Regional anesthesia and pain medicine
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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 · 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 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 · May 2013
Randomized Controlled TrialA randomized comparison between 3 combinations of volume and concentration of lidocaine for ultrasound-guided infraclavicular block.
This prospective, randomized, observer-blinded study compared 3 combinations of volume and concentration using the same total dose of lidocaine for ultrasound-guided infraclavicular block. ⋯ Using an identical dose (525 mg) of adrenalized lidocaine for ultrasound-guided infraclavicular block, we found no differences in onset time among 3 commonly used concentrations (1%, 1.5%, and 2%). Further studies are required to determine the optimal combination of volume and concentration of lidocaine for other ultrasound-guided approaches to the brachial plexus.
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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).