Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2008
Randomized Controlled TrialAnalgesic effect of lidocaine patch 5% in the treatment of acute herpes zoster: a double-blind and vehicle-controlled study.
Although lidocaine patch 5% has been widely used for postherpetic neuralgia, its analgesic effect on the intense pain associated with acute herpes zoster has not been investigated because of its potential hazard to damaged skin. ⋯ This study demonstrates that lidocaine patch 5%, applied twice a day, could serve as a well tolerated and effective modality to relieve moderate to severe pain associated with acute herpes zoster presumably through its pharmacological action and physical barrier effect on sensitized skin.
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Reg Anesth Pain Med · Jul 2008
Randomized Controlled TrialOndansetron given intravenously attenuates arterial blood pressure drop due to spinal anesthesia: a double-blind, placebo-controlled study.
Side effects of spinal anesthesia include arterial hypotension and bradycardia. Both of them may be induced by sympathetic nerve blockade as well as by the Bezold-Jarisch reflex, which may be mediated by peripheral serotonin receptors (5-HT(3) type). The aim of this study was to verify the hypothesis that blockade of type 3 serotonin receptors by intravenous ondansetron administration might reduce hypotension and bradycardia induced by spinal anesthesia. ⋯ Ondansetron given intravenously attenuates the fall of systolic and mean blood pressure, but does not have an influence on diastolic blood pressure or heart rate.
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Reg Anesth Pain Med · May 2008
Randomized Controlled TrialUltrasound guidance improves the success of sciatic nerve block at the popliteal fossa.
Real time ultrasound guidance is a recent development in the area of peripheral nerve blockade. There are limited data from prospective randomized trials comparing its efficacy to that of traditional nerve localization techniques. In the present study, we tested the hypothesis that ultrasound guidance improves the success rate of sciatic nerve block at the popliteal fossa when compared with a nerve stimulator-guided technique. ⋯ Ultrasound guidance enhances the quality of popliteal sciatic nerve block compared with single injection, nerve stimulator-guided block using either a tibial or peroneal endpoint. Ultrasound guidance resulted in higher success, faster onset, and progression of sensorimotor block, without an increase in block procedure time, or complications.
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Reg Anesth Pain Med · May 2008
Randomized Controlled Trial Comparative StudyThe effects of an epidural infusion of ropivacaine versus saline on sensory block after spinal anesthesia.
Several investigators have described the effect of bolus injections on sensory block during combined spinal epidural anesthesia. This study investigates the effects of the immediate epidural infusion of 0.2% ropivacaine versus 0.9% saline on spinal anesthesia. ⋯ Epidural infusion of ropivacaine 0.2% initiated immediately after spinal anesthesia prolonged the regression of motor block but not the regression of sensory block when compared with saline infusion.
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Reg Anesth Pain Med · May 2008
Randomized Controlled Trial Comparative StudyUltrasonographic guidance improves the success rate of interscalene brachial plexus blockade.
The use of ultrasonography in regional anesthetic blocks has rapidly evolved over the past few years. It has been speculated that ultrasound guidance might increase success rates and reduce complications. The aim of our study is to compare the success rate and quality of interscalene brachial plexus blocks performed either with direct ultrasound visualization or with the aid of nerve stimulation to guide needle placement. ⋯ The use of ultrasound to guide needle placement and monitor the spread of local anesthetic improves the success rate of interscalene brachial plexus block.