Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2002
Randomized Controlled Trial Comparative Study Clinical TrialContinuous subgluteus sciatic nerve block after orthopedic foot and ankle surgery: comparison of two infusion techniques.
To compare continuous infusion or a patient-controlled technique for postoperative analgesia after foot surgery, using a new subgluteus approach for continuous sciatic nerve block. ⋯ The continuous subgluteus sciatic nerve block represents an easy and reliable option for postoperative analgesia after foot surgery; using a patient controlled rather than a continuous infusion technique reduces the consumption of local anesthetic solution without affecting the quality of pain relief.
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Reg Anesth Pain Med · Mar 2002
Randomized Controlled Trial Clinical TrialThe efficacy of continuous intrabursal infusion with morphine and bupivacaine for postoperative analgesia after subacromial arthroscopy.
The aim of this study was to determine whether an intrabursal morphine and bupivacaine mixed infusion provides useful analgesia for prolonged pain relief after subacromial arthroscopic operation. ⋯ The continuous intrabursal infusion method resulted in a decreased perception of rest pain and reduced supplemental analgesics requirement for 2 days postoperatively.
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Reg Anesth Pain Med · Mar 2002
Randomized Controlled Trial Clinical TrialBuprenorphine added to the local anesthetic for axillary brachial plexus block prolongs postoperative analgesia.
Buprenorphine added to local anesthetic solutions for supraclavicular block was found to triple postoperative analgesia duration in a previous study when compared with local anesthetic block alone. That study, however, did not control for potentially confounding factors, such as the possibility that buprenorphine was affecting analgesia through intramuscular absorption or via a spinal mechanism. To specifically delineate the role of buprenorphine in peripherally mediated opioid analgesia, the present study controlled for these 2 factors. ⋯ Buprenorphine-local anesthetic axillary perivascular brachial plexus block provided postoperative analgesia lasting 3 times longer than local anesthetic block alone and twice as long as buprenorphine given by IM injection plus local anesthetic-only block. This supports the concept of peripherally mediated opioid analgesia by buprenorphine.
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In thoracic epidural anesthesia, the "loss of resistance" technique is the standard technique for the identification of the epidural space (EDS), the feedback to the operator is often solely tactile. Our aim was to establish ultrasonography for the prepuncture demonstration of the anatomic structures surrounding the thoracic EDS and to evaluate its precision and imaging quality. ⋯ US showed good correlation with MRI, which is a standard imaging technique for the depiction of the spine. We anticipate that prepuncture ultrasonography may facilitate thoracic epidural anesthesia by needle placement.