Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 1998
Computed tomographic study of lumbar (L3-4) epidural depth and its relationship to physical measurements in young adult men.
This study was performed to devise a method for predicting epidural depth more accurately with a variety of physical measurements not previously studied. ⋯ Addition of the physical parameters such as waist circumference/neck circumference ratio or BMI results in a higher predictive value for epidural depth than use of more traditional physical parameters such as weight/height ratio and/or weight only. The value of Sl-Ep is independent of any physical parameters. Thus, the significant correlation between the physical measurements and the epidural depth seems to be due only to obesity-related factors.
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Reg Anesth Pain Med · May 1998
The practice of peripheral nerve blocks in the United States: a national survey [p2e comments].
A nationwide survey was conducted in order to describe practice patterns surrounding the use of peripheral nerve blocks (PNBs). ⋯ Although this survey indicates that regional anesthesia is frequently practiced in the United States, PNBs and particularly PNBs of the lower extremities remain underutilized.
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Reg Anesth Pain Med · May 1998
Clinical Trial Controlled Clinical TrialPostoperative epidural injection of saline can shorten postanesthesia care unit time for knee arthroscopy patients.
The goal of this prospective, double-blind study was to ascertain if the postanesthesia care unit (PACU) stay of outpatients receiving epidural anesthesia for knee arthroscopy is decreased by injection of epidural saline at the end of the case. ⋯ Patients receiving epidural anesthesia for knee arthroscopy had a shorter PACU stay if they received an injection of saline into the epidural space at the end of surgery.
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The role of sympathetic blocks in pain therapy is examined in the light of changing concepts of pain pathophysiology. A critical review of the literature also sought to develop an evidence-based analysis of outcome studies to provide recommendations for appropriate applications of sympathetic blocks, together with ideas for further clinically based research. ⋯ Changes in the understanding of CRPS disorders and the role of the sympathetic nervous system in neuropathic pain has changed both the diagnostic and management strategies for these pain states. The sensitivity and specificity of response to sympathetic blocks in establishing their value at diagnostic aids will not be fully established without further clinical study. Further use of intravenous regional blocks or diagnostic intravenous infusions remains questionable. Preventive and therapeutic use of sympathetic blocks in herpes zoster pain remains open to well-controlled study.