Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2011
Review Case Reports Comparative StudyStroke, regional anesthesia in the sitting position, and hypotension: a review of 4169 ambulatory surgery patients.
Despite frequent incidence of hypotension, no cases of stroke were observed in this audit of 4,169 shoulder surgeries performed in the beach-chair position. Notably though, 97% of the cases were performed under brachial plexus block with intravenous sedation rather than a general or relaxant technique.
The authors estimate the upper limit incidence of stroke in the sitting position under regional anaesthesia as 1 in 1,429 (0.07%).
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Reg Anesth Pain Med · Sep 2011
Randomized Controlled Trial Comparative StudyCatheter orifice configuration influences the effectiveness of continuous peripheral nerve blockade.
We investigated perineural catheter threading distance and orifice configuration during continuous interscalene analgesia. ⋯ These results suggest that multiorifice catheters provide superior intermittent bolus continuous peripheral nerve blockade compared with end-hole catheters. For anterolateral approach interscalene catheter placement, there is minimal benefit, either way, to 2.5- or 5-cm blind catheter advancement.
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Reg Anesth Pain Med · Sep 2011
Comparative StudyMinimum effective volume of lidocaine for ultrasound-guided supraclavicular block.
The aim of this study was to determine the minimum effective volume of lidocaine 1.5% with epinephrine 5 μg/mL in 90% of patients (MEV90) for double-injection ultrasound-guided supraclavicular block (SCB). ⋯ For double-injection ultrasound-guided SCB, the MEV90 of lidocaine 1.5% with epinephrine 5 μg/mL is 32 mL. Further dose finding studies are required for other concentrations of lidocaine, other local anesthetic agents and single-injection techniques.