Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2012
Primary payer status is associated with the use of nerve block placement for ambulatory orthopedic surgery.
Although more than 30 million patients in the United States undergo ambulatory surgery each year, it remains unclear what percentage of these patients receive a perioperative nerve block. We reviewed data from the 2006 National Survey of Ambulatory Surgery to determine the demographic, socioeconomic, geographic, and clinical factors associated with the likelihood of nerve block placement for ambulatory orthopedic surgery. The primary outcome of interest was the association between primary method of payment and likelihood of nerve block placement. In addition, we examined the association between type of surgical procedures, patient demographics, and hospital characteristics with the likelihood of receiving a nerve block. ⋯ For patients receiving ambulatory orthopedic surgery in the United States, our results suggest that geographic and socioeconomic factors are associated with different likelihoods of perioperative peripheral nerve block placement.
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Reg Anesth Pain Med · May 2012
The creation of an objective assessment tool for ultrasound-guided regional anesthesia using the Delphi method.
The assessment of technical skills in ultrasound-guided regional anesthesia is currently subjective and relies largely on observations of the trainer. The objective of this study was to develop a checklist to assess training progress and to detect training gaps in ultrasound-guided regional anesthesia using the Delphi method. ⋯ Using the Delphi method, a checklist and GRS were developed. These tools can serve as an objective means of assessing progress in ultrasound technical skills acquisition.
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Reg Anesth Pain Med · May 2012
Ultrasound-guided regional anesthesia: how much practice do novices require before achieving competency in ultrasound needle visualization using a cadaver model.
Ultrasound needle visualization is a fundamental skill required for competency in ultrasound-guided regional anesthesia. The primary objective of this study using a cadaver model was to quantify the number of procedures that novices need to perform before competency, using a predefined dynamic scoring system was achieved in ultrasound needle visualization skills. ⋯ Trainees became competent in ultrasound needle visualization at a variable rate. This study estimates that novices would require approximately 28 supervised trials with feedback before competency in ultrasound needle visualization is achieved.
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Reg Anesth Pain Med · May 2012
Randomized Controlled Trial Comparative StudyRandomized controlled trial comparing pudendal nerve block under ultrasound and fluoroscopic guidance.
Although fluoroscopy is an established imaging modality for pudendal nerve block, ultrasound (US) technique allows physicians better visualization of anatomic structures. This study aimed to compare the effectiveness and safety between the US- and fluoroscopy-guided techniques. ⋯ Ultrasound-guided pudendal nerve blockade is as accurate as fluoroscopically guided injections when performed by an experienced clinician. However, the former took a longer time to perform.