Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2008
Randomized Controlled Trial Comparative StudyEffects of using the posterior or anterior approaches to the lumbar plexus on the minimum effective anesthetic concentration (MEAC) of mepivacaine required to block the femoral nerve: a prospective, randomized, up-and-down study.
To evaluate if psoas compartment block requires a larger concentration of mepivacaine to block the femoral nerve than does an anterior 3-in-1 femoral nerve block. ⋯ Using a posterior psoas compartment approach to the lumbar plexus does not increase the minimum effective anesthetic concentration of mepivacaine required to block the femoral nerve as compared with the anterior 3-in-1 approach, and provides better quality of intraoperative anesthesia due to the more reliable block of the lateral femoral cutaneous and obturator nerves.
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Reg Anesth Pain Med · Jan 2008
Randomized Controlled TrialEffect of preemptive epidural analgesia on cytokine response and postoperative pain in laparoscopic radical hysterectomy for cervical cancer.
Surgical stress and general anesthesia suppress immune function. Preemptive epidural analgesia can affect the perioperative immune responses, and influence cancer management. ⋯ Preemptive epidural analgesia is a reasonable approach for potentially controlling perioperative immune function and preventing postoperative pain in patients undergoing cancer surgery.
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Reg Anesth Pain Med · Jan 2008
Continuous peripheral nerve block for postoperative pain control at home: a prospective feasibility study in children.
We assessed the feasibility and efficacy of postoperative pain control by continuous peripheral nerve blockade (CPNB) in children after early home discharge under parental surveillance. ⋯ Shortening hospital stays with the use of at-home CPNB under sole parental supervision is feasible, after selecting children with a suitable family environment.
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Major nerves and vessels run alongside each other in a "neurovascular bundle" kept together by connective tissue that is often referred to by anatomists, surgeons, and anesthesiologists as the "sheath." Our goal was to macroscopically demonstrate the brachial plexus sheath in embalmed and fresh cadaver dissections. ⋯ We observed a macroscopic fibrous structure surrounding the plexus, which was filled with loose connective tissue lacking any apparent organization.