Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2010
Randomized Controlled TrialPerioperative inflammatory response in total knee arthroplasty patients: impact of limb preconditioning.
Ischemic preconditioning of tissue that is to undergo procedure-induced underperfusion has been used in a number of surgical settings to reduce the subsequent inflammatory response and its sequelae. The objective of this prospective, randomized study was to evaluate the effect of ischemic preconditioning on the systemic inflammatory response, degree of lung catabolism, and postoperative-pain associated with total knee arthroplasty (TKA). ⋯ Preconditioning of the lower extremity in the setting of TKA under regional anesthesia may have limited value in reducing the systemic inflammatory response and level of lung injury. However, preconditioning may be associated with beneficial effects such as reduction in postoperative pain levels, and thus, further investigations are warranted.
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Reg Anesth Pain Med · Sep 2010
Case ReportsUltrasound-guided continuous phrenic nerve block for persistent hiccups.
Phrenic nerve block can be performed and repeated if necessary for persistent hiccups, when conservative and pharmacological treatment is unsuccessful. We report the first description of an in-plane ultrasound (US)-guided phrenic nerve block (PhNB) with a catheter, after US investigation of the bilateral diaphragm, to treat hiccups while avoiding repeated PhNBs. ⋯ An US-guided in-plane PhNB with catheter is feasible and avoids repeated PhNB when hiccups reoccur. Ultrasound investigation of the bilateral diaphragm should be performed before performing the nerve block.
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Reg Anesth Pain Med · Sep 2010
Experience with 724 epidurograms for epidural catheter placement in pediatric anesthesia.
Epidural analgesia via continuous catheters, placed either via the caudal approach or directly at the desired level, is a commonly used technique in children. It is particularly important that these catheters are placed correctly because most are placed under general anesthesia and require deep sedation or repeat general anesthesia for replacement if malfunctioning. Ideally, correct placement should be confirmed at the time of insertion. ⋯ Our experiments suggest that confirmation of epidural catheter placement via epidurogram is highly efficacious. Epidurography is the only currently available technique that accomplishes all of the following: (a) confirms correct placement, (b) rules out incorrect anatomic space, and (c) predicts analgesic coverage.
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Reg Anesth Pain Med · Sep 2010
Comparative StudyComparison of bupivacaine, ropivacaine, and levobupivacaine in an equal dose and concentration for sympathetic block in dogs.
The aim of this study was to compare the potency of bupivacaine, ropivacaine, and levobupivacaine in an equal dose and concentration for sympathetic block. ⋯ Ropivacaine may induce a greater increase in vasodilation than bupivacaine and levobupivacaine at the same dose and concentration for sympathetic block in dogs.