Recently added articles from Regional Anesthesia and Pain Medicine:
Change - With Our Thanks
Nov 01, 2008; ... We are just completing a historic United States presidential election in which both candidates have tried to outdo each other as the "agent of change." Depending on one's perspective (or politics) change can be good or bad, but change is part of life. Thus it is with mixed emotions that we ...
A Pre-Emptive Multimodal Pathway Featuring Peripheral Nerve Block Improves Perioperative Outcomes After Major Orthopedic Surgery
Nov 01, 2008; ... Background and Objectives: Patients undergoing major orthopedic surgery experience significant postoperative pain. Failure to provide adequate analgesia may impede early physical therapy and rehabilitation, which are important factors for maintaining joint range of motion and facilitating ...
Effects of Local Anesthetic Concentration and Dose on Continuous Interscalene Nerve Blocks: A Dual-Center, Randomized, Observer-Masked, Controlled Study
Nov 01, 2008; ... Background and Objectives: It is currently unknown if the primary determinant of continuous peripheral nerve block effects is simply total drug dose, or whether local anesthetic concentration and/or volume have an influence. We therefore tested the null hypothesis that providing ropivacaine at ...
Ultrasound Guided Fascia Iliaca Block: A Comparison With the Loss of Resistance Technique
Nov 01, 2008; ... Background and Objectives: The aim of this study was to compare the efficacy of fascia iliaca block, performed by loss of resistance and ultrasound guidance techniques. Methods: Eighty patients undergoing either unilateral hip or knee joint replacement surgery were randomly assigned to ...
Needle Visualization in Ultrasound-Guided Regional Anesthesia: Challenges and Solutions
Nov 01, 2008; ... Needle visualization is important for safe and successful ultrasound-guided peripheral nerve block. However, accurate and consistent visualization of the needle tip can be difficult to achieve. This review article describes many of the challenges affecting needle visualization, summarizes the ...
An Ultrasound Study of the Phrenic Nerve in the Posterior Cervical Triangle: Implications for the Interscalene Brachial Plexus Block
Nov 01, 2008; ... Background and Objectives: Concomitant phrenic nerve block frequently occurs after brachial plexus block procedures in the neck and can result in substantial morbidity. In this study we sought to establish the anatomic basis using ultrasound imaging. Methods: We scanned the neck region ...
Feasibility of Ultrasound-Guided Percutaneous Placement of Peripheral Nerve Stimulation Electrodes in a Cadaver Model: Part One, Lower Extremity
Nov 01, 2008; ... Background and Objectives: Peripheral nerve stimulation (PNS) is analgesic for some lower extremity neuropathic pain syndromes. PNS currently involves open surgical placement of electrode(s). Increasingly, ultrasound guidance is used for perioperative neural block. Minimally invasive placement ...
Feasibility of Ultrasound-Guided Percutaneous Placement of Peripheral Nerve Stimulation Electrodes and Anchoring During Simulated Movement: Part Two, Upper Extremity
Nov 01, 2008; ... Background and Objectives: Peripheral nerve stimulation (PNS) may provide analgesia for neuropathic pain syndromes in that nerve distribution. PNS electrode placement using ultrasound (US) guidance for upper extremity pain syndromes has not been reported. Existing anchoring technology may allow ...
The Role of a Preprocedure Systematic Sonographic Survey in Ultrasound-Guided Regional Anesthesia
Nov 01, 2008; ... Background and Objectives: The presence of neurovascular abnormalities may increase the risk of complications following regional anesthesia techniques. Use of conventional nerve localization methods may fail to detect such abnormalities and potentially result in block failure and/or ...
What Local Anesthetic Volume Should Be Used for Suprascapular Nerve Block?
Nov 01, 2008; ... To the Editor: I would like to congratulate Dr. Feigl and his coauthors on a very interesting investigation into the anatomy of the supraspinous fossa.1 In addition to delineating that anatomy, it also offers another safe approach to blocking the suprascapular nerve. I have ...
Epidurals in Aortic Stenosis
Nov 01, 2008; ... To the Editor: I read with great interest the article by Ho et al.1 and applaud them for reducing their rates of in-hospital mortality following the introduction of hypotensive epidural anesthesia (HEA). This publication does raise questions, however, about their clinical practice, study ...
Epidural Catheters Without Holes
Nov 01, 2008; ... To the Editor: Epidural anesthesia and analgesia for postoperative pain and labor are used worldwide. Although it is a safe technique, it is not without complications. Multiorifice catheters have shown to be superior to single orifice catheters for labor analgesia and cesarean delivery.1 ...
ASRA Continuing Education Calendar
Nov 01, 2008; ... For information contact: ASRA, 520 N. Northwest Highway, Park Ridge, LL 60068, U.S.A. telephone 847/825-7246, fax 847/825-5658 E-mail n.bradle@asahq.org http://www.asra.com 2008 November 20-23, 2008 ASRA 2008 Annual Pain Medicine Meeting ...
Pregabalin as a Treatment for Painful Diabetic Peripheral Neuropathy: A Meta-Analysis
Sep 01, 2008; ... Background and Objectives: Painful diabetic peripheral neuropathy (DPN) is an increasingly prevalent disorder that is best managed through a multimodal approach. We examined the effects of pregabalin on pain control, sleep disturbance, and the patient's global impression of change (PGIC) for the ...
Practice Patterns Related to Block Selection, Nerve Localization and Risk Disclosure: A Survey of the American Society of Regional Anesthesia and Pain Medicine
Sep 01, 2008; ... Background and Objectives: We aimed to identify current clinical practice patterns among members of the American Society of Regional Anesthesia and Pain Medicine (ASRA) members that relate to complications of regional anesthesia (RA). Methods: Invitations were posted to the 3,732 ASRA ...
ASRA Practice Advisory on Neurologic Complications in Regional Anesthesia and Pain Medicine
Sep 01, 2008; ... Neurologie complications associated with regional anesthesia and pain medicine practice are extremely rare. The ASRA Practice Advisory on Neurologic Complications in Regional Anesthesia and Pain Medicine addresses the etiology, differential diagnosis, prevention, and treatment of these ...
Complications Associated With Eye Blocks and Peripheral Nerve Blocks: An American Society of Anesthesiologists Closed Claims Analysis
Sep 01, 2008; ... Background and Objectives: Concern for block-related injury and liability has dissuaded many anesthesiologists from using regional anesthesia for eye and extremity surgery, despite many studies demonstrating the benefits of regional over general anesthesia. To determine injury patterns and ...
Anatomy and Pathophysiology of Spinal Cord Injury Associated With Regional Anesthesia and Pain Medicine
Sep 01, 2008; ... The American Society of Regional Anesthesia and Pain Medicine (ASRA) convened a panel in April 2005 to create a Practice Advisory on the Neurologic Complications of Regional Anesthesia and Pain Medicine. This review deals with the pathophysiology of spinal cord injury. The Practice Advisory ...
Pathophysiology of Peripheral Nerve Injury During Regional Anesthesia
Sep 01, 2008; ... Background and Objectives: Despite attention to technical details in performance of regional anesthetics, damage to nerves continues to be a concern. Understanding of pathophysiological mechanisms may aid in decreasing the incidence and severity of such injuries. Methods: Studies from ...
Neurological Injuries Associated With Regional Anesthesia
Sep 01, 2008; ... A peripheral nerve or spinal cord injury is a rare but significant complication of regional anesthesia. Evaluation of acute nerve injury includes a focused history and examination to localize the lesion. Confirmatory testing should include electromyography and appropriate imaging. In most cases ...