Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2006
Randomized Controlled Trial Comparative StudyA comparison of the lateral and posterior approach for brachial plexus block.
Brachial plexus block by the posterior approach described by Pippa is not widely used in contrast to the lateral approach of Winnie. We compared the clinical efficacy of both approaches in a randomized prospective study. ⋯ Both approaches are comparable regarding clinical efficacy for anesthesia of the shoulder and upper arm.
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Reg Anesth Pain Med · Mar 2006
Case ReportsTotal elbow arthroplasty as an outpatient procedure using a continuous infraclavicular nerve block at home: a prospective case report.
Total elbow arthroplasty (TEA) often results in severe postoperative pain requiring hospitalization to provide potent analgesia. This prospective series investigated the feasibility of converting TEA into an ambulatory procedure using a continuous infraclavicular nerve block provided at home with a portable infusion pump. ⋯ These cases suggest that for a subset of patients without major comorbidities, it is feasible to convert total elbow arthroplasty into an ambulatory procedure using a continuous infraclavicular nerve block as part of a multimodal analgesic regimen provided at home. Additional research is required to replicate these results in a controlled trial, define the appropriate subset of patients, and assess the incidence of complications associated with this practice before its mainstream use.
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Reg Anesth Pain Med · Mar 2006
Comparative StudyRelationship between the bevel of the Tuohy needle and catheter direction in thoracic epidural anesthesia.
Directing an epidural catheter cephalad or caudad is usually attempted by orienting the beveled edge of the epidural needle. However, there have been few studies about the relationship between the direction of the bevel of epidural needle and the resulting position of the catheter. We studied this relationship in thoracic epidural catheter placement. Catheter position was confirmed by using picture archiving communication systems (PACS). PACS is a workstation that stores radiologic images, which can be manipulated to visualize the catheters. ⋯ The correlation between bevel direction and location of the thoracic epidural catheter was relatively low. Practices such as threading an epidural catheter by manipulation of the Tuohy needle for the control of pain at a distant site may not yield good results.