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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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
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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Reg Anesth Pain Med · May 2009
Bicarbonate plus epinephrine shortens the onset and prolongs the duration of sciatic block using chloroprocaine followed by bupivacaine in sprague-dawley rats.
Chloroprocaine is a fast-acting local anesthetic, whereas bupivacaine is a long-acting one. They have been coadministered with limited success. The objective of this study was to determine the effect of additives on the efficacy of regional blockade using chloroprocaine followed by bupivacaine. ⋯ Sodium bicarbonate plus epinephrine shortens the onset and prolongs the duration of a chloroprocaine-bupivacaine sciatic block in Sprague-Dawley rats.