Articles: nerve-block.
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Reg Anesth Pain Med · Jul 2015
Randomized Controlled Trial Multicenter Study Comparative StudyA Randomized Comparison Between Single- and Triple-Injection Subparaneural Popliteal Sciatic Nerve Block.
This prospective randomized trial compared ultrasound-guided single-injection (SI) and triple-injection (TI) subparaneural popliteal sciatic nerve block. We hypothesized that multiple injections are not required when local anesthetic (LA) is deposited under the paraneurium because the latter entraps LA molecules, ensuring circumferential spread around the nerve. Therefore, in addition to comparable success rates, we also expected similar total anesthesia-related times (sum of performance and onset times) and designed this study as an equivalency trial. ⋯ Ultrasound-guided SI and TI subparaneural popliteal sciatic nerve blocks result in comparable success rates and total anesthesia-related times. Expectedly, the SI technique requires fewer needle passes.
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Reg Anesth Pain Med · Jul 2015
Multicenter Study Comparative StudyMedial Branch Blocks or Intra-Articular Injections as a Prognostic Tool Before Lumbar Facet Radiofrequency Denervation: A Multicenter, Case-Control Study.
Medial branch blocks (MBBs) and intra-articular (IA) facet joint injections are both used to diagnose facet joint pain and are presumed to be equivalent. No study has sought to determine which has a better prognostic value before radiofrequency (RF) denervation. ⋯ When used as a prognostic tool before lumbar facet radiofrequency, MBB may be associated with a higher success rate than IA injections. Our results should be confirmed by large, prospective, randomized studies.
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Reg Anesth Pain Med · Jul 2015
Multicenter StudyDevelopment and Validation of an Assessment of Regional Anesthesia Ultrasound Interpretation Skills.
Interpretation of ultrasound images and knowledge of anatomy are essential skills for ultrasound-guided peripheral nerve blocks. Competency-based educational models promoted by the Accreditation Council for Graduate Medical Education require the development of assessment tools for the achievement of different competency milestones to demonstrate the longitudinal development of skills that occur during training. ⋯ This study provides evidence for the reliability, content validity, and construct validity of a 47-item multiple choice-style online test of ultrasound interpretation skills for regional anesthesia, which can be used as an assessment of competency milestone achievement in anesthesiology training.
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Multicenter Study Clinical Trial
Totally extraperitoneal (TEP) endoscopic inguinal hernia repair with TAP (transversus abdominis plane) block as a day-case: a prospective cohort study.
Totally extraperitoneal (TEP) endoscopic inguinal hernia repair is indicated for recurrent and bilateral inguinal hernias and traditionally is performed under general anesthesia. However, interventions that minimize pain and reduce opioid consumption have certain advantages for patients by avoiding side effects such as nausea and vomiting. The transversus abdominis plane (TAP) block has been used to minimize pain in a diverse range of surgical procedures but its safety on patients undergoing TEP repair has yet to be investigated. ⋯ These preliminary results suggest that day-case endoscopic hernia repair (TEP) with TAP block without curare is effective, safe, reproducible and can be proposed in all patients.
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Multicenter Study
Wrong-site nerve blocks: 10 yr experience in a large multihospital health-care system.
Although wrong-site surgery has garnered extensive scrutiny, the incidence of wrong-site blocks remains unknown. Our study thus sought to quantify the incidence of wrong-site blocks and examine some of their associated risk factors in our multihospital health-care system. ⋯ Our study provides the first incidence data on wrong-site block in a large patient population and can help hospitals to develop policies based on these data. It is yet to be determined whether active intervention can eliminate this adverse event.