Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2018
Randomized Controlled Trial Comparative StudyComparison of the ED50 and ED95 of Intrathecal Bupivacaine in Parturients Undergoing Cesarean Delivery With or Without Prophylactic Phenylephrine Infusion: A Prospective, Double-Blind Study.
While prophylactic phenylephrine infusions during cesarean delivery are often used to counteract the sympathectomy associated with spinal anesthesia, their use has been associated with decreased rostral spread of local anesthetic. The purpose of this study was to determine the median effective dose (ED50) and 95% effective dose (ED95) of intrathecal hyperbaric bupivacaine for cesarean delivery in the presence and absence of prophylactic phenylephrine infusion. ⋯ This study was registered at the Chinese Clinical Trial Registry, identifier ChiCTR-TRC-16008938.
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Reg Anesth Pain Med · Nov 2018
Randomized Controlled Trial Comparative StudyUltrasound-Guided Infraclavicular Brachial Plexus Block: Prospective Randomized Comparison of the Lateral Sagittal and Costoclavicular Approach.
It has recently been proposed that an infraclavicular brachial plexus block (BPB) at the costoclavicular (CC) space may overcome some of the limitations of the lateral sagittal (LS) approach. In this study, we hypothesized that the CC approach will produce faster onset of sensory blockade of the 4 major terminal nerves of the brachial plexus than the LS approach. ⋯ This study was registered at the Centre for Clinical Trials of The Chinese University of Hong Kong, identifier CUHK_CCT00389.
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Reg Anesth Pain Med · Nov 2018
Randomized Controlled TrialLipid Emulsion Pretreatment Decreased the Maximum Total and Free Plasma Concentration of Levobupivacaine for Femoral and Sciatic Nerve Block in Below-Knee Fracture Surgery.
Although intravenous lipid emulsion has been proved a powerful antidote for local anesthetic toxicity, there are few pharmacokinetic data on using lipid infusion as a pretreatment for other clinical applications. We assessed the influence of lipid pretreatment on the pharmacodynamics and pharmacokinetics of levobupivacaine. ⋯ This study was registered at the Chinese Clinical Trial Registry, identifier ChiCTR-TRC-14005203.
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Reg Anesth Pain Med · Nov 2018
Randomized Controlled Trial Comparative StudyUltrasound-Guided Selective Versus Conventional Block of the Medial Brachial Cutaneous and the Intercostobrachial Nerves: A Randomized Clinical Trial.
For superficial surgery of anteromedial and posteromedial surfaces of the upper arm, the medial brachial cutaneous nerve (MBCN) and the intercostobrachial nerve (ICBN) must be selectively blocked, in addition to an axillary brachial plexus block. We compared efficacy of ultrasound-guided (USG) versus conventional block of the MBCN and the ICBN. ⋯ This study was registered at ClinicalTrials.gov, identifier NCT02940847.
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Reg Anesth Pain Med · Oct 2018
Randomized Controlled Trial Comparative StudyAn Ultrasound-Guided Lateral Approach for Proximal Sciatic Nerve Block: A Randomized Comparison With the Anterior Approach and a Cadaveric Evaluation.
The lateral and anterior approaches for proximal sciatic nerve (SN) block can be used in patients lying supine. We assume that the posterior femoral cutaneous nerve (PFCN) is simultaneously blocked more often via the lateral approach than via the anterior approach, given the proximity of these 2 nerves at the injection level. However, locating the SN is difficult when using the original landmark-based lateral approach. We have introduced ultrasound guidance to alleviate the technical difficulty of the lateral approach and tested the hypothesis that an ultrasound-guided lateral approach would achieve PFCN block more often than the ultrasound-guided anterior approach for SN block. ⋯ This study was registered at UMIN Clinical Trials Registry, identifier UMIN000026748.