Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · May 2017
Randomized Controlled Trial Comparative StudyA Randomized Comparison Between Ultrasound- and Fluoroscopy-Guided Sacral Lateral Branch Blocks.
This randomized trial compared ultrasound (US)- and fluoroscopy-guided sacral lateral branch (SLB) blocks. We hypothesized that US would require a shorter performance time. ⋯ Compared with their fluoroscopic counterparts, US-guided SLB blocks require a shorter performance time as well as fewer needle passes and carry a lower risk of vascular breach.
-
Reg Anesth Pain Med · Mar 2017
Randomized Controlled TrialEffect of Perineural Dexamethasone on the Duration of Single Injection Saphenous Nerve Block for Analgesia After Major Ankle Surgery: A Randomized, Controlled Study.
Patients undergoing major elective ankle surgery often experience pain from the saphenous nerve territory persisting beyond the duration of a single-injection saphenous nerve block. We hypothesized that perineural dexamethasone as an adjuvant for the saphenous nerve block prolongs the duration of analgesia and postpones as well as reduces opioid-requiring pain. ⋯ Perineural dexamethasone as an adjuvant for the single-injection subsartorial saphenous nerve block can prolong analgesia and reduce opioid-requiring pain after major ankle surgery.
-
Reg Anesth Pain Med · Mar 2017
Randomized Controlled Trial Comparative StudyEvaluation of Ultrasound-Assisted Thoracic Epidural Placement in Patients Undergoing Upper Abdominal and Thoracic Surgery: A Randomized, Double-Blind Study.
The placement of thoracic epidurals can be technically challenging and requires a thorough understanding of neuraxial anatomy. Although ultrasound imaging of the thoracic spine has been described, no outcome studies on the use of this imaging have been performed. We evaluated whether preprocedural ultrasound of the thoracic spine would facilitate the process of epidural catheterization. ⋯ NCT02785055 (https://clinicaltrials.gov/).
-
Reg Anesth Pain Med · Jan 2017
Randomized Controlled Trial Comparative StudyProspective, Double-Blind, Randomized Study to Evaluate Single-Injection Adductor Canal Nerve Block Versus Femoral Nerve Block: Postoperative Functional Outcomes After Total Knee Arthroplasty.
Despite multiple clinical trials comparing the adductor canal block (ACB) with femoral nerve block (FNB) for total knee arthroplasty, none looked at the aforementioned nerve blocks from early functional results to up to 6 months after surgery. ⋯ The ACB showed better preservation of quadriceps muscle strength and improved ambulation in the first 24 hours postoperatively without compromising pain control.
-
Reg Anesth Pain Med · Jan 2017
Randomized Controlled Trial Comparative StudyA Prospective Randomized Comparative Trial of Targeted Steroid Injection Via Epidural Catheter Versus Standard C7-T1 Interlaminar Approach for the Treatment of Unilateral Cervical Radicular Pain.
No study has compared cervical interlaminar epidural steroid injection (CIESI) with epidural catheter advancement to the side and level of pathology versus standard C7-T1 CIESI. This study investigated whether cervical radicular pain is more effectively treated by CIESI with a targeted epidural catheter versus a standard C7-T1 approach. ⋯ This trial showed no significant difference in clinical outcomes with CIESI using a targeted epidural catheter compared to a standard C7-T1 approach for the treatment of unilateral cervical radicular pain at the C5 or C6 level. Both techniques were associated with clinically meaningful improvement across outcome domains of pain, function, disability, and medication use. These effects persisted to 6-month follow-up.The study was registered at Clinical Trials.gov (NCT02095197).