Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2009
Randomized Controlled Trial Comparative StudyComparison of 3 intensities of stimulation threshold for brachial plexus blocks at the midhumeral level: a prospective, double-blind, randomized study.
We conducted this prospective randomized study to compare the success rate and the onset time between 3 intensities of stimulation threshold (<0.5, 0.5-0.64, and 0.65-0.8 mA) when using a peripheral nerve stimulation at the midhumeral level. ⋯ We conclude that intensity of stimulation influenced onset time and success rate.
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Reg Anesth Pain Med · Jul 2009
Randomized Controlled Trial Comparative StudyIs ultrasound guidance superior to conventional nerve stimulation for coracoid infraclavicular brachial plexus block?
In different peripheral nerve blocks, it has been speculated that needle guidance by ultrasound improves onset time and success rate compared with the more frequently used nerve stimulation-guided technique. In the present study, we tested the hypothesis that ultrasound guidance improves onset time of coracoid infraclavicular brachial plexus block (IBPB) when compared with a nerve stimulation-guided technique. ⋯ The present investigation demonstrates that ultrasound guidance and nerve stimulation provide similar onset time, success rate, and duration of motor blockade for coracoid IBPB; however, ultrasound guidance reduces the time required to perform the block.
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Reg Anesth Pain Med · Jul 2009
Randomized Controlled Trial Comparative StudyComparison of the transarterial axillary block and the ultrasound-guided infraclavicular block for upper extremity surgery: a prospective randomized trial.
The transarterial axillary block and the ultrasound-guided infraclavicular block are both effective methods of anesthetizing the upper extremity. This study compares these methods with respect to subjective postoperative dysesthesias, block adequacy, patient comfort, and patient satisfaction. ⋯ There is no significant difference between the 2 techniques in terms of adequacy for surgery and subjective postoperative dysesthesias. The ultrasound-guided infraclavicular block is associated with greater patient comfort and willingness to undergo the same anesthetic when compared with the transarterial axillary block.
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Reg Anesth Pain Med · Jul 2009
Randomized Controlled Trial Comparative StudyA randomized, observer-blinded determination of the median effective volume of local anesthetic required to anesthetize the sciatic nerve in the popliteal fossa for stimulating and nonstimulating perineural catheters.
Stimulating perineural catheters are developed to overcome technical problems of nonstimulating catheters, but their efficacy remains controversial. However, no volume-response study has compared success rates between stimulating and nonstimulating catheters. This study of stimulating versus nonstimulating catheters compares the minimal effective volume required to successfully block the sciatic nerve in 50% of patients scheduled for unilateral hallux valgus repair. ⋯ Stimulating popliteal catheters dramatically decrease the volume required to block the sciatic nerve in 50% of patients, compared with nonstimulating catheters.
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Reg Anesth Pain Med · Jul 2009
Randomized Controlled Trial Comparative StudyUltrasound machine comparison: an evaluation of ergonomic design, data management, ease of use, and image quality.
The use of ultrasound technology for vascular access and regional anesthesia is gaining widespread acceptance among anesthesia providers. As a result, many group practices and medical institutions are considering purchasing ultrasound equipment. Currently, comparative information regarding the ergonomic design, physical and adjustable features, data management, ease of use, cost, and image quality of various ultrasound machines is not available. The primary goal of this investigation was to develop an objective process of evaluating ultrasound equipment before purchase. The process of evaluation used in the current investigation may be used when comparing a variety of medical technologies. ⋯ Anesthesia providers considering an ultrasound equipment purchase should objectively evaluate machine models that have features most important to their own clinical practice. Ergonomic design, physical and adjustable features, data management, ease of use, image quality, and cost are important features to consider when evaluating an ultrasound machine.