Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2009
Ultrasound-guided obturator nerve block: an interfascial injection approach without nerve stimulation.
For knee surgery, obturator nerve block (ONB) has been shown to enhance postoperative analgesia provided by femoral block. Current techniques for obturator block use surface landmarks or ultrasound guidance (USG) with nerve stimulation. This preliminary observational study evaluated the success of an ultrasound-guided ONB without the additional use of nerve stimulation. ⋯ Obturator nerve block using USG to achieve interfascial injection without nerve stimulation had success similar to that reported in studies using nerve stimulation.
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Reg Anesth Pain Med · May 2009
Structural injury to the human sciatic nerve after intraneural needle insertion.
Recent clinical reports suggest that intraneural needle placement may not always lead to neurologic injury. To explain the absence of neurologic complications in these reports, we studied the risk and extent of nerve injury after intentional needle-nerve placement in a cryopreserved human sciatic nerve. ⋯ Our findings suggest that intraneural needle insertion may more commonly result in interfascicular rather than intrafascicular needle placement.
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Reg Anesth Pain Med · May 2009
Ultrasound of the lateral femoral cutaneous nerve: normal findings in a cadaver and in volunteers.
To assess the feasibility of ultrasound (US) in visualizing the lateral femoral cutaneous nerve (LFCN) in a cadaver and 8 volunteers. ⋯ Ultrasound enables visualization of the LFCN in a cadaver and in volunteers. Ultrasound-guided injection successfully blocked the LFCN.
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Progress continues on American Society of Regional Anesthesia (ASRA) AcutePOP. Highlights include selection of data fields and creation of definitions for complications jointly accepted by clinical registries for ASRA, American Society of Anesthesiologists, Regional Anesthesia Surveillance System, Society for Obstetric Anesthesia and Perinatology, and Society for Pediatric Anesthesia. Development of a Web site and applications continues, and a demonstration is planned for the ASRA 2009 meeting.
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Reg Anesth Pain Med · May 2009
Evaluation of the longus colli muscle in relation to stellate ganglion block.
The longus colli (LC) muscle is an important structure of the anterior cervical spine and has a critical role in stellate ganglion block. This technique involves withdrawing the needle to locate its port for injection above the anterior surface of the LC muscle; however, its exact thickness at the C5, C6, and C7 levels has not been measured. The aim of this anatomic and magnetic resonance-supported study was to evaluate the thickness of the LC muscle at these levels from the anterior tubercle of each vertebra toward the vertebral body at 5-, 10-, and 15-mm distances to provide precise anatomic data for stellate ganglion block. ⋯ We found a highly variable thickness of the LC muscle in anatomic and imaging studies, which may lead to negative block results.