Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2014
Randomized Controlled TrialTreatment of Postmastectomy Pain With Ambulatory Continuous Paravertebral Nerve Blocks: A Randomized, Triple-Masked, Placebo-Controlled Study.
We aimed to determine with this randomized, triple-masked, placebo-controlled study if benefits are afforded by adding a multiple-day, ambulatory, continuous ropivacaine paravertebral nerve block to a single-injection ropivacaine paravertebral block after mastectomy. ⋯ After mastectomy, adding a multiple-day, ambulatory, continuous ropivacaine infusion to a single-injection ropivacaine paravertebral nerve block results in improved analgesia and less functional deficit during the infusion. However, no benefits were identified after infusion discontinuation.
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Reg Anesth Pain Med · Mar 2014
Locally Injected Dexmedetomidine Induces Vasoconstriction via Peripheral α-2A Adrenoceptor Subtype in Guinea Pigs.
Recent research shows that locally injected dexmedetomidine enhances the local anesthetic potency of lidocaine via the α-2A adrenoceptor subtype in guinea pigs. However, little is known about the effect of locally injected dexmedetomidine on the peripheral vascular response. This study aimed to evaluate the effect of locally injected dexmedetomidine on the peripheral vascular response, measuring skin blood flow in the injected area in guinea pigs. ⋯ The results reveal that locally injected dexmedetomidine at a concentration of 1 μM induced peripheral vasoconstriction without a systemic cardiovascular response via the peripheral α-2A adrenoceptor subtype.
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Reg Anesth Pain Med · Mar 2014
A Prospective Validation of Biplanar Ultrasound Imaging for C5-C6 Cervical Medial Branch Blocks.
Ultrasound (US) guidance offers an alternative to fluoroscopy for medial branch blocks of the upper cervical spine, but it may be less accurate for blocks at the C5 and C6 levels. We hypothesized that a modified technique using biplanar US imaging would facilitate level identification and provide greater accuracy for the lower cervical spine. ⋯ Ultrasound guidance using a biplanar approach is a reliable imaging modality for C5 and C6 medial branch blocks.
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Reg Anesth Pain Med · Mar 2014
Case ReportsPneumothorax After Ultrasound-Guided Supraclavicular Block: Presenting Features, Risk, and Related Training.
Presenting features and estimate of risk of pneumothorax after ultrasound-guided supraclavicular block are discussed, along with related training strategies. ⋯ We estimate the risk of pneumothorax to be 0.4 per 1000 after ultrasound-guided supraclavicular block. We recommend specific training strategies for needle visualization for this technique to reduce the risk of pneumothorax.