Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2005
Randomized Controlled Trial Comparative Study Clinical TrialThe value of adding sciatic block to continuous femoral block for analgesia after total knee replacement.
The benefit of adding a sciatic nerve block to the femoral block to improve analgesia after total knee replacement is controversial. The aim of this study is to address this controversy in a prospective, comparative, and randomized study. ⋯ During the 36 hours immediately after total knee replacement, the combination of continuous femoral and sciatic nerve blocks improves analgesia while decreasing morphine consumption and PONV.
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Reg Anesth Pain Med · Mar 2005
Ultrasound-guided musculocutaneous nerve block: a description of a novel technique.
Localizing the musculocutaneous nerve for neural blockade is crucial to providing surgical anesthesia for the distal forearm. We present a novel approach for localizing and anesthetizing the musculocutaneous nerve. ⋯ Ultrasound can facilitate the localization and local anesthetic block of the musculocutaneous nerve.
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Reg Anesth Pain Med · Mar 2005
Randomized Controlled Trial Clinical TrialDecreased postpartum use of oral pain medication after a single dose of epidural morphine.
Pain after vaginal delivery may result from episiotomy, perineal laceration, or uterine involution. Many women have indwelling epidural catheters in place at delivery. We hypothesized that a small dose of epidural morphine would be an effective strategy for postpartum analgesia. ⋯ These results suggest that epidural morphine decreases the need for oral pain medication in the first 24 hours postpartum. No significant dose-dependent side effects were found.
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Reg Anesth Pain Med · Mar 2005
Randomized Controlled Trial Comparative Study Clinical TrialAnalgesia after arthroscopic rotator cuff repair: subacromial versus interscalene continuous infusion of ropivacaine.
A continuous infusion of local anesthetic in the subacromial space has been shown to provide superior pain relief compared with placebo. This technique has been considered as an alternative to a continuous interscalene infusion. The aim of our study is to compare these 2 techniques for pain relief after arthroscopic rotator cuff repair. ⋯ After arthroscopic rotator cuff repair, continuous interscalene block provides better analgesia compared with continuous subacromial infusion but with an increased incidence of minor side effects.
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Reg Anesth Pain Med · Mar 2005
ReviewLumbar discography: a comprehensive review of outcome studies, diagnostic accuracy, and principles.
Since its advent more than 50 years ago, the use of discography has been mired in controversy. The purpose of this review is to provide a clinical overview of lumbar discography and discogenic back pain, with special emphasis on determining the accuracy of discography and whether or not the procedure improves outcomes for surgery. ⋯ Although discography, especially combined with CT scanning, may be more accurate than other radiologic studies in detecting degenerative disc disease, its ability to improve surgical outcomes has yet to be proven. In the United States and Europe, there are inconsistencies in the use of lumbar discography such that it is routinely used before IDET, yet only occasionally used before spinal fusion.