Regional anesthesia and pain medicine
-
We examined in a volunteer population whether nerves in the forearm could be seen consistently using ultrasound imaging and whether this new information could have implications for the way we perform regional anesthesia of the median, radial, and ulnar nerves. ⋯ Nerves in the forearm are consistently located using ultrasound. Further confirmation in clinical practice is required.
-
Reg Anesth Pain Med · Sep 2007
Review Case Reports Meta AnalysisBeyond spinal headache: prophylaxis and treatment of low-pressure headache syndromes.
This Evidence-Based Case Management article evaluates and grades the evidence for two anesthesiology-related interventions: prophylaxis after unintentional meningeal puncture and treatment of spontaneous intracranial hypotension (SIH). ⋯ The highest quality randomized controlled trials suggest that prophylactic epidural blood patch (EBP) does not reduce the incidence of headache after unintentional meningeal puncture. The weight of existing literature supports EBP as an initial treatment of SIH, although its effectiveness does not approach that seen when EBP is used to treat meningeal puncture headache.
-
Reg Anesth Pain Med · Sep 2007
Randomized Controlled Trial Comparative StudyContinuous lumbar plexus block provides improved analgesia with fewer side effects compared with systemic opioids after hip arthroplasty: a randomized controlled trial.
A single injection lumbar plexus block for acute pain management after hip surgery is usually limited to the immediate postoperative period. We conducted a randomized controlled trial to determine the effect of a continuous lumbar plexus block on perioperative opioid requirements and pain intensity. ⋯ Continuous lumbar plexus block combined with PCA is superior to PCA alone for postoperative pain management following hip replacement. It reduces opioid requirements, opioid related side effects, and enhances patient satisfaction. However, additional research is required to determine its safety in light of the neurologic injury observed.