Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2006
Randomized Controlled Trial Comparative StudyIs there any need for expanding the perineural space before catheter placement in continuous femoral nerve blocks?
There is debate regarding the benefit of perineural space expansion before catheter placement in continuous femoral nerve block. This question is addressed in this prospective, comparative, and randomized study. ⋯ Expansion of the perineural space with D5W is useful for catheter placement in continuous femoral nerve block.
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Reg Anesth Pain Med · Sep 2006
Fluoroscopically guided epidural block in the thoracic and lumbar regions.
Epidural block in the midthoracic region is difficult, even with fluoroscopically guided methods, because of the inability to view the interlaminar space on radiographs. We have, therefore, proposed fluoroscopically guided epidural block for the midthoracic region, as well as other thoracic and lumbar regions, by use of the pedicle as a landmark to show the height of the interlaminar space. ⋯ This study showed the usefulness of our fluoroscopically guided method for the midthoracic region, and other thoracic and lumbar regions. We propose an alternative method for a blind epidural approach at Th6-7, Th9-10, Th12-L1, or L3-4.
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Reg Anesth Pain Med · Sep 2006
Ultrasound-guided lumbar medial-branch block: a clinical study with fluoroscopy control.
For diagnostic lumbar medial-branch blocks, fluoroscopic guidance is considered mandatory, but this technique comes with radiation exposure. The clinical feasibility of the ultrasound-guided lumbar medial-branch block has been demonstrated. We evaluated the success rate and validity of this new method by use of fluoroscopy controls in patients previously diagnosed with lumbar facet joint-mediated pain. ⋯ Ultrasound-guided lumbar medial-branch blocks can be performed with a high success rate. However, to be completely independent from fluoroscopy controls, this technique requires further studies regarding the detection of intravascular spread.
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Reg Anesth Pain Med · Sep 2006
Local anesthetics in lipid-depot formulations--neurotoxicity in relation to duration of effect in a rat model.
The aim of this study was to investigate the possible local neurotoxicity of a number of lipid-depot formulations of local anesthetics in relation to their duration of action in sciatic-nerve block. ⋯ The findings suggest that depot formulations of local anesthetics with advantageous pharmaceutical and pharmacologic properties can be prepared by use of bupivacaine as the active component and natural lipids as carriers. A favorable balance between effects and toxicity may conceivably be obtained. After supplemental testing in more sensitive models for toxicity, such formulations could be candidates for clinical trials.