Annals of palliative medicine
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Ultrasound-guided costoclavicular (CC) brachial plexus blocks (BPBs) are a novel approach for nerve block in upper extremity surgery. However, comparisons between CC-BPB and conventional supraclavicular (SC) BPB have not clearly delineated the benefits or costs of either method. ⋯ CC-BPB is a safe and efficient approach for upper extremity surgery.
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Randomized Controlled Trial
A randomized trial of the dural puncture epidural technique combined with programmed intermittent epidural boluses for labor analgesia.
Continuous epidural infusion (CEI) can provide analgesia during labor. The dural puncture epidural (DPE) technique is used to accelerate the onset of neuraxia anesthesia. The primary objective of this study was to compare the percentage of patients that received adequate labor analgesia following an injection of 0.08% epidural ropivacaine via the DPE and CEI techniques combined with the PIEB mode of maintenance. ⋯ The percentage of parturients with adequate analgesia at 10 minutes was higher with DPE + PIEB compared to CEI + PIEB. Furthermore, the DPE + PIEB mode was associated with a faster time to a VAS score ≤30 mm.
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Bereavement care is best conceptualized as a preventive model of care. It is an integral component of palliative care where support for the family begins at the time of diagnosis and continues beyond the death of the patient. Even though grief is a normal response to loss, the death of a loved one is believed to be the most powerful stressor in everyday life with the potential to cause great distress in all those closely associated with the deceased. ⋯ Despite this, research into the experience of bereaved caregivers is limited. As such, an opportunity exists to identify ways to help family caregivers not only cope with the death of their loved one but also to help families prepare for the death ahead of time. In this article, we offer guidelines about how best to support family caregivers before and after the death of the patient, drawing on the palliative care and bereavement literature.