Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2006
Meta AnalysisThe analgesic effects of perioperative gabapentin on postoperative pain: a meta-analysis.
Gabapentin is an anticonvulsant that has been shown to be effective in the treatment of neuropathic and inflammatory pain in animal and human studies. The analgesic effect of its perioperative use has not been fully elucidated. ⋯ Based on this systematic review, perioperative oral gabapentin is a useful adjunct for the management of postoperative pain that provides analgesia through a different mechanism than opioids and other analgesic agents and would make a reasonable addition to a multimodal analgesic treatment plan.
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Reg Anesth Pain Med · May 2006
Randomized Controlled Trial Comparative StudyThoracic paravertebral block: influence of the number of injections.
The purpose of this study was to assess the radiographic and clinical distribution of 1 to 4 paravertebral injections by use of the same total volume of local anesthetic mixture. ⋯ The main finding of the present study was that multiple paravertebral injections resulted in more reliable radiographic and clinical distribution compared with a single-injection technique.
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Reg Anesth Pain Med · May 2006
Case ReportsEpidural spread after continuous cervical paravertebral block: a case report.
This report illustrates epidural spread after continuous cervical paravertebral block (CCPVB). By fluoroscopy, it also explains the mechanism of the complication. ⋯ Continuous cervical paravertebral block is a relatively new, but generally well-accepted, modality for postoperative pain control after major surgery to the upper limb. Epidural spread is recognized as a complication. In this particular case, medial placement of the catheter was possibly caused by unintentional medial direction of the bevel of the Tuohy needle. Meticulous attention to the direction of the needle bevel and early recognition and management of adverse events are mandatory. The same principles may apply for continuous thoracic, lumbar, and sacral paravertebral blocks.
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Reg Anesth Pain Med · May 2006
Randomized Controlled Trial Comparative StudyComparison of analgesic methods for total knee arthroplasty: metabolic effect of exogenous glucose.
This study was set up to assess whether postoperative suppression of gluconeogenesis by dextrose infusion would be influenced by continuous peripheral nerve block (CPNB) with local anesthetics, in comparison with epidural and with intravenous analgesia. ⋯ Excellent analgesia was achieved in the epidural and continuous nerve block groups. Postoperative gluconeogenesis was totally suppressed by dextrose infusion independent of the analgesia technique with no change in glucose utilization.
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Reg Anesth Pain Med · May 2006
Infraorbital nerve block in children: a computerized tomographic measurement of the location of the infraorbital foramen.
Infraorbital nerve blocks are performed in children undergoing cleft-lip surgery and endoscopic sinus surgery. The nerve exits the maxilla at the level of the infraorbital foramen. A sensory block of the infraorbital nerve can be performed by use of an intraoral route or an extraoral route. The objective of this study was to derive a mathematical formula to determine the position of the infraorbital foramen. ⋯ Our study found a linear correlation with age to the distance of the infraorbital foramen. This anatomic knowledge of the location of the infraorbital foramen may facilitate correct positioning of the needle. Future studies on the use of this formula with anatomic coordinates should be performed to test the validity of this formula.