Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2010
ReviewEvidence-based medicine: Assessment of ultrasound imaging for regional anesthesia in infants, children, and adolescents.
This review was performed to evaluate and discuss the quality and outcomes of studies assessing ultrasound imaging in pediatric regional anesthesia. Literature searches were conducted using MEDLINE and EMBASE, combining the search term "ultrasonography" with "regional anesthesia," "nerve block," "epidural anesthesia," and "spinal anesthesia," with the limit of 0 to 18 years. ⋯ The search resulted in 211 total publications in pediatric literature, of which 12 were included in the evaluation of peripheral nerve blocks and 12 in the evaluation of neuraxial anesthesia. Although there is some evidence to support ultrasound for various outcomes in pediatric regional anesthesia, more randomized controlled studies with sufficient power are required to further support these findings and to evaluate the potential for ultrasound to reduce complications for regional anesthesia in children.
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Reg Anesth Pain Med · Mar 2010
ReviewEvidence-based medicine: ultrasound guidance for truncal blocks.
We performed a systematic search of the medical literature and reviewed the evidence examining success rates and incidence of complications of ultrasound (US) guidance relative to traditional techniques for the following blocks: paravertebral, intercostal, transversus abdominis plane, rectus sheath, and ilioinguinal/iliohypogastric. We included studies of sufficient methodologic quality for review and excluded poor-quality studies. ⋯ Although relatively few studies have compared US guidance with established techniques, the available evidence suggests that the use of US guidance is a safe and effective means to facilitate correct needle placement and adequate spread of local anesthetic for truncal blocks. Further studies are needed to directly compare US guidance to traditional techniques and to clarify potential benefits and limitations of US guidance for truncal blocks.
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Reg Anesth Pain Med · Mar 2010
Randomized Controlled TrialUltrasound does not improve the success rate of a deep peroneal nerve block at the ankle.
The deep peroneal nerve is 1 of 5 nerves anesthetized when performing an ankle block. Multiple techniques of blocking the deep peroneal nerve have been described, but little evidence exists to delineate the efficacy of any one technique. We hypothesized that ultrasound would increase both the success rate and the quality of a deep peroneal nerve block at the ankle. ⋯ The use of ultrasound seems to improve the onset of deep peroneal nerve block at the ankle but does not improve the overall quality of the block.