Canadian journal of anaesthesia = Journal canadien d'anesthésie
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In this narrative review, we aim to provide the pathophysiology and diagnostic criteria of the piriformis syndrome (PS), an underdiagnosed cause of buttock and leg pain that can be difficult to treat. Based on existing evidence, frequencies of clinical features are estimated in patients reported to have PS. In view of the increasing popularity of ultrasound for intervention, the ultrasound-guided technique in the treatment of PS is described in detail. ⋯ Piriformis syndrome continues to be a controversial diagnosis for sciatic pain. Electrophysiological testing and nerve blocks play important roles when the diagnosis is uncertain. Injection of local anesthetics, steroids, and botulinum toxin into the piriformis muscle can serve both diagnostic and therapeutic purposes. An ultrasound-guided injection technique offers improved accuracy in locating the piriformis muscle. Optimizing the therapeutic approach requires an interdisciplinary evaluation of treatment.
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Randomized Controlled Trial Comparative Study
Oral and intravenous thyroxine (T4) achieve comparable serum levels for hormonal resuscitation protocol in organ donors: a randomized double-blinded study.
Thyroxine (T4) administration is advocated in the management of organ donors; however, the bioavailability of oral thyroxine is unknown in this patient population. ⋯ Orally administered T4 is well absorbed and achieves a bioavailability of approximately 91-93% of intravenous T4 in organ donors. Inotropic/vasopressor requirements and hemodynamic responses following oral or intravenous thyroxine administration were comparable. Oral T4 is suitable for hormonal therapy for organ donors. This trial was registered at www.clinicaltrials.gov : NCT00238030.