Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Mar 2016
Review Meta AnalysisLumbar Neuraxial Ultrasound for Spinal and Epidural Anesthesia: A Systematic Review and Meta-Analysis.
This systematic review examines the evidence for preprocedural neuraxial ultrasound as an adjunct to lumbar spinal and epidural anesthesia in adults. ⋯ We know that neuraxial ultrasound is a useful complement to clinical examination when performing lumbar central neuraxial blocks. It provides anatomical information including the depth of the epidural space, the identity of a given intervertebral level, and the location of the midline and interspinous/interlaminar spaces. This information can be used to successfully guide subsequent needle insertion.Since 2010, new data from RCTs and 1 meta-analysis suggest that neuraxial ultrasound increases the success and reduces the technical difficulty of lumbar central neuraxial blocks. Findings from the meta-analysis suggest that neuraxial ultrasound reduces the risk of traumatic procedures, and thus may possibly contribute to the safety of lumbar central neuraxial blocks.
-
Reg Anesth Pain Med · Nov 2015
Review Meta AnalysisPreventive Acetaminophen Reduces Postoperative Opioid Consumption, Vomiting, and Pain Scores After Surgery: Systematic Review and Meta-Analysis.
Preventive analgesia has been proposed as a potential strategy to reduce postoperative pain. However, there is currently no review that focuses on acetaminophen for preventive analgesia. ⋯ To our knowledge, this is the first review to describe a potential preventive effect of acetaminophen. However, well-conducted randomized controlled trials are necessary to substantiate the conclusions of this review.
-
Reg Anesth Pain Med · Sep 2015
Review Meta AnalysisThe Effects of Perioperative Regional Anesthesia and Analgesia on Cancer Recurrence and Survival After Oncology Surgery: A Systematic Review and Meta-Analysis.
Potentially, perioperative regional anesthesia and analgesia (RA) could influence the outcomes of patients with cancer. The aim of this systematic review and meta-analysis was to evaluate the effects of perioperative RA on survival and cancer recurrence after oncologic surgery. ⋯ Our meta-analysis suggests that RA may improve overall survival but not reduce cancer recurrence after oncologic surgery.
-
Reg Anesth Pain Med · Mar 2015
Review Meta AnalysisObesity and Chronic Pain: Systematic Review of Prevalence and Implications for Pain Practice.
The combination of obesity and pain may worsen a patient's functional status and quality of life more than each condition in isolation. We systematically searched PubMed/MEDLINE and the Cochrane databases for all reports published on obesity and pain. The prevalence of combined obesity and pain was substantial. ⋯ Screening for obesity, pain-related disability, and behavioral disorders as well as monitoring of functional performance should become routine in pain medicine practices. Such an approach requires additional physician and staff training. Further research should focus on better understanding the interplay between these 2 very common conditions and the development of effective treatment strategies.
-
Reg Anesth Pain Med · Sep 2014
Review Meta AnalysisUltrasound-Guided Interventional Procedures in Pain Medicine: A Review of Anatomy, Sonoanatomy, and Procedures. Part V: Knee Joint.
Ultrasound-guided injection in pain medicine is emerging as a popular technique for pain intervention. It can be applied to the intra-articular injection of the knee joint. The first objective of this review was to describe and summarize the anatomy and sonoanatomy of the knee and associated structures relevant for intra-articular injection. The second objective was to examine the feasibility, accuracy, and effectiveness of injections as well as injection techniques.