Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2007
Randomized Controlled Trial Comparative StudyMedial branch blocks versus pericapsular blocks in selecting patients for percutaneous cryodenervation of lumbar facet joints.
At many institutions, it is not practically feasible to perform a series of controlled or placebo-controlled medial branch blocks on several facet joints in order to select patients for facet joint rhizotomy. As for uncontrolled blocks, there is no proof that medial branch blocks are superior to other types of blocks. This study was performed to compare medial branch blocks to simple pericapsular blocks for the selection of patients for lumbar facet joint cryodenervation. ⋯ Our results suggest that uncontrolled medial branch blocks are superior to pericapsular blocks in selecting patients for facet joint cryodenervation, but both blocks work. If serial controlled blocks cannot be used, lumbar facet joint pain remains a diagnostic dilemma.
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Reg Anesth Pain Med · Jan 2007
Epidural catheter placement in neonates: sonoanatomy and feasibility of ultrasonographic guidance in term and preterm neonates.
We report the first prospective sonoanatomic study in neonates with the aim to perform ultrasonographic-guided epidural catheter placement in this age group. ⋯ Ultrasound examination of the spinal cord anatomy provides valuable information for epidural catheter placement in neonates. Ultrasonography enables a real-time identification of the tip of the needle within the epidural space and a visualization of the spread of local anesthetic in these patients.
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Reg Anesth Pain Med · Jan 2007
Randomized Controlled Trial Comparative StudySingle-injection brachial plexus anesthesia for arteriovenous fistula surgery of the forearm: a comparison of infraclavicular coracoid and axillary approach.
The surgical site for the creation of an arteriovenous fistula at the lateral aspect of the distal forearm may be faster and more effectively blocked with the infraclavicular coracoid approach than with the axillary approach for brachial plexus block. ⋯ Blockade of the musculocutaneous nerve developed faster with the infraclavicular coracoid approach than with the axillary approach. The infraclavicular coracoid approach may be preferable in patients scheduled for the creation of an arteriovenous fistula at the forearm.
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Reg Anesth Pain Med · Jan 2007
Case Reports Clinical TrialFalls associated with lower-extremity-nerve blocks: a pilot investigation of mechanisms.
Documented falls after lower-extremity-nerve blocks are rare. We believe this paucity of documented falls is the result of underreporting and the lack of serious complications resulting from these falls. In addition, the mechanism(s) for falls after lower-extremity-nerve blocks has not been elucidated. ⋯ Lower-extremity-nerve blocks result in decreased leg stiffness and lateral instability, which may lead to difficulty with pivoting maneuvers.