Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2013
Thermal hyperalgesia after sciatic nerve block in rat is transient and clinically insignificant.
Ropivacaine has been associated with transient heat hyperalgesia in sciatic nerve blocks in rat. The goal of the present study was to evaluate the hypothesized presence of transient heat hyperalgesia after perineural injection of ropivacaine with a secondary subanalysis of 2 published studies. ⋯ Although statistically significant, the single time point measurement represented only an 11% change from baseline and was no longer present 30 minutes later. These data support the need for a reevaluation of the interpretation that pain can be worsened by perineural ropivacaine injection.
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Reg Anesth Pain Med · Mar 2013
Randomized Controlled TrialA prospective, randomized, blinded study of continuous ropivacaine infusion in the median sternotomy incision following cardiac surgery.
The aim of this prospective, randomized, double-blind, placebo controlled trial was to evaluate the safety and efficacy of continuous ropivacaine infusion of into the sternal wound. ⋯ The phase III trial did not show improvement in time to extubation of the trachea or pain control in the 0.3% ropivacaine group, but it was stopped early by the data safety monitoring board.
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Reg Anesth Pain Med · Mar 2013
Randomized Controlled Trial Comparative StudyPharmacokinetics of sublingual sufentanil tablets and efficacy and safety in the management of postoperative pain.
A sublingual sufentanil tablet is being developed as a potential alternative to intravenous (IV) opioids for the management of postoperative pain. The objective of these studies was to evaluate the pharmacokinetics, efficacy, and safety of sublingual sufentanil tablets for postoperative pain management. ⋯ Sufentanil formulated as a sublingual solid dosage form provides a duration of action that allows effective analgesia for postoperative patients in a medically supervised setting.
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Reg Anesth Pain Med · Mar 2013
Randomized Controlled TrialContinuous saphenous nerve block as supplement to single-dose local infiltration analgesia for postoperative pain management after total knee arthroplasty.
Local infiltration analgesia (LIA) reduces pain after total knee arthroplasty without the motor blockade associated with epidural analgesia or femoral nerve block. However, the duration and efficacy of LIA are not sufficient. A saphenous nerve block, in addition to single-dose LIA, may improve analgesia without interfering with early mobilization. ⋯ The combination of a saphenous nerve block with single-dose LIA offered better pain relief on the day of surgery than LIA alone.
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Reg Anesth Pain Med · Mar 2013
Inflammatory response after injection of aqueous gel into subarachnoid space in piglets.
Ultrasound-guided neuraxial anesthesia requires the application of ultrasound gel between the transducer and the skin to avoid signal drop-off. As the needle is inserted, the gel may be introduced intrathecally. The purpose of this study was to examine the evidence of an inflammatory response in the subarachnoid space after intrathecal gel introduction. ⋯ Subarachnoid injection of ultrasound gel in piglets results in an inflammatory response within neuraxial space.