Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2009
Randomized Controlled Trial Comparative StudyA comparison of sensory and motor loss after a femoral nerve block conducted with ultrasound versus ultrasound and nerve stimulation.
Controversy exists regarding the need for nerve stimulation when performing an ultrasound (US)-guided peripheral nerve block. We tested the hypothesis that the quality of a femoral nerve block (FNB) performed with US is equivalent to an FNB performed with US and nerve stimulation. ⋯ The addition of nerve stimulation to a US-guided FNB did not change preoperative block efficacy.
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Reg Anesth Pain Med · Sep 2009
Randomized Controlled TrialDoes local anesthetic dilution influence the clinical effectiveness of multiple-injection axillary brachial plexus block?: a prospective, double-blind, randomized clinical trial in patients undergoing upper limb surgery.
The relationship between the dose, volume, and concentration of local anesthetic and the quality and success of regional anesthesia remains unclear. Our aim was to test whether using 3 different volumes of the same local anesthetic dose influences the success rate of an axillary brachial plexus block with a multiple-injection technique in patients undergoing upper limb surgery. ⋯ An axillary brachial plexus block induced with a multiple-injection technique with mepivacaine 400 mg yields a high success rate regardless of the volume of anesthetic injected.
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Reg Anesth Pain Med · Jul 2009
Randomized Controlled Trial Comparative StudyA randomized, observer-blinded determination of the median effective volume of local anesthetic required to anesthetize the sciatic nerve in the popliteal fossa for stimulating and nonstimulating perineural catheters.
Stimulating perineural catheters are developed to overcome technical problems of nonstimulating catheters, but their efficacy remains controversial. However, no volume-response study has compared success rates between stimulating and nonstimulating catheters. This study of stimulating versus nonstimulating catheters compares the minimal effective volume required to successfully block the sciatic nerve in 50% of patients scheduled for unilateral hallux valgus repair. ⋯ Stimulating popliteal catheters dramatically decrease the volume required to block the sciatic nerve in 50% of patients, compared with nonstimulating catheters.
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Reg Anesth Pain Med · Jul 2009
Randomized Controlled Trial Comparative StudyUltrasound machine comparison: an evaluation of ergonomic design, data management, ease of use, and image quality.
The use of ultrasound technology for vascular access and regional anesthesia is gaining widespread acceptance among anesthesia providers. As a result, many group practices and medical institutions are considering purchasing ultrasound equipment. Currently, comparative information regarding the ergonomic design, physical and adjustable features, data management, ease of use, cost, and image quality of various ultrasound machines is not available. The primary goal of this investigation was to develop an objective process of evaluating ultrasound equipment before purchase. The process of evaluation used in the current investigation may be used when comparing a variety of medical technologies. ⋯ Anesthesia providers considering an ultrasound equipment purchase should objectively evaluate machine models that have features most important to their own clinical practice. Ergonomic design, physical and adjustable features, data management, ease of use, image quality, and cost are important features to consider when evaluating an ultrasound machine.
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Reg Anesth Pain Med · Jul 2009
Randomized Controlled Trial Comparative StudyParavertebral block in inguinal hernia surgeries: two segments or 4 segments?
In this study, we compare paravertebral block (PVB) of the T10 and L1 segments and multiple-segment PVB for anesthesia and analgesia in inguinal hernia surgeries. ⋯ Two-segment PVB can be an alternative to 4-segment PVB in inguinal hernia surgeries. Decreasing the number of injections required in this technique may further increase patient comfort and decrease complications.