Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2009
Randomized Controlled Trial Comparative StudyUltrasound improves the success rate of a tibial nerve block at the ankle.
The tibial nerve provides the majority of sensation to the foot. Although multiple techniques have been described, there exists little evidence-based medicine evaluating different techniques for blocking the tibial nerve at the ankle. We hypothesized that an ultrasound (US)-guided tibial nerve block at the ankle would prove more successful than a conventional approach based on surface landmarks. ⋯ In healthy volunteers, US guidance results in a more successful tibial nerve block at the ankle than does a traditional approach using surface landmarks.
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Reg Anesth Pain Med · May 2009
Randomized Controlled Trial Comparative StudyClinical impact of epidural anesthesia simulation on short- and long-term learning curve: High- versus low-fidelity model training.
Epidural anesthesia is a technically challenging regional anesthetic technique that can be difficult to teach to novices. Epidural simulators are now available to allow realistic training within a safe and controlled environment before attempting the procedure on patients. Potentially, this may improve skill acquisition by novice residents. The purpose of this study was to examine the effect of a high-fidelity epidural anesthesia simulator on residents' ability to perform their first labor epidurals and on their learning curve compared with a group having training with a low-fidelity model. ⋯ Our study shows that a simple model can be as useful for learning how to place an epidural catheter as an expensive anatomically correct simulator. New and more technologically advanced simulators should be compared against lower fidelity models to establish their utility and cost-effectiveness.
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Reg Anesth Pain Med · May 2009
Randomized Controlled Trial Comparative StudyThe rectus sheath block: accuracy of local anesthetic placement by trainee anesthesiologists using loss of resistance or ultrasound guidance.
The aim of this study was to compare the accuracy of local anesthetic placement in the rectus sheath block when performed by trainee anesthetists using loss of resistance (LOR) or ultrasound guidance. ⋯ Ultrasound guidance improves the accuracy of local anesthetic placement when undertaking the rectus sheath block. An additional fascial plane above the anterior layer of the rectus sheath may be wrongly perceived as the anterior layer of the rectus sheath when the block is undertaken without the aid of ultrasound.