Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2010
Randomized Controlled Trial Comparative StudyA prospective, randomized comparison between single- and double-injection ultrasound-guided infraclavicular brachial plexus block.
This prospective, randomized, observer-blinded study compared single- and double-injection ultrasound-guided infraclavicular brachial plexus block for upper extremity surgery. ⋯ The double-injection ultrasound-guided infraclavicular block provides no significant advantages compared with its single-injection counterpart.
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Reg Anesth Pain Med · Jan 2010
Comparative StudyNeedle-induced paresthesiae during single-shot spinal anesthesia: a comparison of sitting versus lateral decubitus position.
Paresthesiae occasionally occur during spinal puncture or injection of local anesthetic for spinal anesthesia. No information is currently available regarding the effects of the patient's position on the incidence of needle-induced paresthesiae. The purpose of this prospective, observational study was to compare the occurrence of needle-induced paresthesiae in patients who received single-shot spinal anesthesia in the sitting position or in the lateral decubitus position. ⋯ Patient's position may influence the occurrence of needle-induced paresthesiae during spinal anesthesia. Lateral decubitus position resulted in a higher incidence of paresthesiae than the sitting position. However, there is no position-related difference noted if a single-needle puncture is sufficient to perform the block.
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Reg Anesth Pain Med · Jan 2010
Modeling cost of ultrasound versus nerve stimulator guidance for nerve blocks with sensitivity analysis.
Ultrasound guidance for regional anesthesia has increased in popularity. However, the cost of ultrasound versus nerve stimulator guidance is controversial, as multiple and varying cost inputs are involved. Sensitivity analysis allows modeling of different scenarios and determination of the relative importance of each cost input for a given scenario. ⋯ If revenue is generated, then ultrasound-guided blocks consistently become a profit center regardless of clinical scenario in our model. Without revenue, the clinical scenario dictates the cost of ultrasound. In an ambulatory setting, ultrasound is highly competitive with nerve stimulator and requires at least a 96% success rate with nerve stimulator before becoming more expensive. In a hospitalized scenario, ultrasound is consistently more expensive as the uniform use of general anesthesia and hospitalization negate any positive cost effects from greater efficiency with ultrasound.
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Reg Anesth Pain Med · Jan 2010
The efficiency of pulsed radiofrequency application on L5 and l6 dorsal roots in rabbits developing neuropathic pain.
Injury of a peripheral nerve may lead to neuropathic pain, a form of chronic pain that does not respond to traditional pain therapies. The aim of this study was to investigate the effect of pulsed radiofrequency (PRF) applied to the L5 and L6 dorsal roots on the neuropathic pain that develops after sciatic nerve injury in rabbits. ⋯ The hyperalgesia that develops as a result of neuropathic pain in rabbits was observed to be reduced by PRF application.