Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2013
Randomized Controlled TrialValue of an electronic tutorial for image interpretation in ultrasound-guided regional anesthesia.
Use of ultrasound-guided regional anesthesia (UGRA) requires considerable training. An embedded electronic tutorial as an element of an ultrasound machine may help to identify sonoanatomy for novices. Therefore, we investigated whether an electronic tutorial could improve accuracy or speed of performance in identifying anatomical structures. ⋯ An electronic tutorial can help novices in UGRA identify anatomical structures. A significant increase in correct identifications was gained at the expense of significantly longer time required for this process. Increased time required may partly be related to unfamiliarity with the tutorial.
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Reg Anesth Pain Med · Jan 2013
Dual-epidural catheter technique and perioperative outcomes after Ivor-Lewis esophagectomy.
Ivor-Lewis esophagectomy is associated with significant postoperative analgesic requirements and perioperative complications. A dual-epidural technique may improve perioperative outcomes compared with single thoracic epidural analgesia. ⋯ The DEC technique improved postoperative analgesia and reduced the incidence of major postoperative complications and hospital length of stay in patients undergoing Ivor-Lewis esophagectomy. Future studies should evaluate the efficacy of this technique in a controlled randomized clinical trial.
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Reg Anesth Pain Med · Jan 2013
The utility of ultrasound imaging in predicting ease of performance of spinal anesthesia in an orthopedic patient population.
Ultrasonography of the spine improves technical performance of spinal anesthesia, but what is unclear is whether it can predict difficulty. We tested the hypothesis that a good ultrasound view at a given intervertebral level is associated with absence of technical difficulty. ⋯ Ultrasound can be useful in predicting the absence of technical difficulty in performing dural puncture and thus in selecting the optimal intervertebral level for spinal anesthesia.
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Reg Anesth Pain Med · Jan 2013
Minimum effective volume of lidocaine for double-injection ultrasound-guided axillary block.
The aim of this study was to determine the minimum effective volume of lidocaine 1.5% with epinephrine 5 μg/mL in 90% of patients (MEV90) for double-injection ultrasound-guided axillary block (AXB). ⋯ For double-injection ultrasound-guided AXB, the MEV90 of lidocaine 1.5% with epinephrine 5 μg/mL is 5.5 and 23.5 mL for the musculocutaneous nerve and perivascular injection, respectively. Further dose-finding studies are required for other concentrations of lidocaine, other local anesthetic agents, and other techniques for ultrasound-guided AXB.