% with epinephrine 5 μg/mL in 90% of patients (MEV(90)) for single-injection ultrasound-guided infraclavicular block (ICB). ⋯ For single-injection ultrasound-guided ICB, the MEV(90) of lidocaine 1.5% with epinephrine 5 μg/mL is 35 mL. Further dose-finding studies are required for other concentrations of lidocaine, other local anesthetic agents as well as techniques involving multiple injections, a more medial approach to ICB, or precise location of all 3 cords of the brachial plexus.
-
Reg Anesth Pain Med · Mar 2011
Randomized Controlled Trial Comparative StudyCombined versus sequential injection of mepivacaine and ropivacaine for supraclavicular nerve blocks.
An ideal local anesthetic with rapid onset and prolonged duration has yet to be developed. Clinicians use mixtures of local anesthetics in an attempt to combine their advantages. We tested the hypothesis that sequential supraclavicular injection of 1.5% mepivacaine followed 90 secs later by 0.5% ropivacaine speeds onset of sensory block and prolongs duration of analgesia compared with simultaneous injection of the same 2 local anesthetics. ⋯ Sequential injection of 1.5% mepivacaine followed 90 secs later by 0.5% ropivacaine provides no advantage compared with simultaneous injection of the same doses.
-
Reg Anesth Pain Med · Mar 2011
Randomized Controlled Trial Comparative Study Clinical TrialUltrasound guidance improves a continuous popliteal sciatic nerve block when compared with nerve stimulation.
Continuous sciatic nerve blockade at the popliteal level effectively alleviates postoperative pain after major foot and ankle surgery. No randomized controlled trials have previously compared the success rate of continuous sciatic nerve sensory blockade between ultrasound and nerve stimulation guidance. In the current study, we tested the hypothesis that ultrasound-guided catheter placement improves the success rate of continuous sciatic nerve sensory blockade compared with catheter placement with nerve stimulation guidance. ⋯ Ultrasound guidance used for sciatic catheter placement improves the success rate of sensory block, number of needle passes, patient satisfaction during catheter placement, and morphine consumption compared with nerve stimulation guidance.
-
Reg Anesth Pain Med · Mar 2011
Randomized Controlled Trial Comparative StudyPosterior versus anterolateral approach interscalene catheter placement: a prospective randomized trial.
Two distinctly different approaches to interscalene catheter placement have been in common use for close to a decade. This prospective randomized study tested the hypothesis that interscalene catheters placed using the posterior approach would provide a more effective analgesia after shoulder surgery compared with catheters placed using the anterolateral approach. ⋯ Anterolateral interscalene catheters perform more effectively and are procedurally more easily placed compared with catheters placed using the posterior approach.