Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Aug 2018
Randomized Controlled Trial Multicenter StudyPectoral I Block Does Not Improve Postoperative Analgesia After Breast Cancer Surgery: A Randomized, Double-Blind, Dual-Centered Controlled Trial.
General anesthesia for breast surgery may be supplemented by using a regional anesthetic technique. We evaluated the efficacy of the first pectoral nerve block (Pecs I) in treating postoperative pain after breast cancer surgery. ⋯ This study was registered at ClinicalTrials.gov, identifier NCT01670448.
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Reg Anesth Pain Med · Aug 2018
Randomized Controlled Trial Comparative StudyPerineural Low-Dose Dexamethasone Prolongs Interscalene Block Analgesia With Bupivacaine Compared With Systemic Dexamethasone: A Randomized Trial.
Perineural dexamethasone and intravenous (IV) dexamethasone have been shown to prolong peripheral nerve block duration. The effects of perineural and IV dexamethasone have only been compared at doses of 4 mg or greater. This triple-blind, randomized trial examined the effect of 1 mg IV versus perineural dexamethasone on interscalene block (ISB) analgesia duration. ⋯ This study was registered at Clinicaltrials.gov, identifier NCT02506660.
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Reg Anesth Pain Med · Aug 2018
Real-Time Ultrasound-Assisted Thoracic Epidural Placement: A Feasibility Study of a Novel Technique.
The placement of thoracic epidural catheters is complicated by the layering of the vertebral lamina. Therefore, traditional blind palpation techniques require insertion of an epidural needle with likely contact of lamina with redirections into the epidural space. ⋯ Successful epidural placement was achieved in every patient. All catheters were found to be effective for use in the postoperative phase.
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Reg Anesth Pain Med · Aug 2018
Randomized Controlled TrialUltrasound-Guided Percutaneous Peripheral Nerve Stimulation: Neuromodulation of the Sciatic Nerve for Postoperative Analgesia Following Ambulatory Foot Surgery, a Proof-of-Concept Study.
Percutaneous peripheral nerve stimulation (PNS) is an analgesic modality involving the insertion of a lead through an introducing needle followed by the delivery of electric current. This modality has been reported to treat chronic pain as well as postoperative pain the day following knee surgery. However, it remains unknown if this analgesic technique may be used in ambulatory subjects following foot procedures beginning within the recovery room immediately following surgery, and with only short series of patients reported to date, the only available data are derived from strictly observational studies. The purposes of this proof-of-concept study were to demonstrate the feasibility of using percutaneous sciatic nerve PNS to treat postoperative pain following ambulatory foot surgery in the immediate postoperative period and provide the first available data from a randomized controlled study design to provide evidence of analgesic effect. ⋯ This study was registered at Clinicaltrials.gov, identifier NCT02898103.
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Reg Anesth Pain Med · Aug 2018
Ultrasound Assessment of Ice-Ball Formation by Cryoneurolysis Device in an Ex Vivo Model.
Real-time ice-ball formation during cryoneurolysis has sparsely been assessed with ultrasound (US). Cryoneurolysis in lower back pain syndrome represents a validated management option in cases of facet joint syndrome. Ultrasound may be a useful tool to perform facet joint cryodenervation. The objective of this study was to assess, ex vivo, the ability of US to assess the ice-ball formation of a cryoneurolysis device. ⋯ Ultrasound is a useful tool to monitor the formation of ice ball during a cryoneurolysis freezing cycle. Power Doppler appears as the only option to monitor the ice ball with low-frequency transducers. This novel finding may be useful in cases of lumbar medial branch cryoneurolysis, an application we plan to assess in a future pilot prospective study.