Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2009
Review Case ReportsRetained intrathecal catheter fragment after spinal drain insertion.
The placement of lumbar spinal drains is being done with increasing frequency to facilitate high-risk surgical procedures. One risk associated with these procedures is catheter shearing, resulting in a retained foreign body in the intrathecal space. Unlike retained epidural fragments, there are no guidelines on the management of this complication. The purpose of this article was to synthesize the literature on this subject to come up with guidelines for preventing and managing this complication. ⋯ A retained intrathecal catheter can be managed conservatively in certain contexts. Periodic follow-up visits, with or without repeat imaging, are recommended in these circumstances.
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Reg Anesth Pain Med · Jul 2009
Randomized Controlled Trial Comparative StudyComparison of the transarterial axillary block and the ultrasound-guided infraclavicular block for upper extremity surgery: a prospective randomized trial.
The transarterial axillary block and the ultrasound-guided infraclavicular block are both effective methods of anesthetizing the upper extremity. This study compares these methods with respect to subjective postoperative dysesthesias, block adequacy, patient comfort, and patient satisfaction. ⋯ There is no significant difference between the 2 techniques in terms of adequacy for surgery and subjective postoperative dysesthesias. The ultrasound-guided infraclavicular block is associated with greater patient comfort and willingness to undergo the same anesthetic when compared with the transarterial axillary block.
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Reg Anesth Pain Med · Jul 2009
Randomized Controlled Trial Comparative StudyUltrasound machine comparison: an evaluation of ergonomic design, data management, ease of use, and image quality.
The use of ultrasound technology for vascular access and regional anesthesia is gaining widespread acceptance among anesthesia providers. As a result, many group practices and medical institutions are considering purchasing ultrasound equipment. Currently, comparative information regarding the ergonomic design, physical and adjustable features, data management, ease of use, cost, and image quality of various ultrasound machines is not available. The primary goal of this investigation was to develop an objective process of evaluating ultrasound equipment before purchase. The process of evaluation used in the current investigation may be used when comparing a variety of medical technologies. ⋯ Anesthesia providers considering an ultrasound equipment purchase should objectively evaluate machine models that have features most important to their own clinical practice. Ergonomic design, physical and adjustable features, data management, ease of use, image quality, and cost are important features to consider when evaluating an ultrasound machine.