Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2012
Randomized Controlled TrialAddition of pregabalin to multimodal analgesic therapy following ankle surgery: a randomized double-blind, placebo-controlled trial.
Pregabalin is often used as a perioperative analgesic adjunct; some studies show benefit, but others do not. Adverse effects, such as confusion and sedation, have been attributed to perioperative use of pregabalin. We tested the hypothesis that pregabalin, when used as part of a multimodal analgesic regimen, reduces the duration of moderate to severe pain in the first 24 hrs following foot or ankle surgery. Secondary outcomes included measures of opioid and pregabalin adverse effects. ⋯ No clinical benefit was obtained from perioperative administration of pregabalin (100 mg preoperative, then 50 mg every 12 hrs) as part of a multimodal postoperative analgesic regimen following foot and ankle surgery.
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Reg Anesth Pain Med · May 2012
Randomized Controlled Trial Comparative StudyA prospective, randomized comparison between double-, triple-, and quadruple-injection ultrasound-guided axillary brachial plexus block.
This prospective, randomized, observer-blinded study compared double-, triple-, and quadruple-injection ultrasound (US)-guided axillary brachial plexus block (AXB) for upper-extremity surgery. ⋯ Double-, triple-, and quadruple-injection US-guided perivascular AXB result in comparable success rates and total anesthesia-related times. Because it requires fewer needle passes, the double-injection technique provides a simple alternative for US-guided AXB.
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Reg Anesth Pain Med · May 2012
Biography Historical ArticleCarl Koller, cocaine, and local anesthesia: some less known and forgotten facts.
Modern-day local anesthesia began in 1884 with a discovery by a young unknown ophthalmologist from Vienna named Carl Koller, who placed a cocaine solution on the cornea, thus producing insensibility. The news of his discovery spread throughout the world in less than a month. "Not surprisingly," a controversial priority discussion emerged. ⋯ In addition, Carl Koller's decision to leave Vienna is also surrounded in secrecy. The story surrounding the revelation of the local anesthetic effect of cocaine and the personalities involved is fascinating and relatively unknown.
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Reg Anesth Pain Med · May 2012
Randomized Controlled TrialDistribution patterns, dermatomal anesthesia, and ropivacaine serum concentrations after bilateral dual transversus abdominis plane block.
The ability of transversus abdominis plane (TAP) blocks to anesthetize the upper abdomen remains debatable. We aimed to describe the local anesthetic distribution following ultrasound-guided TAP blocks with repeated magnetic resonance imaging investigations and to relate this to the resulting dermatomal anesthesia. ⋯ Magnetic resonance imaging analysis revealed a significant time-dependent expansion of injectates. Magnetic resonance imaging and the degree of dermatomal anesthesia confirmed that the upper and lateral TAP compartments do not appear to communicate. Separate injections at the upper intercostal and lateral classic TAP plexuses are necessary to block the entire abdominal wall.