Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2008
Biography Historical ArticleRegional anesthesia: advancing the practice of medicine; the 2008 Gaston Labat Award lecture.
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Reg Anesth Pain Med · Sep 2008
Review Practice GuidelineRegional anesthesia in anesthetized or heavily sedated patients.
The American Society of Regional Anesthesia and Pain Medicine (ASRA) Practice Advisory on Neurologic Complications in Regional Anesthesia and Pain Medicine includes an evidence- and expert opinion-based section on performing procedures on anesthetized or heavily sedated patients. This practice advisory is based on existing scientific literature, pathophysiological principles, and expert opinion. ⋯ The advisory panel also considered whether or not the ability to recognize and report symptoms could actually affect the occurrence of nerve injury or local anesthetic systemic toxicity. The advisory contains recommendations pertaining to both adult and pediatric patients.
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Reg Anesth Pain Med · Sep 2008
Practice GuidelineASRA Practice Advisory on Neurologic Complications in Regional Anesthesia and Pain Medicine.
Neurologic complications associated with regional anesthesia and pain medicine practice are extremely rare. The ASRA Practice Advisory on Neurologic Complications in Regional Anesthesia and Pain Medicine addresses the etiology, differential diagnosis, prevention, and treatment of these complications. This Advisory does not focus on hemorrhagic and infectious complications, because they have been addressed by other recent ASRA Practice Advisories. The current Practice Advisory offers recommendations to aid in the understanding and potential limitation of neurologic complications that may arise during the practice of regional anesthesia and pain medicine.
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Reg Anesth Pain Med · Sep 2008
Case ReportsLong-axis ultrasound imaging of the nerves and advancement of perineural catheters under direct vision: a preliminary report of four cases.
Ultrasound allows visualization of in plane needle insertion toward a nerve and the perineural spread of local anesthetic (LA) solution. However, advancement and final positioning of perineural catheters is difficult to visualize. We assessed the feasibility of long axis nerve scans for controlling perineural catheter placement. ⋯ This short case series suggests that long axis imaging of the nerve, the needle, and the catheter allows visualization of a catheter's advancement. Using to-and-fro movements, and slight rotation the needle's bevel, the catheter may be maneuvered under the ultrasound beam, which facilitates correct positioning.