Articles: nerve-block.
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Anesthesia and analgesia · Jun 2020
Multicenter Study Observational StudyVariation Between and Within Hospitals in Single Injection Caudal Local Anesthetic Dose: A Report From the Pediatric Regional Anesthesia Network.
Given that variation exists in health care utilization, expenditure, and medical practice, there is a paucity of data on variation within the practice of anesthesia. The Pediatric Regional Anesthesia Network (PRAN) data lend itself to explore whether different medical practice patterns exist and if there are nerve blocks with more local anesthetic dosing variation than others. The primary aim of this study was to quantify variation in single injection caudal block dosing, and the secondary aim was to explore possible causes for variation (eg, number of blocks performed versus geographic location). ⋯ Wide variation in caudal local anesthetic dosing and administered volume exists. This variation is independent of the number of cases performed at each center but rather is determined by study site (ie, variation between centers) with considerable additional variation within study centers, suggesting additional variability dependent on individual practitioners. While there are legitimate reasons to vary dosing, the current approach is inconsistent and not supported by strong evidence over giving a standardized dose.
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Randomized Controlled Trial Multicenter Study
Brachial Plexus Block with Liposomal Bupivacaine for Shoulder Surgery Improves Analgesia and Reduces Opioid Consumption: Results from a Multicenter, Randomized, Double-Blind, Controlled Trial.
The utility of single-injection and continuous peripheral nerve blocks is limited by short duration of analgesia and catheter-related complications, respectively. This double-blind, multicenter trial evaluated the efficacy, safety, and pharmacokinetics of single-injection, ultrasound-guided brachial plexus block (BPB) with liposomal bupivacaine (LB) added to a standardized pain management protocol for shoulder surgery. ⋯ Single-injection BPB with LB 133 mg provided analgesia through 48 hours postsurgery with reduced opioid use compared with placebo after shoulder surgery.
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Letter Multicenter Study Observational Study
A prospective multicentre observational study on perioperative analgesia practices for total knee arthroplasty in France: the KNEEONE survey.
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Minerva anestesiologica · Sep 2019
Randomized Controlled Trial Multicenter Study Comparative StudyPostoperative analgesia and early functional recovery after day-case anterior cruciate ligament reconstruction: a randomized trial on local anesthetic delivery methods for continuous infusion adductor canal block.
This study assessed the effects of different local anesthetic delivery techniques for continuous adductor canal block, after arthroscopic day-case anterior cruciate ligament reconstruction (ACLR). ⋯ Intermittent boluses did not provide superior analgesia over continuous infusion for adductor canal block after outpatient ACLR, but significantly decreased the local anesthetic consumption. Both techniques are suitable for the early functional recovery.
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Randomized Controlled Trial Multicenter Study Comparative Study
Adductor canal versus femoral triangle anatomical locations for continuous catheter analgesia after total knee arthroplasty: a multicentre randomised controlled study.
Adductor canal (AC) catheters are being used to provide continuous postoperative analgesia after total knee arthroplasty (TKA) surgery. There are anatomical arguments that most AC catheters are being inserted into the femoral triangle (FT) compartment of the thigh rather than the AC compartment. The clinical relevance of this is unknown with respect to motor weakness, quality of analgesia, and opioid consumption. We hypothesised that AC catheters provide superior functional mobilisation on postoperative Day 1 after TKA as measured using the Timed Up and Go (TUG) test. ⋯ ANZCTR12617001421325.