Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2007
Randomized Controlled Trial Comparative StudyUltrasound-guided versus computed tomography-controlled facet joint injections in the lumbar spine: a prospective randomized clinical trial.
Facet joint injections are widely used for alleviation of back pain. Injections are preferentially performed as fluoroscopy or computed tomography (CT)-controlled interventions. Ultrasound provides real-time monitoring, does not produce ionizing radiation, and is broadly available. ⋯ The ultrasound approach to the facet joints in the lumbar spine is feasible with minimal risks in a large majority of patients and results in a significant reduction of procedure duration and radiation dose.
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Reg Anesth Pain Med · Jul 2007
Randomized Controlled Trial Comparative StudyPreliminary evaluation of infraclavicular catheters inserted using ultrasound guidance: through-the-catheter anesthesia is not inferior to through-the-needle blocks.
This prospective study compared the initial block quality and surgical anesthesia rates of ultrasound-guided infraclavicular blocks with local-anesthetic injected through a catheter versus through a needle. We hypothesized that positioning of the catheter immediately posterior to the axillary artery would produce through-the-catheter (TTC) anesthesia with rates of complete block not inferior to through-the-needle (TTN) injection. ⋯ Ultrasound-guided TTC infraclavicular block produced perioperative anesthesia that was not inferior to a TTN technique.
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Reg Anesth Pain Med · Jul 2007
Case ReportsUneventful removal of an epidural catheter guided by impedance aggregometry in a patient with recent coronary stenting and treated with clopidogrel and acetylsalicylic acid.
This report suggests that impedance aggregometry can be helpful to assess optimum time for and minimize the risk of catheter removal during double antiplatelet therapy. ⋯ Balancing the risks of stent occlusion and epidural bleeding, bedside impedance aggregometry helped to identify the optimum time window for epidural catheter removal with the lowest bleeding risk in this patient.