Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2007
Ultrasound guidance with nerve stimulation reduces the time necessary for resident peripheral nerve blockade.
Educating residents in peripheral nerve blockade may impact the efficiency of a busy regional anesthesia service. Ultrasound guidance may affect the efficiency and effectiveness of nerve block. We examined the impact of ultrasound guidance on resident performance of peripheral nerve block in a regional anesthesia rotation. ⋯ During resident teaching, ultrasound-aided peripheral nerve-stimulated block required less time to perform than did nerve-stimulator-guided blocks. Fewer needle insertions were required to perform the ultrasound-guided blocks, and there were fewer blood vessel punctures when ultrasound was used.
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Reg Anesth Pain Med · Sep 2007
Transversus abdominis plane block: a cadaveric and radiological evaluation.
The abdominal wall is a significant source of pain after abdominal surgery. Anterior abdominal wall analgesia may assist in improving postoperative analgesia. We have recently described a novel approach to block the abdominal wall neural afferents via the bilateral lumbar triangles of Petit, which we have termed a transversus abdominis plane block. The clinical efficacy of the transversus abdominis plane block has recently been demonstrated in a randomized controlled clinical trial of adults undergoing abdominal surgery. ⋯ These findings define the anatomic characteristics of the transversus abdominis plane block, and underline the clinical potential of this novel block.
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Reg Anesth Pain Med · Sep 2007
Review Case Reports Meta AnalysisBeyond spinal headache: prophylaxis and treatment of low-pressure headache syndromes.
This Evidence-Based Case Management article evaluates and grades the evidence for two anesthesiology-related interventions: prophylaxis after unintentional meningeal puncture and treatment of spontaneous intracranial hypotension (SIH). ⋯ The highest quality randomized controlled trials suggest that prophylactic epidural blood patch (EBP) does not reduce the incidence of headache after unintentional meningeal puncture. The weight of existing literature supports EBP as an initial treatment of SIH, although its effectiveness does not approach that seen when EBP is used to treat meningeal puncture headache.