Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2024
Randomized Controlled TrialComparison of the incidence of intravascular injection using the Tuohy and Quincke needles during ultrasound-guided caudal epidural block: a prospective randomized controlled study.
Intravascular injection of a local anesthetic can lead to life-threatening complications, such as deficits in neurological function after caudal epidural block. This study aimed to determine whether the intravascular injection rate of the Tuohy needle is lower than that of the Quincke needle during an ultrasound-guided caudal block. ⋯ The overall incidence of inadvertent intravascular injections during ultrasound-guided caudal block confirmed using DSA was 10.9%. Tuohy needles did not reduce intravascular injection rates during the ultrasound-guided caudal block.
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Reg Anesth Pain Med · Jan 2024
Randomized Controlled TrialUltrasonography versus palpation for spinal anesthesia in obese parturients undergoing cesarean delivery: a randomized controlled trial.
Ultrasonography may facilitate neuraxial blocks in obstetrics. This randomized controlled trial aimed to compare preprocedural ultrasonography with landmark palpation for spinal anesthesia in obese parturients undergoing cesarean delivery. ⋯ Preprocedural ultrasonography did not decrease the number of needle passes required to obtain free CSF flow or improve other outcomes compared with landmark palpation during spinal anesthesia performed by a single experienced anesthesiologist in obese parturients undergoing cesarean delivery.
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Reg Anesth Pain Med · Jan 2024
Clinical TrialIncidence and characteristics of chronic postsurgical pain at 6 months after total mastectomy under pectoserratus and interpectoral plane block combined with general anesthesia: a prospective cohort study.
Chronic postsurgical pain (CPSP) occurs in 20%-30% of patients who undergo total mastectomy (TM) performed under general anesthesia alone and significantly affects the quality of life. Pectoserratus and interpectoral plane block have been reportedly combined with general anesthesia to control immediate postoperative pain after TM. Our prospective cohort study aimed to evaluate the incidence of CPSP after TM when pectoserratus and interpectoral plane block were combined with general anesthesia. ⋯ Although postoperative analgesia has significantly improved in the last decade, there is still need for improvement to reduce CPSP after oncologic breast surgery.
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Reg Anesth Pain Med · Jan 2024
Improved outcomes for spinal versus general anesthesia for hip fracture surgery: a retrospective cohort study of the National Surgical Quality Improvement Program.
There is a lack of consensus in the literature as to whether anesthetic modality influences perioperative complications in hip fracture surgery. The aim of the present study was to assess the effect of spinal anesthesia compared with general anesthesia on postoperative morbidity and mortality in patients who underwent hip fracture surgery using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). ⋯ Our propensity-matched analysis suggests that spinal anesthesia as compared with general anesthesia is associated with lower postoperative morbidity and mortality in patients undergoing hip fracture surgery.