Showing papers in "Regional Anesthesia and Pain Medicine in 2014"

TL;DR: Dexmedetomidine added to ropivacaine for interscalene blocks increased the duration of the nerve block and improved postoperative pain, and additional efficacy and safety data should encourage further study of peripheral perineural dexmedETomidine in humans.

TL;DR: The use of prescription opioid analgesics among adult Americans has increased in recent years, and this increase does not seem to be associated with improvements in disability and health status among users, and data suggest that there may be an opportunity to reduce the prescribing of opioids without worsening of population health metrics.

TL;DR: There is no significant difference in the incidence or relative risk of chronic pain at 3 and 6 months after an MRM when TPVB is used in conjunction with GA, Nevertheless, patients who receive a TPVB report less severe chronic pain, exhibit fewer symptoms and signs of Chronic pain, and also experience better physical and mental HRQOL.

TL;DR: The risk of systemic local anesthetic toxicity after this procedure remains unknown in this population and plasma concentration of local anesthetics should be measured in case of suspected toxicity to limit this risk.

TL;DR: In this article, the authors analyzed more than 50,000 pediatric regional anesthesia blocks from an observational prospective database, and determined the rate of adverse events in relation to the patient's state at the time of block placement.

TL;DR: Multivariable logistic regressions showed that neuraxial anesthesia was associated with decreased odds for combined major complications, need for intensive care services, and prolonged length of stay compared with general anesthesia in all patient subgroups.

TL;DR: The case report illustrates that the ACB can result in clinically significant quadriceps muscle paralysis and suggests that patients should be monitored vigilantly for this occurrence to decrease the risk of falls.

TL;DR: Based on the innervation pattern and using bony landmarks identifiable under ultrasound and fluoroscopy, 2 radiofrequency ablation techniques were proposed and further research is required to determine the accuracy and reliability of needle placement and to evaluate clinical outcomes.

TL;DR: Pulsed radiofrequency (PRF) is considered an option in treatment of radicular pain and both in vitro and in vivo studies aiming at elucidating part of the mechanism of action of PRF are described.

TL;DR: After mastectomy, adding a multiple-day, ambulatory, continuous ropivacaine infusion to a single-injection ropvacaine paravertebral nerve block results in improved analgesia and less functional deficit during the infusion, however, no benefits were identified after infusion discontinuation.

TL;DR: Performing an FICB before positioning for SA provides superior pain management compared with IVFE administration, facilitates spinal performance, and yields satisfactory postoperative analgesia and wide patient acceptance, hence improving overall quality and efficiency of care.

TL;DR: In a prospective, randomized single-blinded study, a designated Reader with an electronic DST improved adherence to guidelines in the management of an in situ simulation of LAST.

TL;DR: For ultrasound-guided subparaneural (analgesic) popliteal sciatic nerve block, the MEV90 of combined lidocaine 1.0%–bupivacaine 0.25% with epinephrine 5 &mgr;g/mL was estimated to be 13.3 mL (95% confidence interval, 10.2–16.4 mL).

TL;DR: It is suggested that patients with persistently high pain scores despite opioid therapy are more likely than those with lower levels of pain to present with characteristics associated with having centralized pain.

TL;DR: It is suggested that an epidural catheter placed under meticulous fluoroscopic guidance to minimize damage to surrounding tissue may be an appropriate option for children with OPPG undergoing lowerextremity surgery.

TL;DR: The findings did not show a significant effect of IV lidocaine during breast cancer surgery on opioid consumption, pain score, PONV, or fatigue, indicating that the benefit of this approach does not generalize across all types of surgery.

TL;DR: The risk of nerve injury persists despite US guidance and is underscored by reports of new functional deficits after interscalene brachial plexus block (ISB) performed under US guidance by experienced providers.

TL;DR: Analyzing interscalene blocks in children placed under GA, it is found that placement of IS blocks under GA in children is no less safe than placement in awake adults, calling into question the American Society of Regional Anesthesia and Pain Medicine advisory proscribing GA during IS block in pediatric patients.

TL;DR: A subparaneural injection accelerated the onset time and increased the duration of tibial nerve sensory blockade compared with circumferential extraneural injection.

TL;DR: The diagnostic accuracy of ultrasound assessment using a criterion standard was determined and the sensitivity of assessment in novices was significantly lower, highlighting the need for focused education in ultrasound-guided regional anesthesia.

TL;DR: A high proportion of survey respondents were willing to undergo repeat PNB in case of future surgery and were satisfied with their anesthetic care, and targeted interventions to improve quality of PNB should be aimed at improving comfort, information provision, and physician-patient interaction.

TL;DR: The evidence for neural blockade as a potential diagnostic tool or treatment for persistent pain after breast cancer surgery is examined, with only 7 studies assessing blocks directed at 3 neural structures—stellate ganglion, paravertebral plexus, and intercostal nerves—but none focusing on the intercostobrachial nerve.

TL;DR: This is the first large-scale effort to use a clinical registry to provide comparative outcome rates representing the safety and effectiveness of regional anesthesia and how these data can be used by hospitals to identify areas for quality improvement.

TL;DR: Ulasound-guided BTPV block provides improved postoperative analgesia for children undergoing the Nuss procedure as compared with intravenous PCA and decreases the incidence of postoperative behavioral disturbance.

TL;DR: Epidural analgesia may increase survival after cancer surgery by reducing recurrence, but whether this is true or simply a result of insufficient power is unclear.

TL;DR: Although it is apparent that local modification will be needed, the basic points and principles should be adopted for the performance of regional blocks, and it seems prudent to incorporate the recommended safety steps into a formalized checklist to be reviewed before performance of a regional block.

TL;DR: The combination of continuous femoral and SNB provides a superior opioid sparing effect and improves analgesia after TKA.

TL;DR: Key educational concepts presented in this article can be divided into 3 sections, namely, how residents acquire manual skills, how tutors teach, and type of feedback.

TL;DR: It is demonstrated that ghrelin alleviated neuropathic pain through a GHSR-1a–mediated suppression of the p38 MAPK/NF-&kgr;B pathway.

TL;DR: Evidence is provided that median time to discharge is shorter when RA is used instead of GA, controlling for other clinically important factors, and RA use during surgery was associated with a decrease in in-hospital mortality.