Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2014
Randomized Controlled Trial Comparative StudyDexmedetomidine Added to Ropivacaine Extends the Duration of Interscalene Brachial Plexus Blocks for Elective Shoulder Surgery When Compared with Ropivacaine Alone: A Single-Center, Prospective, Triple-Blind, Randomized Controlled Trial.
Dexmedetomidine 150 mcg significantly extends the duration of ropivacaine interscalene block by almost 30% without significant adverse effect.
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Reg Anesth Pain Med · Jan 2014
Randomized Controlled TrialUltrasound-Guided Single-Penetration Dual-Injection Block for Leg and Foot Surgery: A Prospective, Randomized, Double-blind Study.
A single-penetration dual-injection block of the sciatic and saphenous nerves was faster to perform but equally effective as traditional techniques.
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Reg Anesth Pain Med · Jan 2014
Randomized Controlled TrialThe Effect of Nitrous Oxide Anesthesia on Early Postoperative Opioid Consumption and Pain.
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Reg Anesth Pain Med · Jan 2014
Randomized Controlled TrialIncreases in the Use of Prescription Opioid Analgesics and the Lack of Improvement in Disability Metrics Among Users.
In the United States, use of oral opioid analgesics has been associated with increasing rates of addiction, abuse, and diversion. However, little is known about the recent national use of non-illicit prescription opioid analgesics (those prescribed in a physician-patient relationship), the primary source of these drugs for the general US population. Our primary objective was to examine trends in the use of prescription opioid analgesics in the United States and to identify defining characteristics of patient users of prescribed opioids from 2000 to 2010. ⋯ The use of prescription opioid analgesics among adult Americans has increased in recent years, and this increase does not seem to be associated with improvements in disability and health status among users. On a public health level, these data suggest that there may be an opportunity to reduce the prescribing of opioid analgesics without worsening of population health metrics.
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Reg Anesth Pain Med · Jan 2014
Case ReportsAn Epidural Blood Patch Causing Acute Neurologic Dysfunction Necessitating a Decompressive Laminectomy.
One risk with placement of an epidural blood patch (EDBP) is spinal cord or nerve root compression resulting from the epidural blood volume injected, a complication necessitating immediate surgical decompression. We could not find a previous report of this in the literature. Here, we review and discuss one such case. ⋯ A cauda equina syndrome from an epidural hematoma may occur as a rare complication of an EDBP, even with direct fluoroscopic guidance. Early diagnosis of symptoms and prompt surgical evacuation of an epidural hematoma is essential and may result in the resolution of symptoms. This complication remains a rare occurrence and should not deter the performance of an EDBP, when indicated.