Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2015
Randomized Controlled Trial Comparative StudyA Randomized Comparison Between Ultrasound- and Fluoroscopy-Guided C7 Medial Branch Block.
Because of its location in the lower neck and anatomical variability, the C7 medial branch represents a challenging target for local anesthetic blocks. Although ultrasound (US) guidance offers an alternative to fluoroscopy for C3 to C6 cervical medial branch blocks (CMBBs), its use at the C7 level has not been examined. We hypothesized that US, using a biplanar imaging technique, could provide a shorter performance time than conventional fluoroscopy for C7 CMBB. ⋯ Ultrasound guidance using a biplanar approach provides a similar success rate to fluoroscopy for C7 CMBB. However, US is associated with improved efficiency (decreased performance time and fewer needle passes).
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Reg Anesth Pain Med · Jan 2015
Randomized Controlled Trial Comparative StudyEffect of Adductor Canal Block Versus Femoral Nerve Block on Quadriceps Strength, Mobilization, and Pain After Total Knee Arthroplasty: A Randomized, Blinded Study.
Total knee arthroplasty (TKA) is often associated with severe pain. Different regional anesthetic techniques exist, all with varying degrees of motor blockade. We hypothesized that pain relief provided by the adductor canal block (ACB) could increase functional muscle strength. ⋯ Adductor canal block provides a clinically relevant and statistically significant increase in quadriceps muscle strength for patients in severe pain after TKA.
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Reg Anesth Pain Med · Jan 2015
Randomized Controlled Trial Comparative StudyA Randomized Comparison Between Infraclavicular Block and Targeted Intracluster Injection Supraclavicular Block.
This prospective, randomized trial compared ultrasound-guided targeted intracluster injection (TII) supraclavicular brachial plexus block (SCB) and infraclavicular brachial plexus block (ICB). ⋯ Ultrasound-guided TII SCB and ICB provide comparable success rates. Due to its quick onset, TII SCB results in a shorter total anesthesia-related time.
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Reg Anesth Pain Med · Jan 2015
Ultrasound-Guided Lumbar Plexus Block Using a Transverse Scan Through the Lumbar Intertransverse Space: A Prospective Case Series.
A paramedian transverse scan (PMTS) can be used to delineate the anatomy relevant for ultrasound-guided lumbar plexus block (LPB) through the lumbar intertransverse space. This case series evaluated the feasibility of using the PMTS to guide LPBs for anesthesia. ⋯ Ultrasound-guided LPBs can be reliably accomplished using the PMTS.
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Reg Anesth Pain Med · Jan 2015
Infection Related to Ultrasound-Guided Single-Injection Peripheral Nerve Blockade: A Decade of Experience at Toronto Western Hospital.
The use of ultrasound guidance has revolutionized regional anesthesia practice. Ultrasound equipment disinfection techniques vary between institutions. ⋯ No indications of block-related infection were found. We conclude that using a practical and efficient low-level disinfection technique and sterile barrier dressing results in an extremely low rate of block-related infection following ultrasound-guided single-injection peripheral nerve blockade.