Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2005
Multicenter StudyClinical evaluation of the lateral sagittal infraclavicular block developed by MRI studies.
Lateral sagittal infraclavicular block by single injection has a faster performance time and causes less discomfort than does axillary block by multiple injections. This prospective, descriptive, multicenter study assessed block effectiveness, onset time, and incidence of adverse events and verified the noninvasive measurements from magnetic resonance imaging (MRI). ⋯ Block effectiveness (91%) and onset time (20 minutes) were satisfactory and comparable to the vertical paracoracoid approach. The low rate of axillary vessel punctures (2%) may be the most important advantage of this block. The needle insertion depth measurements confirmed the MRI findings, but the dorsal angle was steeper than predicted.
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Reg Anesth Pain Med · Jul 2005
Plasma concentrations and analgesic effects of ropivacaine 3.75 mg/ml during long-term extrapleural analgesia after thoracotomy.
Fourteen patients received long-term extrapleural analgesia with ropivacaine for postoperative pain relief after posterolateral thoracotomy. We determined plasma concentrations of ropivacaine as well as pain scores and opioid consumption to assess the analgesic effect. ⋯ A dose of 0.375 mg/kg/h of ropivacaine can safely be administered for long-term extrapleural analgesia after thoracotomy.
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Reg Anesth Pain Med · Jul 2005
Differential block of N-propyl derivatives of amitriptyline and doxepin for sciatic nerve block in rats.
The propyl group of ropivacaine ( N -propyl-2',6'-pipecoloxylidide hydrochloride) could be responsible for conferring some sensory selectivity to this drug. Thus, adding a propyl group to experimental local anesthetics (LAs) (e.g., the tricyclic antidepressants amitriptyline and doxepin) to increase sensory selectivity may be useful. We, therefore, synthesized N -propyl amitriptyline and N -propyl doxepin and investigated a potential predominance of sensory/nociceptive block over motor block (differential block) in a rat sciatic nerve block model. In addition, tetrodotoxin (TTX), a naturally occuring Na + channel blocker, was coinjected to investigate whether it increased block duration. ⋯ Detailed histopathologic nerve toxicity evaluations are justified to determine whether N -propyl amitriptyline has potential as a more sensory-selective local anesthetic at lower concentrations or as a predominantly sensory-selective neurolytic agent at higher concentrations.
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Reg Anesth Pain Med · Jul 2005
Ultrasound-guided periradicular injections in the middle to lower cervical spine: an imaging study of a new approach.
The objective of this study was to show the efficacy of ultrasound in facilitating the performance of a simulated cervical periradicular injection in cadavers. ⋯ This preclinical study suggests that ultrasound is a useful guiding tool for periradicular injections in the cervical spine.
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Reg Anesth Pain Med · Jul 2005
Systemic meloxicam reduces tactile allodynia development after L5 single spinal nerve injury in rats.
Although recent evidence suggests that cyclooxygenase-2 (COX-2) may contribute to the development and management of neuropathic pain, the efficacy of COX-2 inhibitor against neuropathic pain is still unclear. In this study, we investigated the effects of the systemic administration of the selective COX-2 inhibitor meloxicam at an early stage after nerve injury on the development of tactile allodynia in L5 single spinal-nerve injury in rats. ⋯ Systemic administration of 2 mg/kg and 4 mg/kg of meloxicam at an early stage after nerve injury attenuated the development of tactile allodynia. These results suggest that COX-2 may be at least in part involved in the development of tactile allodynia in an L5 single spinal-nerve injury model.