Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2006
Efficacy of lidocaine or bupivacaine combined with ephedrine in rat sciatic nerve block.
The adrenergic drug ephedrine inhibits Na(+) current in cultured cells expressing Na(+) channels and provides dose-dependent reversible rat sciatic nerve blockade. The dosage required for peripheral nerve blockade in humans would cause unacceptable cardiovascular side effects. We therefore hypothesized that either lidocaine or bupivacaine would show synergy with ephedrine in a rat sciatic nerve block model, allowing a dose reduction and limiting side effects while improving efficacy. ⋯ A combination of ephedrine with either lidocaine or bupivacaine is unlikely to allow a significant dose reduction because of a lack of synergy. Furthermore, the cardiovascular side effects will limit the maximal tolerable dosage of ephedrine.
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Reg Anesth Pain Med · Jan 2006
Randomized Controlled TrialThe effect of cyclooxygenase-2 inhibition on acute and chronic donor-site pain after spinal-fusion surgery.
The development of chronic pain after spinal-fusion surgery represents a significant source of morbidity. One of the predictive factors for the development of chronic postsurgical pain is inadequate acute postoperative pain management. Further, the up-regulation of cyclooxygenase-2 (COX-2) after surgery may result in neuro-plastic changes that may contribute to a progression from acute to chronic pain. The goal of this prospective, randomized, double-blind study was to examine the effect of perioperative COX-2 inhibition on acute and chronic donor-site pain in patients undergoing spinal-fusion surgery. ⋯ The administration of celecoxib for the first 5 days after spinal-fusion surgery resulted in improved analgesia and a reduction in chronic donor-site pain at 1 year after surgery.
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Reg Anesth Pain Med · Jan 2006
Historical ArticleWhite Knight: ASRA, ASA, and the formation of the ABA.
The original American Society of Regional Anesthesia (1924-1940) was instrumental in the formation of the American Board of Anesthesiology, whereupon competence in anesthesiology was placed on the same footing as every other specialty practice in the United States.
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Reg Anesth Pain Med · Jan 2006
Randomized Controlled TrialEfficacy of intra-articular bupivacaine, ropivacaine, or a combination of ropivacaine, morphine, and ketorolac on postoperative pain relief after ambulatory arthroscopic knee surgery: a randomized double-blind study.
Effective pain relief is important after diagnostic and therapeutic arthroscopic knee surgery to permit early discharge and improve comfort and mobility at home. The aim of this study was to assess the efficacy of bupivacaine, ropivacaine, or a combination of ropivacaine, morphine, and ketorolac injected intra-articularly for postoperative pain relief after arthroscopic knee surgery. ⋯ Addition of morphine and ketolorac to ropivacaine intra-articularly enhances analgesic efficacy of LA, reduces postdischarge analgesic consumption, and improves ADLs without increasing side effects after ambulatory arthroscopic knee surgery.
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Reg Anesth Pain Med · Jan 2006
Historical ArticleThe American Society of Regional Anesthesia: a concise history of the original group-its birth, growth, and eventual dissolution.
The history of the original American Society of the Regional Anesthesia is presented-its birth, growth, and eventual dissolution. Reasons for its dissolution are discussed.