Regional anesthesia and pain medicine
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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
Multicenter StudyDevelopment and Validation of an Assessment of Regional Anesthesia Ultrasound Interpretation Skills.
Interpretation of ultrasound images and knowledge of anatomy are essential skills for ultrasound-guided peripheral nerve blocks. Competency-based educational models promoted by the Accreditation Council for Graduate Medical Education require the development of assessment tools for the achievement of different competency milestones to demonstrate the longitudinal development of skills that occur during training. ⋯ This study provides evidence for the reliability, content validity, and construct validity of a 47-item multiple choice-style online test of ultrasound interpretation skills for regional anesthesia, which can be used as an assessment of competency milestone achievement in anesthesiology training.
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Reg Anesth Pain Med · Jul 2015
Randomized Controlled TrialOndansetron Does Not Attenuate Hemodynamic Changes in Patients Undergoing Elective Cesarean Delivery Using Subarachnoid Anesthesia: A Double-Blind, Placebo-Controlled, Randomized Trial.
Hypotension is the most common complication after subarachnoid anesthesia for cesarean delivery. Several therapeutic and preventive measures are used to attenuate this side effect. Serotonin receptor-blocking drugs have been suggested as one such approach. We sought to determine whether prophylactically administered intravenous ondansetron could attenuate hypotension in patients undergoing elective cesarean delivery performed under subarachnoid anesthesia. ⋯ Ondansetron premedication does not attenuate hemodynamic changes after subarachnoid anesthesia nor does it reduce the amount of vasopressor use, pruritus, or nausea and vomiting.
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Reg Anesth Pain Med · Jul 2015
Multicenter Study Comparative StudyMedial Branch Blocks or Intra-Articular Injections as a Prognostic Tool Before Lumbar Facet Radiofrequency Denervation: A Multicenter, Case-Control Study.
Medial branch blocks (MBBs) and intra-articular (IA) facet joint injections are both used to diagnose facet joint pain and are presumed to be equivalent. No study has sought to determine which has a better prognostic value before radiofrequency (RF) denervation. ⋯ When used as a prognostic tool before lumbar facet radiofrequency, MBB may be associated with a higher success rate than IA injections. Our results should be confirmed by large, prospective, randomized studies.