Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2010
Comparative StudyPerineural dexmedetomidine provides an increased duration of analgesia to a thermal stimulus when compared with a systemic control in a rat sciatic nerve block.
The present study was designed to test the hypothesis that perineural dexmedetomidine provides a longer duration of analgesia than the same dose given subcutaneously in a peripheral nerve block in rats. ⋯ Sensory analgesia provided by dexmedetomidine added to ropivacaine for peripheral nerve blocks in rat is a peripherally mediated effect.
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Reg Anesth Pain Med · Sep 2010
Ultrasound-guided continuous oblique subcostal transversus abdominis plane blockade: description of anatomy and clinical technique.
Recently, ultrasound-guided transversus abdominis plane blockade for abdominal wall analgesia has been described, and it involves injection of local anesthetic into the transversus abdominis plane. The posterior approach involves injection of local anesthetic in the lateral abdominal wall between the costal margin and the iliac crest and is suitable for postoperative analgesia after surgery below the umbilicus. The subcostal approach is suitable after abdominal surgery in the periumbilical region. The subcostal block can be modified, and the needle can be introduced along the oblique subcostal line from the xyphoid process toward the anterior part of the iliac crest. ⋯ A catheter can be placed along the oblique subcostal line in the transversus abdominis plane for continuous infusion of local anesthetic. Multimodal analgesia and intravenous opioid are used in addition because visceral pain is not blocked. Continuous oblique subcostal transversus abdominis plane block is a new technique and requires both a detailed knowledge of sonographic anatomy and technical skill for it to be successful.