Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2015
Biography Historical ArticlePeggy's Pain and the Creation of Gone With the Wind.
Margaret Mitchell (1900-1949), author of the best-selling novel Gone With the Wind had chronic, widespread pain for most of her adult life. She was accident prone and sustained injuries leading to unexpectedly prolonged periods of recovery and had unusual illnesses that puzzled her physicians. ⋯ In this report, the details of her health problems are reviewed. During her life, her diagnoses were problematic and remain so now, but would most likely include fibromyalgia and irritable bowel syndrome.
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Reg Anesth Pain Med · Jul 2015
Randomized Controlled TrialAddition of Dexamethasone and Buprenorphine to Bupivacaine Sciatic Nerve Block: A Randomized Controlled Trial.
Sciatic nerve block provides analgesia after foot and ankle surgery, but block duration may be insufficient. We hypothesized that perineural dexamethasone and buprenorphine would reduce pain scores at 24 hours. ⋯ Pain scores were very low at 24 hours after surgery in the context of multimodal analgesia and were not improved by additives. However, perineural buprenorphine and dexamethasone prolonged block duration, reduced the worst pain experienced, and reduced opioid use. Intravenous buprenorphine caused troubling nausea and vomiting. Future research is needed to confirm and extend these observations.
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Reg Anesth Pain Med · Jul 2015
Randomized Controlled Trial Multicenter Study Comparative StudyA Randomized Comparison Between Single- and Triple-Injection Subparaneural Popliteal Sciatic Nerve Block.
This prospective randomized trial compared ultrasound-guided single-injection (SI) and triple-injection (TI) subparaneural popliteal sciatic nerve block. We hypothesized that multiple injections are not required when local anesthetic (LA) is deposited under the paraneurium because the latter entraps LA molecules, ensuring circumferential spread around the nerve. Therefore, in addition to comparable success rates, we also expected similar total anesthesia-related times (sum of performance and onset times) and designed this study as an equivalency trial. ⋯ Ultrasound-guided SI and TI subparaneural popliteal sciatic nerve blocks result in comparable success rates and total anesthesia-related times. Expectedly, the SI technique requires fewer needle passes.