Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2012
Randomized Controlled Trial Multicenter Study Comparative StudyBupivacaine extended-release liposome injection exhibits a favorable cardiac safety profile.
Bupivacaine extended-release liposome injection is an investigational local analgesic intended for use in postsurgical pain management. In recognition of the incompletely characterized association of bupivacaine use and cardiac effects, this article reviews the cardiac safety profile of this novel formulation of bupivacaine. ⋯ A focused assessment of ECG data from a phase 2 study and cardiac findings/AEs data from other studies in the bupivacaine extended-release development program did not reveal any cardiac safety issues.
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Reg Anesth Pain Med · Mar 2012
Randomized Controlled TrialThe analgesic effects of a bilateral sternal infusion of ropivacaine after cardiac surgery.
The aim of this study was to assess the effects of a continuous postoperative administration of local anesthetic through 2 catheters placed deeply under fascia at the lateral edges of the sternum, close to the emergence of the intercostal nerves. We focused on pain during mobilization, as this aspect is likely to interact with postoperative morbidity. ⋯ This technique may find a role within the framework of multimodal analgesia after sternotomy, although further confirmatory studies are needed.
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Reg Anesth Pain Med · Mar 2012
Randomized Controlled Trial Comparative StudyBilateral transversus abdominis plane block does not decrease postoperative pain after laparoscopic cholecystectomy when compared with local anesthetic infiltration of trocar insertion sites.
Transversus abdominis plane (TAP) block has been shown to reduce pain and analgesic requirements after abdominal surgery. Our hypothesis was that bilateral TAP blocks decrease pain after laparoscopic cholecystectomy when compared with local anesthetic infiltration of trocar insertion sites. ⋯ Bilateral ultrasound-guided TAP block is equivalent to local anesthetic infiltration of trocar insertion sites for overall postoperative pain in a heterogeneous group of patients undergoing laparoscopic cholecystectomy.
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Reg Anesth Pain Med · Jan 2012
Randomized Controlled TrialUltrasound-guided regional anesthesia performance in the early learning period: effect of simulation training.
Success in performing ultrasound-guided peripheral nerve blockade (PNB) demands sound knowledge of sonoanatomy, good scanning techniques, and proper hand-eye coordination. The objectives of our study were to evaluate whether simulator training aids success of novice operators in ultrasound-guided PNB and to determine what number of procedures is required to attain proficiency. ⋯ Simulation training improves success rate in ultrasound-guided performance of regional anesthesia.
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Reg Anesth Pain Med · Jan 2012
Randomized Controlled Trial Comparative StudyTriple-blind randomized clinical trial of time until sensory change using 1.5% mepivacaine with epinephrine, 0.5% bupivacaine, or an equal mixture of both for infraclavicular block.
Practitioners mix faster-onset, intermediate-duration local anesthetics (LAs) with slower-onset, long-duration LAs to get fast peripheral nerve block (PNB) onset and long duration. We hypothesized that 1.5% mepivacaine (with epinephrine) (mepivacaine) or 1.5% mepivacaine (with epinephrine) mixed with 0.5% bupivacaine (mixed) would reduce PNB sensory onset by 20% or more versus 0.5% bupivacaine alone (bupivacaine). ⋯ Mixing 1.5% mepivacaine (with epinephrine) with 0.5% bupivacaine speeds up PNB sensory (motor) onset compared with 0.5% bupivacaine alone.