Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2014
Randomized Controlled TrialTreatment of Postmastectomy Pain With Ambulatory Continuous Paravertebral Nerve Blocks: A Randomized, Triple-Masked, Placebo-Controlled Study.
We aimed to determine with this randomized, triple-masked, placebo-controlled study if benefits are afforded by adding a multiple-day, ambulatory, continuous ropivacaine paravertebral nerve block to a single-injection ropivacaine paravertebral block after mastectomy. ⋯ After mastectomy, adding a multiple-day, ambulatory, continuous ropivacaine infusion to a single-injection ropivacaine paravertebral nerve block results in improved analgesia and less functional deficit during the infusion. However, no benefits were identified after infusion discontinuation.
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Reg Anesth Pain Med · Mar 2014
Randomized Controlled Trial Comparative StudyA Randomized Comparison of the Efficacy of 2 Techniques for Piriformis Muscle Injection: Ultrasound-Guided Versus Nerve Stimulator With Fluoroscopic Guidance.
Piriformis muscle injections are most often performed using fluoroscopic guidance; however, ultrasound (US) guidance has recently been described extensively in the literature. No direct comparisons between the 2 techniques have been performed. Our objective was to compare the efficacy and efficiency of fluoroscopic- and US-guided techniques. ⋯ Ultrasound-guided piriformis injections provide similar outcomes to fluoroscopically guided injections without differences in imaging, needling, or overall procedural times.
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Reg Anesth Pain Med · Jan 2014
Randomized Controlled Trial Comparative StudyDexmedetomidine Added to Ropivacaine Extends the Duration of Interscalene Brachial Plexus Blocks for Elective Shoulder Surgery When Compared with Ropivacaine Alone: A Single-Center, Prospective, Triple-Blind, Randomized Controlled Trial.
Dexmedetomidine 150 mcg significantly extends the duration of ropivacaine interscalene block by almost 30% without significant adverse effect.
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Reg Anesth Pain Med · Jan 2014
Randomized Controlled TrialThe Effect of Nitrous Oxide Anesthesia on Early Postoperative Opioid Consumption and Pain.
Intraoperative nitrous oxide use does not improve post-operative analgesia or reduce opioid consumption.
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Reg Anesth Pain Med · Jan 2014
Randomized Controlled TrialIncreases in the Use of Prescription Opioid Analgesics and the Lack of Improvement in Disability Metrics Among Users.
In the United States, use of oral opioid analgesics has been associated with increasing rates of addiction, abuse, and diversion. However, little is known about the recent national use of non-illicit prescription opioid analgesics (those prescribed in a physician-patient relationship), the primary source of these drugs for the general US population. Our primary objective was to examine trends in the use of prescription opioid analgesics in the United States and to identify defining characteristics of patient users of prescribed opioids from 2000 to 2010. ⋯ The use of prescription opioid analgesics among adult Americans has increased in recent years, and this increase does not seem to be associated with improvements in disability and health status among users. On a public health level, these data suggest that there may be an opportunity to reduce the prescribing of opioid analgesics without worsening of population health metrics.