Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2012
Three-dimensional/four-dimensional volumetric ultrasound imaging of the sciatic nerve.
Currently, there are limited data on the use of 3-dimensional ultrasound to image peripheral nerves. We undertook this imaging study to determine the feasibility of using 3-dimensional ultrasound imaging to delineate the anatomy of the sciatic nerve. ⋯ We have demonstrated that it is feasible to perform 3-dimensional ultrasound imaging of the sciatic nerve. The anatomic information obtained is more detailed than that with a 2-dimensional scan, which provides better insight into the spatial relationship of the sciatic nerve with its surrounding structures. A distinct "perineural space" was also identified alongside the course of the sciatic nerve, which may play a significant role in sciatic nerve blockade.
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Reg Anesth Pain Med · Jan 2012
Association of perioperative use of nonsteroidal anti-inflammatory drugs with postoperative myocardial infarction after total joint replacement.
Use of nonsteroidal anti-inflammatory drug (NSAIDs) analgesics is controversial because of cardiovascular risk, but perioperative use may be advantageous for total joint replacement. Thus, we performed this single-center observational cohort study to determine any association between NSAID use and postoperative myocardial infarction (POMI). ⋯ Brief perioperative use of NSAIDs was not associated with increased risk for myocardial infarction after total hip and knee replacement; it may provide benefit in length of stay.
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Reg Anesth Pain Med · Jan 2012
Comparative StudyCutaneous analgesia and systemic toxicity of carbetapentane and caramiphen in rats.
Caramiphen produces spinal anesthesia; caramiphen and carbetapentane have never been tested as infiltrative cutaneous analgesic. The aim of this study was to compare cutaneous analgesia of caramiphen and carbetapentane with bupivacaine and evaluated their central nervous system and cardiovascular toxicity. ⋯ Carbetapentane and caramiphen were similar to bupivacaine at producing durations of cutaneous analgesia but were less likely than bupivacaine to induce central nervous system and cardiovascular systemic toxicity.
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Reg Anesth Pain Med · Jan 2012
Regional hemodynamic changes after an axillary brachial plexus block: a pulsed-wave Doppler ultrasound study.
Brachial plexus block (BPB) causes vasodilatation and an increase in blood flow to the ipsilateral upper limb. However, no reports have comprehensively evaluated the regional hemodynamic changes after a BPB. ⋯ Regional hemodynamic changes that occur after an axillary BPB include a change in the morphology of the PWD spectral waveform, arterial vasodilatation, an increase in blood flow velocity, and an increase in blood flow through the ipsilateral brachial artery.