Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2009
Comparative StudyRedistribution of tissue blood flow after stellate ganglion block in the rabbit.
The goal of this study was to compare tissue blood flow at various sites before and after stellate ganglion block (SGB) and to discuss the redistribution of tissue blood flow after SGB. ⋯ These results indicate that lower limb and visceral blood flow as well as blood flow on the nonblock side are redistributed to the block side after SGB. Redistribution from peripheral tissue may have a more important role than that of visceral blood flow redistribution after SGB.
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Reg Anesth Pain Med · Nov 2009
Randomized Controlled TrialThe transversus abdominis plane block, when used as part of a multimodal regimen inclusive of intrathecal morphine, does not improve analgesia after cesarean delivery.
The transversus abdominis plane (TAP) block has been shown to provide analgesia for lower abdominal wall incisions. We evaluated the efficacy of the TAP block for post-cesarean delivery (CD) patients used as a part of a multimodal regimen. ⋯ The TAP block, when used as part of a multimodal regimen inclusive of intrathecal morphine, does not improve the quality of post-CD analgesia.
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Reg Anesth Pain Med · Nov 2009
Randomized Controlled Trial Comparative StudyA prospective randomized comparison of ultrasound guidance versus neurostimulation for interscalene catheter placement.
Ultrasound (US) imaging facilitates catheter placement adjacent to the most appropriate elements of the brachial plexus, which for shoulder surgery are the C5YC6 roots or superior trunk. Therefore, it was investigated whether such placement would improve catheter effectiveness compared to placement with traditional techniques. ⋯ After shoulder surgery, interscalene catheters placed with US demonstrated improved effectiveness during the first 24 hrs compared with those placed with NS. These catheters were also placed with less needling and a very small reduction in procedure-related pain.
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Reg Anesth Pain Med · Nov 2009
Feasibility and efficacy of ultrasound-guided block of the saphenous nerve in the adductor canal.
Saphenous nerve (SN) block can be technically challenging because it is a small and exclusively sensory nerve. Traditional techniques using surface landmarks and nerve stimulation are limited by inconsistent success rates. This descriptive prospective study assesses the feasibility of performing an ultrasound-guided SN block in the distal thigh. ⋯ In this small descriptive study, ultrasound-guided SN block in the adductor canal was technically simple and reliable, providing consistent nerve identification and block success.
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Reg Anesth Pain Med · Nov 2009
Randomized Controlled Trial Multicenter Study Comparative StudyHemidiaphragmatic paresis can be avoided in ultrasound-guided supraclavicular brachial plexus block.
Supraclavicular brachial plexus block is associated with 50% to 67% incidence of hemidiaphragmatic paresis as a result of phrenic nerve block. We examined whether ultrasound-guided compared with nerve stimulation supraclavicular brachial plexus block using 0.75% ropivacaine results in a lower incidence of hemidiaphragmatic paresis. ⋯ Ultrasound-guided supraclavicular brachial plexus block, using 20 mL of 0.75% ropivacaine with the described technique, is not associated with hemidiaphragmatic paresis.