Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialSpinal hyperbaric ropivacaine-fentanyl for day-surgery.
Adequate intraoperative analgesia combined with faster mobilization might be achieved by replacing hyperbaric ropivacaine partly with fentanyl. ⋯ Faster mobilization but equal onset and duration of analgesia were achieved with intrathecal hyperbaric ropivacaine 10 mg plus fentanyl 20 microg as compared with hyperbaric ropivacaine 15 mg.
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Reg Anesth Pain Med · Jan 2005
ReviewNo evidence for analgesic effect of intra-articular morphine after knee arthroscopy: a qualitative systematic review.
Intra-articular (IA) injection of morphine has been the subject of many randomized clinical trials (RCTs). Both negative and positive results have been obtained in trials with a preemptive design, and the question of efficacy remains unresolved. Recent RCTs on patients whose inclusion was delayed until a baseline pain of at least moderate intensity was documented have illuminated the pitfalls of IA analgesic trials. Previously published systematic reviews may have included flawed RCTs in the analyses. ⋯ There are few well-controlled RCTs on IA morphine, and the negative trials of higher quality counter the evidence from the numerous positive ones of lower quality. The quality of most published trials is poor, and performing meta-analysis on these data is not meaningful. Properly controlled trials, in which early postoperative pain intensity is documented, suggest that there is no added analgesic effect of IA morphine compared with saline alone.
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Reg Anesth Pain Med · Jan 2005
Case ReportsTwo cases of a wrong-site peripheral nerve block and a process to prevent this complication.
The purpose of this study was to develop a system to prevent laterality errors while performing peripheral nerve blockade. ⋯ The anesthesiologist plays an important role in preventing wrong-site peripheral nerve blockade and surgery. The protocol developed for "Pre-Anesthetic Site Verification" as a supplement to our preoperative site verification policy is invaluable in preventing wrong-site anesthesia and surgery.