Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2015
Randomized Controlled TrialPectoral Nerves I and II Blocks in Multimodal Analgesia for Breast Cancer Surgery: A Randomized Clinical Trial.
The pectoral nerves (Pecs) block types I and II are novel techniques to block the pectoral, intercostobrachial, third to sixth intercostals, and the long thoracic nerves. They may provide good analgesia during and after breast surgery. Our study aimed to compare prospectively the quality of analgesia after modified radical mastectomy surgery using general anesthesia and Pecs blocks versus general anesthesia alone. ⋯ The combined Pecs I and II block is a simple, easy-to-learn technique that produces good analgesia for radical breast surgery.
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Reg Anesth Pain Med · Nov 2014
Randomized Controlled TrialEffect of Intravenous Lidocaine on Postoperative Recovery of Patients Undergoing Mastectomy: A Double-Blind, Placebo-Controlled Randomized Trial.
One of the modalities of treatment for breast cancer surgery pain is opioids, and opioids are associated with adverse effects such as itching and postoperative nausea and vomiting (PONV). Intravenous (IV) lidocaine has been shown to reduce opioid consumption and to improve overall postoperative outcomes in abdominal surgery. In this study, we tested the effect of intraoperative IV lidocaine infusion on the quality of postoperative recovery after breast cancer surgery. ⋯ Our findings did not show a significant effect of IV lidocaine during breast cancer surgery on opioid consumption, pain score, PONV, or fatigue, indicating that the benefit of this approach does not generalize across all types of surgery.
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Reg Anesth Pain Med · Nov 2014
Randomized Controlled TrialContinuous Right Thoracic Paravertebral Block Following Bolus Initiation Reduced Postoperative Pain After Right-Lobe Hepatectomy: A Randomized, Double-Blind, Placebo-Controlled Trial.
We hypothesized that continuous right thoracic paravertebral block, following bolus initiation, decreases opioid consumption after right-lobe hepatectomy in patients receiving patient-controlled intravenous analgesia with sufentanil. ⋯ Continuous right thoracic paravertebral block, following bolus initiation, has an opioid-sparing effect on sufentanil patient-controlled intravenous analgesia for right-lobe hepatectomy patients and reduces numerical rating scale pain scores at rest and with coughing in the first 24 postoperative hours.
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Reg Anesth Pain Med · Nov 2014
Randomized Controlled TrialThe Effect of Gowning on Labor Epidural Catheter Colonization Rate: A Randomized Controlled Trial.
The need to gown for labor epidural catheter insertion is controversial. The American Society of Regional Anesthesia and Pain Medicine has identified a lack of randomized controlled trials investigating this issue. The purpose of this study was to examine the effect of gowning on colonization rates following epidural catheter insertion for labor analgesia. ⋯ The use of gowns in the current study did not affect catheter colonization rate. Overall, there was a relatively high incidence of catheter-tip colonization in both groups, which underscores the need for strict aseptic technique.
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Reg Anesth Pain Med · Sep 2014
Randomized Controlled TrialUltrasound-Guided Continuous Interscalene Block: The Influence of Local Anesthetic Background Delivery Method on Postoperative Analgesia After Shoulder Surgery: A Randomized Trial.
Automated bolus delivery has recently been shown to reduce local anesthetic consumption and improve analgesia, compared with continuous infusion, in continuous sciatic and epidural block. However, there are few data on the influence of local anesthetic delivery method on local anesthetic consumption following interscalene blockade. This randomized, double-blind trial was designed to determine whether hourly automated perineural boluses (4 mL) of local anesthesia delivered with patient-controlled pro re nata (PRN, on demand) boluses would result in a reduction in total local anesthesia consumption during continuous interscalene blockade after shoulder surgery compared with continuous perineural infusion (4 mL/h) plus patient-controlled PRN boluses. ⋯ In continuous interscalene blockade under ultrasound guidance after shoulder surgery, automated boluses of local anesthetic combined with PRN boluses did not provide any reduction in local anesthetic consumption or rescue analgesia, compared with continuous infusion combined with PRN boluses.