Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2010
Randomized Controlled TrialUltrasound provides a reliable test of local anesthetic spread.
We predicted that practitioners could identify injectate spread in a model of ultrasound-guided peripheral nerve block. ⋯ This study shows that ultrasound is a reliable method of detecting injectate spread in a gelatin phantom model.
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Reg Anesth Pain Med · Jul 2010
ReviewUltrasound-guided interventional procedures in pain medicine: a review of anatomy, sonoanatomy, and procedures. Part II: axial structures.
There is a growing trend in using ultrasonography in pain medicine as evident by the plethora of published reports. Ultrasound(US) provides direct visualization of various soft tissues and real-time needle advancement and avoids exposing both the health care provider and the patient to the risks of radiation. ⋯ In a previous review, we discussed the challenges and limitations of US, anatomy, sonoanatomy, and techniques of interventional procedures of peripheral structures. In the present review, we discuss the anatomy, sonoanatomy, and US-guided techniques of interventional pain procedures for axial structures and review the pertinent literature.
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Reg Anesth Pain Med · Jul 2010
Prospective survey of patient-controlled epidural analgesia with bupivacaine and hydromorphone in 3736 postoperative orthopedic patients.
Patient-controlled epidural analgesia(PCEA) has been shown to be superior to intravenous patient-controlled analgesics (PCA) for postoperative analgesia after thoracic, abdominal, pelvic, and lower extremity surgery. However, it is unclear which opioid is optimal for PCEA. Hydromorphone has potential advantages, yet there are no data to establish its efficacy and safety. Thus, we prospectively monitored our patients receiving PCEA with bupivacaine combined with hydromorphone after orthopedic surgery. ⋯ Patient-controlled epidural analgesia with bupivacaine and hydromorphone provides effective and safe postoperative analgesia for orthopedic surgery.