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    118 results match your criteria Local and Regional Anesthesia

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    Spinal anesthesia instead of general anesthesia for infants undergoing tendon Achilles lengthening.
    Local Reg Anesth 2018 3;11:25-29. Epub 2018 May 3.
    Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
    Spinal anesthesia (SA) has been used relatively sparingly in the pediatric population, as it is typically reserved for patients in whom the perceived risk of general anesthesia is high due to comorbid conditions. Recently, concern has been expressed regarding the potential long-term neurocognitive effects of general anesthesia during the early stages of life. In view of this, our center has developed a program in which SA may be used as the sole agent for applicable surgical procedures. Read More

    Remifentanil-induced postoperative hyperalgesia: current perspectives on mechanisms and therapeutic strategies.
    Local Reg Anesth 2018 9;11:15-23. Epub 2018 Apr 9.
    Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
    The use of remifentanil in clinical practice offers several advantages and it is used for a wide range of procedures, ranging from day-surgery anesthesia to more complex procedures. Nonetheless, remifentanil has been consistently linked with development of opioid-induced hyperalgesia (OIH), which is described as a paradoxical increase in sensitivity to painful stimuli that develops after exposure to opioid treatment. The development of OIH may cause several issues, delaying recovery after surgery and preventing timely patient's discharge. Read More

    Effect of warming anesthetic on pain perception during dental injection: a split-mouth randomized clinical trial.
    Local Reg Anesth 2018 22;11:9-13. Epub 2018 Feb 22.
    Department of Center for Interdisciplinary Studies on Nervous System (CISNe), Universidad Austral de Chile, Valdivia, Chile.
    Background: The purpose of this study is to determine the effectiveness of warming anesthesia on the control of the pain produced during the administration of dental anesthesia injection and to analyze the role of Transient Receptor Potential Vanilloid-1 nociceptor channels in this effect.

    Patients And Methods: A double-blind, split-mouth randomized clinical trial was designed. Seventy-two volunteer students (22. Read More

    Local anesthetics for brain tumor resection: current perspectives.
    Local Reg Anesth 2018 1;11:1-8. Epub 2018 Feb 1.
    Department of Anesthesiology, Erasmus MC, Rotterdam, The Netherlands.
    This review summarizes the added value of local anesthetics in patients undergoing craniotomy for brain tumor resection, which is a procedure that is carried out frequently in neurosurgical practice. The procedure can be carried out under general anesthesia, sedation with local anesthesia or under local anesthesia only. Literature shows a large variation in the postoperative pain intensity ranging from no postoperative analgesia requirement in two-thirds of the patients up to a rate of 96% of the patients suffering from severe postoperative pain. Read More

    Esophageal Manometry and Regional Transpulmonary Pressure in Lung Injury.
    Am J Respir Crit Care Med 2018 Apr;197(8):1018-1026
    2 Translational Medicine, Departments of Critical Care Medicine and Anesthesia, Hospital for Sick Children, and.
    Rationale: Esophageal manometry is the clinically available method to estimate pleural pressure, thus enabling calculation of transpulmonary pressure (Pl). However, many concerns make it uncertain in which lung region esophageal manometry reflects local Pl.

    Objectives: To determine the accuracy of esophageal pressure (Pes) and in which regions esophageal manometry reflects pleural pressure (Ppl) and Pl; to assess whether lung stress in nondependent regions can be estimated at end-inspiration from Pl. Read More

    Administration of epidural labor analgesia is not associated with a decreased risk of postpartum depression in an urban Canadian population of mothers: a secondary analysis of prospective cohort data.
    Local Reg Anesth 2017 31;10:99-104. Epub 2017 Oct 31.
    Alberta Children's Hospital Research Institute and Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
    Background: Postpartum depression (PPD) is a common complication of pregnancy, affecting approximately 13% of mothers internationally. Previous research has examined whether epidural analgesia used for pain control during labor and birth is associated with a lower risk of PPD, but reports conflicting results and may have suffered from methodological shortcomings. Our study aimed to prospectively assess whether epidural analgesia is associated with a lower risk of PPD (at either 6 weeks or 6 months postpartum) after attempting to adequately adjust for selection bias and confounding variables. Read More

    Efficiency of spinal anesthesia versus general anesthesia for lumbar spinal surgery: a retrospective analysis of 544 patients.
    Local Reg Anesth 2017 10;10:91-98. Epub 2017 Oct 10.
    Department of Neurosurgery.
    Background: Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia to general in lumbar surgery. Some studies have shown reduced surgical time, postoperative pain, time in the postanesthesia care unit (PACU), incidence of urinary retention, postoperative nausea, and more favorable cost-effectiveness with spinal anesthesia. Despite these results, the current literature has also shown contradictory results in between-group comparisons. Read More

    Preventing nausea and vomiting in women undergoing regional anesthesia for cesarean section: challenges and solutions.
    Local Reg Anesth 2017 9;10:83-90. Epub 2017 Aug 9.
    Department of Anesthesia and Critical Care, University Hospitals of Wuerzburg, Wuerzburg.
    Background: Intraoperative nausea and vomiting (IONV) or postoperative nausea and vomiting (PONV) affecting women undergoing regional anesthesia for cesarean section is an important clinical problem since these techniques are used widely. There are burdens of literature about IONV/PONV and several in parturient and cesarean. However, it needs more attention. Read More

    Case report: bilateral tunneled epidural catheters to prevent unilateral analgesia for cancer-related pain.
    Local Reg Anesth 2017 20;10:79-82. Epub 2017 Jul 20.
    Interventional Pain, Moffitt Cancer Center, University of South Florida, Tampa, FL, USA.
    Objective: Unilateral analgesia often occurs with epidural analgesia. Traditional methods of troubleshooting this problem can be insufficient in obtaining adequate pain relief in a timely manner for terminal cancer patients. This case report demonstrates a safe and effective solution which can be utilized in these circumstances. Read More

    Great auricular neuropraxia with beach chair position.
    Local Reg Anesth 2017 20;10:75-77. Epub 2017 Jul 20.
    Department of Anesthesiology, New York Methodist Hospital, New York, NY, USA.
    Shoulder arthroscopy has been shown to be the procedure of choice for many diagnostic and therapeutic interventions. Neuropraxia of the great auricular nerve (GAN) is an uncommon complication of shoulder surgery, with the patient in the beach chair position. We report a case of great auricular neuropraxia associated with direct compression by a horseshoe headrest, used in routine positioning for uncomplicated shoulder surgery. Read More

    Efficacy of single-injection unilateral thoracic paravertebral block for post open cholecystectomy pain relief: a prospective randomized study at Gondar University Hospital.
    Local Reg Anesth 2017 10;10:67-74. Epub 2017 Jul 10.
    Department of Anesthesia, School of Medicine, Gondar College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
    Background: Cholecystectomy can be associated with considerable postoperative pain. While the benefits of paravertebral block (PVB) on pain after thoracotomy and mastectomy have been demonstrated, not enough investigations on the effects of PVB on pain after open cholecystectomy have been conducted. We tested the hypothesis that a single-injection thoracic PVB reduces pain scores, decreases opioid consumption, and prolongs analgesic request time after cholecystectomy. Read More

    Does the approach influence the success rate for ultrasound-guided rectus sheath blocks? An anatomical case series.
    Local Reg Anesth 2017 5;10:61-65. Epub 2017 Jul 5.
    Institute of Anatomy, Medical University of Rostock, Rostock, Germany.
    The anterior cutaneous branches of the thoracolumbar spinal nerves enter the rectus sheath at its lateral border and perforate the muscle after travelling a short distance in the ventral direction. In this anatomical case series, we show that dye injection at the medial margin did not lead to reliable impregnation of the target nerves. The local anesthetic should therefore be injected at the lateral edge of the rectus sheath. Read More

    Epidural anesthesia for labor and delivery in a patient with May-Hegglin anomaly: a case report.
    Local Reg Anesth 2017 28;10:53-58. Epub 2017 Apr 28.
    Department of Anesthesia, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.
    We report a case of May-Hegglin anomaly (MHA) in a woman who had a successful labor and delivery under epidural anesthesia. MHA is an inherited thrombocytopenia easily misdiagnosed as idiopathic (immune) thrombocytopenic purpura (ITP). Early and appropriate diagnosis of MHA during pregnancy is essential for optimal maternal and neonatal delivery outcome. Read More

    Ambulatory anesthetic care in children undergoing myringotomy and tube placement: current perspectives.
    Local Reg Anesth 2017 19;10:41-49. Epub 2017 Apr 19.
    Department of Anaesthesia, Royal Aberdeen Children's Hospital, Aberdeen, UK.
    Purpose: Myringotomy and tube placement is one of the most frequently performed ear, nose and throat (ENT) surgeries in the pediatric population. Effective anesthetic management is vital to ensuring successful ambulatory care and ensuring child and parental satisfaction.

    Recent Findings: This review summarizes recently published studies about the long-term effects of general anesthesia in young children, novel approaches to preoperative fasting and simplified approaches to the assessment and management of emergence delirium (ED) and emergence agitation (EA). Read More

    Ambulatory thyroidectomy: an anesthesiologist's perspective.
    Local Reg Anesth 2017 5;10:31-39. Epub 2017 Apr 5.
    Department of Anaesthesia and Critical Care.
    Thyroidectomy has been performed on an inpatient basis because of concerns regarding postoperative complications. These include cervical hematoma, bilateral recurrent laryngeal nerve injury and symptomatic hypocalcemia. We have reviewed the current available evidence and aimed to collate published data to generate incidence of the important complications. Read More

    Spinal anesthesia after intraoperative cardiac arrest during general anesthesia in an infant.
    Local Reg Anesth 2017 31;10:25-29. Epub 2017 Mar 31.
    Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital.
    Although generally safe and effective, severe perioperative complications, including cardiac arrest, may occur during general anesthesia in infants. With the emergence of evidence that specific anesthetic agents may affect future neurocognitive outcomes, there has been an increased focus on alternatives to general anesthesia, including spinal anesthesia. We present a case of cardiac arrest during general anesthesia in an infant who required urologic surgery. Read More

    Prilocaine hydrochloride 2% hyperbaric solution for intrathecal injection: a clinical review.
    Local Reg Anesth 2017 31;10:15-24. Epub 2017 Mar 31.
    Department of Medical and Surgical Sciences, Anesthesia and Intensive Care Unit, Policlinico S. Orsola-Malpighi, Bologna, Italy.
    Prilocaine is a local anesthetic characterized by intermediate potency and duration and fast onset of action. As hyperbaric formulation of 5% solution, it was introduced and has been successfully used for spinal anesthesia since 1960. A new formulation of 2% plain and hyperbaric solution is currently available in Europe. Read More

    Assessment of risk factors for postdural puncture headache in women undergoing cesarean delivery in Jordan: a retrospective analytical study.
    Local Reg Anesth 2017 17;10:9-13. Epub 2017 Mar 17.
    Department of Anesthesia.
    Purpose: Postdural puncture headache (PDPH) is one of the most recognized complications after spinal anesthesia in women undergoing cesarean delivery. This study aimed to investigate the incidence of PDPH and its associated risk factors in women undergoing cesarean delivery in Jordan.

    Patients And Methods: This study included all women who underwent cesarean delivery at King Abdullah University Hospital in Jordan during 2015. Read More

    Anesthesia for the patient undergoing total knee replacement: current status and future prospects.
    Local Reg Anesth 2017 8;10:1-7. Epub 2017 Mar 8.
    Department of Anesthesiology, Weill Cornell Medical College, New York, NY, USA.
    Total knee arthroplasty (TKA) has become one of the most common orthopedic surgical procedures performed nationally. As the population and surgical techniques for TKAs have evolved over time, so have the anesthesia and analgesia used for these procedures. General anesthesia has been the dominant form of anesthesia utilized for TKA in the past, but regional anesthetic techniques are on the rise. Read More

    The analgesic efficacy of intravenous lidocaine infusion after laparoscopic fundoplication: a prospective, randomized, double-blind, placebo-controlled trial.
    Local Reg Anesth 2016 2;9:87-93. Epub 2016 Dec 2.
    Concord Clinical School, The University of Sydney, Sydney, Australia.
    This study aimed to determine if intravenous lidocaine infusion reduces postoperative pain intensity following laparoscopic fundoplication surgery and to also validate the safety of intravenous lidocaine at the dose tested. This was an equally randomized, double-blind, placebo-controlled, parallel-group, single center trial. Adult patients undergoing laparoscopic fundoplication were recruited. Read More

    Single-shot lamina thoracic paravertebral block with ketofol for modified radical mastectomy.
    Local Reg Anesth 2016 6;9:83-86. Epub 2016 Oct 6.
    World Health Organisation, Akure, Ondo State, Nigeria.
    We describe the use of single-shot lamina thoracic paravertebral block (TPVB) with sedation for a 56-year-old female patient who had modified radical mastectomy with axillary clearance. Two years ago, she suffered vocal cord palsy post thyroidectomy, which was managed with tracheostomy. The tracheostomy tube was removed 8 months later, leaving the patient with persistent hoarseness of voice and left vocal cord palsy. Read More

    Regional anesthesia or patient-controlled analgesia and compartment syndrome in orthopedic surgical procedures: a systematic review.
    Local Reg Anesth 2016 6;9:65-81. Epub 2016 Oct 6.
    Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL.
    A systematic review of the literature on the use of regional anesthesia (RA) and patient-controlled analgesia (PCA) was conducted in patients who require orthopedic extremity procedures to determine whether either analgesic technique contributes to a delayed diagnosis of compartment syndrome (CS). A total of 34 relevant articles (28 case reports and six research articles) were identified. Of all case report articles published after 2009, the majority (75%) concluded that RA does not put the patient at an increased risk of a delayed diagnosis of CS. Read More

    An electronic surgical order, undertaking patient education, and obtaining informed consent for regional analgesia before the day of surgery reduce block-related delays.
    Local Reg Anesth 2016 5;9:59-64. Epub 2016 Oct 5.
    Department of Anesthesiology and Perioperative Medicine.
    Background: Obtaining patient informed consent for a regional analgesia block on the day of surgery can result in surgical case delays. We hypothesized that implementing a preoperative electronic surgical order, undertaking patient education, and obtaining informed consent for a regional block in our preoperative assessment clinic prior to the day of surgery would reduce surgical case delays attributed to our regional anesthesia pain service and increase the percentage of patients for whom our regional anesthesia pain service was requested to provide a block.

    Methods: A prospective two-group time-series design, with a nonrandomized, pre- and post-intervention data collection strategy, was applied. Read More

    Managing anesthesia for cesarean section in obese patients: current perspectives.
    Local Reg Anesth 2016 16;9:45-57. Epub 2016 Aug 16.
    Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.
    Obesity is a worldwide epidemic. It is associated with increased comorbidities and increased maternal, fetal, and neonatal complications. The risk of cesarean delivery is also increased in obese parturients. Read More

    Optimal point of insertion of the needle in neuraxial blockade using a midline approach: study in a geometrical model.
    Local Reg Anesth 2016 10;9:39-44. Epub 2016 Aug 10.
    Department of Anesthesiology, Canisius Wilhelmina Ziekenhuis, Nijmegen, the Netherlands.
    Performance of neuraxial blockade using a midline approach can be technically difficult. It is therefore important to optimize factors that are under the influence of the clinician performing the procedure. One of these factors might be the chosen point of insertion of the needle. Read More

    Successful treatment of Raynaud's syndrome in a lupus patient with continuous bilateral popliteal sciatic nerve blocks: a case report.
    Local Reg Anesth 2016 15;9:35-7. Epub 2016 Jun 15.
    Department of Anesthesiology, The University of Texas Health Science Center at Houston, Houston, TX, USA.
    Raynaud's syndrome has been treated medically and invasively, sometimes with regional anesthesia leading up to sympathectomy. We demonstrate that regional anesthesia was in this case a useful technique that can allow some patients to find temporary but significant relief from symptoms of Raynaud's syndrome exacerbation. We present a 43-year-old woman with Raynaud's syndrome secondary to lupus who was treated with bilateral popliteal nerve block catheters for ischemic pain and necrosis of her feet; this led to almost immediate resolution of her pain and return of color and function of her feet. Read More

    Postoperative epidural analgesia for patients undergoing pectus excavatum corrective surgery: a 10-year retrospective analysis.
    Local Reg Anesth 2016 25;9:25-33. Epub 2016 May 25.
    Canterbury Anesthetic Services, Victoria, Australia.
    Introduction: Managing postoperative pain in patients undergoing minimally invasive pectus excavatum repair (Nuss procedure) is challenging but essential in facilitating ambulation and minimizing the length of stay. Although multiple epidural regimens with varying opioids are presently used for pain management, there is currently no clinical consensus regarding which epidural regimen provides the best analgesia outcomes with the fewest side effects. This 10-year retrospective cohort study was performed to compare the quality of analgesia and the incidence of side effects associated with the three most common epidural regimens used at a tertiary care children's hospital, in patients undergoing the Nuss procedure. Read More

    Epinephrine Affects Pharmacokinetics of Ropivacaine Infiltrated Into Palate.
    Anesth Prog 2016 ;63(2):71-9
    The Nippon Dental University, School of Life Dentistry at Tokyo, Department of Dental Anesthesiology, Tokyo, Japan, and.
    Pulpal anesthesia success rates for ropivacaine following maxillary infiltration anesthesia seem to be low. We investigated the hypothesis that the addition of epinephrine would affect the pharmacokinetics of ropivacaine by retaining ropivacaine in the mucosa of the injected area through the time-dependent distribution of ropivacaine in the rat maxilla and serum following maxillary infiltration anesthesia using (3)H-labeled ropivacaine. We then examined the vasoactivity of ropivacaine with or without epinephrine on local peripheral blood flow. Read More

    A double-blind randomized controlled trial comparing dexamethasone and clonidine as adjuvants to a ropivacaine sciatic popliteal block for foot surgery.
    Local Reg Anesth 2016 5;9:17-24. Epub 2016 May 5.
    Department of Cardiovascular Sciences and Anesthesiology, Catholic University Hospitals, Louvain, Belgium.
    Background And Aims: A popliteal block is effective in managing postoperative pain for foot surgery, but since the duration of analgesia is limited following a single-shot popliteal fossa block technique, methods to prolong effective postoperative analgesia are mandatory. The aim of this study was to assess the effect of adjuvants to ropivacaine on the duration of sensory and motor block.

    Methods: In this double-blind randomized placebo-controlled study, we evaluated the analgesic effect of clonidine or dexamethasone (DXM) when added to ropivacaine for hallux valgus surgery. Read More

    Efficacy of ultrasound-guided transversus abdominis plane block for postoperative analgesia in patients undergoing inguinal hernia repair.
    Local Reg Anesth 2016 18;9:7-12. Epub 2016 Jan 18.
    Department of Anaesthesia, SRM Medical College Hospital, and Research Centre, Chennai, Tamil Nadu, India.
    Background And Aim: Transversus abdominis plane block (TAP block) is a novel procedure to provide postoperative analgesia following inguinal hernia surgery. The utilization of ultrasound has greatly augmented the success rate of this block and additionally avoiding complications. The aim of our study was to gauge the analgesic efficacy of ultrasound-guided TAP block in patients undergoing unilateral inguinal hernia repair. Read More

    The effectiveness of articaine in mandibular facial infiltrations.
    Local Reg Anesth 2016 18;9:1-6. Epub 2015 Dec 18.
    Windham Dental Group, Willimantic, CT, USA.
    Four percent articaine local anesthetic has been successfully used to attain local anesthesia for dental procedures. Mandibular block anesthesia may consume longer time to attain and have a higher failure of local anesthesia compared to infiltration. Mandibular facial infiltration has been reported to successfully attain effective local anesthesia for dental procedures. Read More

    Out-of-plane ultrasound-guided paravertebral blocks improve analgesic outcomes in patients undergoing video-assisted thoracoscopic surgery.
    Local Reg Anesth 2015 15;8:123-8. Epub 2015 Dec 15.
    Department of Anesthesiology, University of Wisconsin Hospital and Clinics, Madison, WI, USA.
    Purpose: Paravertebral blocks (PVBs) are a method of limiting postoperative pain for patients undergoing video-assisted thoracoscopic surgery (VATS). We began providing ultrasound-guided PVBs for patients undergoing VATS in the spring of 2011, using an out-of-plane approach. The aim of this study was to evaluate this practice change. Read More

    A retrospective study to correlate breech presentation and enhanced risk of postspinal hypotension during cesarean delivery.
    Local Reg Anesth 2015 16;8:129-34. Epub 2015 Dec 16.
    Department of Gynecology and Obstetrics, Maharani Laxmi Bai Medical College, Jhansi, India.
    Background: Subarachnoid blockade for cesarean section still poses a threat of profound hypotension and can result in unstable maternal and fetal hemodynamics. The correlation of fetal breech and vertex presentation with the occurrence of hypotension under spinal anesthesia is reviewed in this retrospective, double-blind study.

    Patients And Methods: The study was conducted on pregnant females scheduled for a lower segment cesarean section between January 2014 and December 2014. Read More

    Effect of a combined continuous and intermittent transcutaneous electrical nerve stimulation on pain perception of burn patients evaluated by visual analog scale: a pilot study.
    Local Reg Anesth 2015 15;8:119-22. Epub 2015 Dec 15.
    Health Sciences Department, Centro Universitario de Tonalá, University of Guadalajara, Guadalajara, Mexico ; Diabetes sin Complicaciones, Zapopan, Mexico.
    Aim: The aim of this study was to assess the effect of continuous and intermittent electrical transcutaneous nerve stimulation on the perception of pain in patients with burns of different types.

    Materials And Methods: A pilot study was conducted in 14 patients (age 30.9±7. Read More

    Evolution of transversus abdominis plane infiltration techniques for postsurgical analgesia following abdominal surgeries.
    Local Reg Anesth 2015 10;8:113-7. Epub 2015 Dec 10.
    Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA ; Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
    Transversus abdominis plane (TAP) infiltration is a regional anesthesia technique that has been demonstrated to be effective for management of postsurgical pain after abdominal surgery. There are several different clinical variations in the approaches used for achieving analgesia via TAP infiltration, and methods for identification of the TAP have evolved considerably since the landmark-guided technique was first described in 2001. There are many factors that impact the analgesic outcomes following TAP infiltration, and the various nuances of this technique have led to debate regarding procedural classification of TAP infiltration. Read More

    Impact of volume expansion on the efficacy and pharmacokinetics of liposome bupivacaine.
    Local Reg Anesth 2015 7;8:105-11. Epub 2015 Dec 7.
    Urology San Antonio, San Antonio, TX, USA.
    Liposome bupivacaine is a prolonged-release liposomal formulation of bupivacaine indicated for single-dose infiltration into the surgical site to produce postsurgical analgesia of longer duration than traditional local anesthetics. This review summarizes the available data on how volume expansion may impact the analgesic efficacy of liposome bupivacaine. The Phase II and III clinical studies that involved surgical site administration of liposome bupivacaine at various concentrations in different surgical settings revealed no apparent concentration-efficacy relationship. Read More

    Thoracic combined spinal epidural anesthesia for laparoscopic cholecystectomy in a geriatric patient with ischemic heart disease and renal insufficiency.
    Local Reg Anesth 2015 2;8:101-4. Epub 2015 Dec 2.
    Department of Anesthesiology and Intensive Care, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, Jammu and Kashmir, India.
    Older people undergoing any surgery have a higher incidence of morbidity and mortality, resulting from a decline in physiological reserves, associated comorbidities, polypharmacy, cognitive dysfunction, and frailty. Most of the clinical trials comparing regional versus general anesthesia in elderly have failed to establish superiority of any single technique. However, the ideal approach in elderly is to be least invasive, thus minimizing alterations in homeostasis. Read More

    Topical local anesthesia: focus on lidocaine-tetracaine combination.
    Local Reg Anesth 2015 27;8:95-100. Epub 2015 Nov 27.
    Otorhinolaryngology Unit, Department of Surgery, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy.
    In recent years, the popularity of aesthetic and cosmetic procedures, often performed in outpatient settings, has strongly renewed interest in topical anesthetics. A number of different options are widely used, alone or in combination, in order to minimize the pain related to surgery. Moreover, interest in local anesthetics in the treatment of some painful degenerative conditions such as myofascial trigger point pain, shoulder impingement syndrome, or patellar tendinopathy is increasing. Read More

    Regional anesthesia for pediatric knee surgery: a review of the indications, procedures, outcomes, safety, and challenges.
    Local Reg Anesth 2015 5;8:85-91. Epub 2015 Nov 5.
    Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Pennsylvania, PA, USA.
    The indications for surgery on the knee in children and adolescents share some similarity to adult practice in that there are an increasing number of sports-related injuries requiring surgical repair. In addition, there are some unique age-related conditions or congenital abnormalities that may present as indications for orthopedic intervention at the level of the knee. The efficacy and safety of peripheral nerve blocks (PNBs) for postoperative analgesia following orthopedic surgery has been well established in adults. Read More

    Comparative evaluation of continuous intercostal nerve block or epidural analgesia on the rate of respiratory complications, intensive care unit, and hospital stay following traumatic rib fractures: a retrospective review.
    Local Reg Anesth 2015 27;8:79-84. Epub 2015 Oct 27.
    Department of Emergency Medicine, Genesys Regional Medical Center, Grand Blanc, MI, USA.
    Background: Thoracic trauma accounts for 10%-15% of all trauma admissions. Rib fractures are the most common injury following blunt thoracic trauma. Epidural analgesia improves patient outcomes but is not without problems. Read More

    Lidocaine versus ropivacaine for postoperative continuous paravertebral nerve blocks in patients undergoing laparoscopic bowel surgery: a randomized, controlled, double-blinded, pilot study.
    Local Reg Anesth 2015 14;8:71-7. Epub 2015 Sep 14.
    Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
    Background And Objectives: Lidocaine could provide many advantages in continuous regional anesthesia techniques, including faster onset, greater titratability, and lower cost than long-acting local anesthetics. This prospective, randomized, double-blinded, pilot study is therefore intended to compare lidocaine to ropivacaine in bilateral continuous paravertebral blocks using a multimodal approach for postoperative pain management following laparoscopic bowel surgery.

    Methods: Thirty-five ASA I-III consecutive patients undergoing elective laparoscopic bowel surgery and bilateral thoracic paravertebral continuous blocks were analyzed: bilateral thoracic paravertebral infusions of ropivacaine 0. Read More

    Neuraxial and peripheral nerve blocks in patients taking anticoagulant or thromboprophylactic drugs: challenges and solutions.
    Local Reg Anesth 2015 4;8:21-32. Epub 2015 Aug 4.
    Department of Anesthesiology, Yale University, Yale New Haven Hospital, New Haven, CT, USA.
    Incidence of hemorrhagic complications from neuraxial blockade is unknown, but classically cited as 1 in 150,000 epidurals and 1 in 220,000 spinals. However, recent literature and epidemiologic data suggest that for certain patient populations the frequency is higher (1 in 3,000). Due to safety concerns of bleeding risk, guidelines and recommendations have been designed to reduce patient morbidity/mortality during regional anesthesia. Read More

    Ophthalmic regional blocks: management, challenges, and solutions.
    Local Reg Anesth 2015 20;8:57-70. Epub 2015 Aug 20.
    Department of Anesthesiology, Perioperative Medicine and Pain Management, Miller School of Medicine, University of Miami, Miami, FL, USA.
    In the past decade ophthalmic anesthesia has witnessed a major transformation. The sun has set on the landscape of ophthalmic procedures performed under general anesthesia at in-hospital settings. In its place a new dawn has ushered in the panorama of eye surgeries conducted under regional and topical anesthesia at specialty eye care centers. Read More

    Regional anesthesia for the trauma patient: improving patient outcomes.
    Local Reg Anesth 2015 12;8:45-55. Epub 2015 Aug 12.
    Department of Anesthesiology, Duke University, Durham, NC, USA.
    Trauma is a significant health problem and a leading cause of death in all age groups. Pain related to trauma is frequently severe, but is often undertreated in the trauma population. Opioids are widely used to treat pain in injured patients but have a broad range of undesirable effects in a multitrauma patient such as neurologic and respiratory impairment and delirium. Read More

    Simulation in teaching regional anesthesia: current perspectives.
    Local Reg Anesth 2015 11;8:33-43. Epub 2015 Aug 11.
    Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA ; Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
    The emerging subspecialty of regional anesthesiology and acute pain medicine represents an opportunity to evaluate critically the current methods of teaching regional anesthesia techniques and the practice of acute pain medicine. To date, there have been a wide variety of simulation applications in this field, and efficacy has largely been assumed. However, a thorough review of the literature reveals that effective teaching strategies, including simulation, in regional anesthesiology and acute pain medicine are not established completely yet. Read More

    Separation of stimulating catheters for continuous peripheral regional anesthesia during their removal - two case reports and a critical appraisal of the use of steel-coil containing stimulating catheters.
    Local Reg Anesth 2015 30;8:15-9. Epub 2015 Jun 30.
    Department of Anesthesia and Intensive Care Medicine, University Hospital Marburg, Marburg, Germany.
    Purpose: Stimulating catheters are widely used for continuous peripheral nerve block techniques in regional anesthesia. The incidence of reported complications is somewhat similar to that for non-stimulating catheters. However, as many stimulating catheters contain a coiled steel wire for optimal stimulation, they may cause specific complications. Read More

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