Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2014
Case ReportsAdductor canal block can result in motor block of the quadriceps muscle.
The block of nerves in the adductor canal is considered to cause a sensory block without a motor component. In this report, we describe a case of significant quadriceps muscle weakness after an adductor canal block (ACB). ⋯ Several studies have reported that ACB involves no motor blockade. However, our case report illustrates that the ACB can result in clinically significant quadriceps muscle paralysis. This report suggests that patients should be monitored vigilantly for this occurrence to decrease the risk of falls.
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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
Case ReportsEpidural Hematomas After Removal of Percutaneous Spinal Cord Stimulator Trial Leads: Two Case Reports.
We report 2 cases of spinal epidural hematoma formation after the removal of percutaneous spinal cord stimulator trial leads and discuss the possible etiologies of these complications. ⋯ Currently, the neuromodulation community ascribes to the American Society of Regional Anesthesia and Pain Medicine guidelines, which state that nonsteroidal anti-inflammatory drugs do not significantly increase the risk for epidural hematoma with neuraxial anesthesia and, therefore, there is no need to discontinue these drugs before epidural or spinal anesthesia. We suggest that these guidelines may not be appropriate for neuromodulatory techniques that likely subject the surrounding vasculature to more trauma than neuraxial anesthesia. We recommend discontinuing nonsteroidal anti-inflammatory drugs, particularly aspirin, before neuromodulation procedures. Further investigation will establish a timeframe for holding these drugs to optimize patient safety.
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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.
pearl