Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2003
Randomized Controlled Trial Clinical TrialTopical amitriptyline in healthy volunteers.
The antidepressant amitriptyline is used as an adjuvant in the treatment of a variety of chronic pain conditions. This drug interacts with many receptors and ion channels, such as Na+ channels. In a randomized, double-blinded, and placebo-controlled trial, we investigated whether amitriptyline also is capable of providing cutaneous analgesia when applied topically in 14 healthy volunteers. ⋯ Topically applied amitriptyline is effective as an analgesic in humans. Different vehicles may improve its efficacy and decrease the skin redness observed.
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Reg Anesth Pain Med · Jul 2003
Randomized Controlled Trial Comparative Study Clinical TrialComparison of continuous 3-in-1 and fascia Iliaca compartment blocks for postoperative analgesia: feasibility, catheter migration, distribution of sensory block, and analgesic efficacy.
Efficacy and technical aspects of continuous 3-in-1 and fascia iliaca compartment blocks were compared. ⋯ The authors conclude that a catheter for continuous lumbar plexus block can be placed more quickly and at lesser cost using the fascia iliaca technique than the perivascular technique with equivalent postoperative analgesic efficacy.
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Military anesthesiologists must master the complexities of modern anesthesia at home, like their civilian counterparts, and also be prepared to provide effective, safe anesthesia in the chaotic and austere environment of the modern battlefield. This article describes the Army Regional Anesthesia Initiative and Operational Anesthesia Rotation programs designed to facilitate this difficult goal.
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Reg Anesth Pain Med · Jul 2003
Effect of postoperative epidural analgesia on morbidity and mortality after total hip replacement surgery in medicare patients.
The effect of postoperative epidural analgesia (vs. systemic analgesia) on patient outcomes is unclear. Available randomized controlled trials (RCTs) have focused on the intraoperative period and not properly examined the effect of postoperative epidural analgesia (EA) on outcomes. ⋯ The use of postoperative EA was not associated a lower incidence of mortality and major morbidity in Medicare patients undergoing total hip arthroplasty. However, the results should be interpreted with caution because of limitations in using the Medicare claims data for analysis. Further trials using other properly conducted and designed studies (e.g., RCTs) would be ideal to validate these results.