Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2012
ReviewRegional anesthesia and analgesia in critically ill patients: a systematic review.
Regional anesthesia has become invaluable for the treatment of pain during and after a wide range of surgical procedures. However, its benefits in the nonsurgical setting have been less well studied. ⋯ Patients in the critical care unit present special challenges to the regional anesthesiologist, including coagulopathies, infections, immunocompromised states, sedation- and ventilation-associated problems, and factors potentially increasing the risk for systemic toxicity. This review is intended to evaluate the role of regional anesthesia in critically ill patients, to discuss potential benefits, and to provide a summary of the published evidence on the subject.
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Reg Anesth Pain Med · Sep 2012
ReviewThe definition of block "success" in the contemporary literature: are we speaking the same language?
A successful nerve block is the common goal that shapes modern regional anesthesia practice and research, yet the meaning of block "success" can be open to interpretation. For this Special Article, we reviewed all applicable randomized controlled trials published over the last decade to determine the most commonly used definitions of block success. We also sought to uncover which relevant indicators of block success are routinely reported in the contemporary literature. ⋯ Surgeon- and hospital administrator-related indicators were not collected in any trial. We found that the definition of block success is highly variable in the contemporary regional anesthesia literature. Our findings underscore the clear and present need for a comprehensive definition of block success, whereas future research should endeavor to capture the indicators of block success that are important to all key perioperative stakeholders.