Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2016
Randomized Controlled Trial Comparative StudyA Comparison of Combined Suprascapular and Axillary Nerve Blocks to Interscalene Nerve Block for Analgesia in Arthroscopic Shoulder Surgery: An Equivalence Study.
The primary objective of this study was to compare the analgesic efficacy of combined suprascapular and axillary nerve block (SSAX) with interscalene block (ISB) after arthroscopic shoulder surgery. Our hypothesis was that ultrasound-guided SSAX would provide postoperative analgesia equivalent to ISB. ⋯ Combined suprascapular and axillary nerve block provides nonequivalent analgesia compared with ISB after arthroscopic shoulder surgery. While SSAX provides better quality pain relief at rest and fewer adverse effects at 24 hours, ISB provides better analgesia in the immediate postoperative period. For arthroscopic shoulder surgery, SSAX can be a clinically acceptable analgesic option with different analgesic profile compared with ISB.
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Reg Anesth Pain Med · Sep 2016
Randomized Controlled Trial Comparative StudyComparison of 2-Chloroprocaine, Bupivacaine, and Lidocaine for Spinal Anesthesia in Patients Undergoing Knee Arthroscopy in an Outpatient Setting: A Double-Blind Randomized Controlled Trial.
Knee arthroscopy is a well-established procedure in day-case surgery, which is frequently performed under spinal anesthesia. It is, however, controversial whether the choice for a specific local anesthetic translates into relevant outcomes. We hypothesized that the use of 2-chloroprocaine would be associated with a faster recovery from sensorimotor block. ⋯ For spinal anesthesia in patients undergoing ambulatory knee arthroscopy, chloroprocaine has the shortest time to complete recovery of sensory and motor block compared with bupivacaine and lidocaine.
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Reg Anesth Pain Med · Sep 2016
Case ReportsSubdural Hematoma Associated With Labor Epidural Analgesia: A Case Series.
This report aimed to describe the characteristics and impact of subdural hematoma (SDH) after labor epidural analgesia. ⋯ Subdural hematoma after labor epidural anesthesia is rare but potentially more common than historically estimated. Cases of postdural puncture headache after labor epidural anesthesia should be monitored closely for severe neurologic signs and symptoms that could herald SDH.
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Reg Anesth Pain Med · Sep 2016
Case ReportsInsufficient Penetration of Bone Cement Into the Trabecular Bone: A Potential Risk for Delayed Bone Cement Displacement After Kyphoplasty?
Balloon kyphoplasty is a minimally invasive procedure used in the treatment of vertebral compression fractures. Although cement leakage is a well-known complication of the procedure, delayed displacement of the injected bone cement material, occurring several weeks after kyphoplasty, is a rare occurrence. In this report, we describe a case of delayed dislodgement of the bone cement occurring 4 weeks after successful kyphoplasty for an osteoporotic compression fracture of L4. ⋯ As delayed displacement of bone cement can result in progression of an osteoporotic compression fracture of the vertebrae, we propose that sufficient penetration of bone cement into the microstructure of the trabecular bone of the vertebral body during kyphoplasty could reduce the risk of this phenomenon.