Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2013
Randomized Controlled TrialAdjuvant dexamethasone for bupivacaine sciatic and ankle blocks: results from 2 randomized placebo-controlled trials.
Perineural dexamethasone may improve post-op analgesia for sciatic blocks but not for ankle blocks when compared with systemic dexamethasone.
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Reg Anesth Pain Med · Jul 2013
Randomized Controlled Trial Comparative StudyThe effects of ultrasound-guided adductor canal block versus femoral nerve block on quadriceps strength and fall risk: a blinded, randomized trial of volunteers.
Adductor canal block (ACB) has been suggested as an analgesic alternative to femoral nerve block (FNB) for procedures on the knee, but its effect on quadriceps motor function is unclear. We performed a randomized, blinded study to compare quadriceps strength following adductor canal versus FNB in volunteers. Our hypothesis was that quadriceps strength would be preserved following ACB, but not FNB. Secondary outcomes included relative preservation of hip adduction and degree of balance impairment. ⋯ Compared with FNB, ACB results in significant quadriceps motor sparing and significantly preserved balance.
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Reg Anesth Pain Med · Jul 2013
Randomized Controlled TrialPatient perspectives of patient-controlled analgesia (PCA) and methods for improving pain control and patient satisfaction.
This study aimed to (1) identify patient-controlled analgesia (PCA) attributes that negatively impact patient satisfaction and ability to control pain while using PCA and (2) obtain data on patient perceptions of new PCA design features. ⋯ A majority of patients, irrespective of their satisfaction with PCA, preferred a new PCA design. Certain attributes of current PCA technology may negatively impact patient experience, and modifications could potentially address these concerns and improve patient outcomes.
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Reg Anesth Pain Med · May 2013
Randomized Controlled TrialFascia lliaca block for analgesia after hip arthroplasty: a randomized double-blind, placebo-controlled trial.
Fascia iliaca block (FIB) is often used to treat pain after total hip arthroplasty (THA), despite a lack of randomized trials to evaluate its efficacy for this indication. The objective of this study was to assess the analgesic benefit of FIB after THA. Our primary hypothesis was administration of FIB decreases the intensity of postoperative pain (numeric rating scale [NRS-11] score) compared with sham block (SB) in patients after THA. ⋯ The evidence in these data suggests that the difference in average pain intensity after FIB versus SB was not significant (95% confidence interval, -2.2-1.4 NRS units).
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Reg Anesth Pain Med · May 2013
Randomized Controlled Trial Comparative StudyUltrasound-guided popliteal block through a common paraneural sheath versus conventional injection: a prospective, randomized, double-blind study.
The macroscopic anatomy of a common paraneural sheath that surrounds the sciatic nerve in the popliteal fossa has been studied recently in a human cadaveric study. It has been suggested that an injection through this sheath could be an ideal location for local anesthetic administration for popliteal block. The aim of the present study was to evaluate the hypothesis that popliteal sciatic nerve blockade through a common paraneural sheath results in shorter onset time when compared with conventional postbifurcation injection external to the paraneural tissue. To illustrate the microscopic anatomy of the paraneural tissues, we performed histological examinations of a human leg specimen. ⋯ An ultrasound-guided popliteal sciatic nerve block through a common paraneural sheath at the site of sciatic nerve bifurcation is a simple, safe, and highly effective block technique. It results in consistently short onset time, while respecting the integrity of the epineurium and intraneural structures.