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    97 results match your criteria Local and Regional Anesthesia

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    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

    Blockade of the mental nerve for lower lip surgery as a safe alternative to general anesthesia in two very old patients.
    Local Reg Anesth 2015 14;8:11-4. Epub 2015 May 14.
    Department of Surgery, de Tjongerschans Hospital, Heerenveen, the Netherlands.
    Purpose: Regional anesthesia is gaining popularity with anesthesiologists as it offers superb postoperative analgesia. However, as the sole anesthetic technique in high-risk patients in whom general anesthesia is not preferred, some regional anesthetic possibilities may be easily overlooked. By presenting two cases of very old patients with considerable comorbidities, we would like to bring the mental nerve field block under renewed attention as a safe alternative to general anesthesia and to achieve broader application of this simple nerve block. Read More

    Ultrasound-guided epidural anesthesia for a parturient with severe malformations of the skeletal system undergoing cesarean delivery: a case report.
    Local Reg Anesth 2015 6;8:7-10. Epub 2015 May 6.
    Department of Anesthesiology, West China Second Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
    Anesthetic management of patients with preexisting diseases is challenging and individualized approaches need to be determined based on patients' complications. We report here a case of ultrasound-guided epidural anesthesia in combination with low-dose ketamine during cesarean delivery on a parturient with severe malformations of the skeletal system and airway problems. The ultrasound-guided epidural anesthesia was performed in the L1-L2 space, followed by an intravenous administration of ketamine (0. Read More

    Pain relief after transversus abdominis plane block for abdominal surgery in children: a service evaluation.
    Local Reg Anesth 2015 7;8:1-6. Epub 2015 Apr 7.
    Department of Anaesthesia and Pain Medicine, Birmingham Children's Hospital, Birmingham, UK.
    We carried out a prospective service evaluation of the quality of pain control after preoperative transverse abdominis plane (TAP) block in 100 children undergoing abdominal surgery. Data were collected on type of procedure, age, weight, level of the block, local anesthetic used, additional analgesia, and hourly pain scores. Of the 100 patients, 87 were included in the evaluation, 77% of who were less than 1 year old. Read More

    Infiltration of liposome bupivacaine into the transversus abdominis plane for postsurgical analgesia in robotic laparoscopic prostatectomy: a pilot study.
    Local Reg Anesth 2014 12;7:69-74. Epub 2014 Dec 12.
    Department of Urology, Steward St Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA, USA.
    Background: Transversus abdominis plane (TAP) infiltration has been increasingly used for postsurgical analgesia in abdominal/pelvic procedures; however, duration/extent of analgesia with standard local anesthetics is limited. This pilot study assessed the preliminary efficacy and safety of two volumes of liposome bupivacaine administered via TAP infiltration in patients undergoing robotic laparoscopic prostatectomy.

    Methods: In this single-center, open-label, prospective study, patients older than 18 years received TAP infiltration with liposome bupivacaine immediately after surgery. Read More

    Is there a difference in postdural puncture headache after continuous spinal anesthesia with 28G microcatheters compared with punctures with 22G Quincke or Sprotte spinal needles?
    Local Reg Anesth 2014 10;7:63-7. Epub 2014 Nov 10.
    Fakultät für Gesundheit der Universität, Witten-Herdecke, Germany.
    In this retrospective study, the question was raised and answered whether the rate of postdural puncture headache (PDPH) after continuous spinal anesthesia with a 28G microcatheter varies using a Quincke or a Sprotte needle. The medical records of all patients with allogenic joint replacement of the knee or hip or arthroscopic surgery of the knee joint undergoing continuous spinal anesthesia with a 22G Quincke (n=1,212) or 22G Sprotte needle (n=377) and a 28G microcatheter during the past 6 years were reviewed. We obtained the approval of the ethical committee. Read More

    PDLA a potential new potent topical analgesic: a case report.
    Local Reg Anesth 2014 24;7:59-61. Epub 2014 Oct 24.
    Durham Veterans Affairs Medical Center ; Duke University School of Medicine, Durham, NC, USA.
    Polymer D-lactic acid (PDLA) is a hydrogel that has been shown to sequester L-lactate (lactate). This reaction is rapid, spontaneous, and non-enzymatic. Lactate has been shown to have many functions within the nervous system including its use as a secondary fuel to sustain neural activity and as a neuromodulator. Read More

    Preperitoneal catheter analgesia is an effective method for pain management after colorectal surgery: the results of 100 consecutive patients.
    Local Reg Anesth 2014 9;7:53-7. Epub 2014 Oct 9.
    Department of General Surgery, Uludağ University, Görükle, Turkey.
    Background: In a previous prospective randomized trial, we showed that local anesthetic infusion using a preperitoneal catheter is an effective postoperative analgesic method following colorectal resections. Over time, we have improved the technique of preperitoneal catheter analgesia. In this prospective cohort study, we report the results of 100 consecutive patients who underwent colorectal resections. Read More

    Factors associated with difficult neuraxial blockade.
    Local Reg Anesth 2014 8;7:47-52. Epub 2014 Oct 8.
    Institute of Public Health for Osijek-Baranya County, Osijek, Croatia.
    Spinal and epidural blocks are common practice in anesthesia and are usually used for various surgical or endoscopic procedures. Correct identification and puncture of the epidural or subarachnoid space determine the success or failure of the technique. Multiple attempts and difficult access to the epidural or subarachnoid space is a frequent problem in operating theaters and may be hazardous due to a number of possible acute or long-term complications. Read More

    Factors influencing the quality of postoperative epidural analgesia: an observational multicenter study.
    Local Reg Anesth 2014 5;7:39-45. Epub 2014 Aug 5.
    Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway ; Medical Faculty, Oslo University, Oslo, Norway.
    Background: Epidural analgesia (EDA) is used widely for postoperative pain treatment. However, studies have reported a failure rate of EDA of up to 30%. We aimed to evaluate the quality of postoperative EDA in patients undergoing a laparotomy in five Norwegian hospitals. Read More

    Intravenous patient-controlled fentanyl with and without transversus abdominis plane block in cirrhotic patients post liver resection.
    Local Reg Anesth 2014 29;7:27-37. Epub 2014 May 29.
    Department of Community Medicine and Public Health, Liver Institute, Menoufiya University, Shebin El-Kom, Egypt.
    Background: Coagulation changes can complicate liver resection, particularly in patients with cirrhosis. The aim of this prospective hospital-based comparative study was to compare the postoperative analgesic efficacy of intravenous fentanyl patient-controlled analgesia (IVPCA) with and without transversus abdominis plane (TAP) block.

    Methods: Fifty patients with Child's A cirrhosis undergoing liver resection were randomly divided into two groups for postoperative analgesia, ie, an IVPCA group receiving a 10 μg/mL fentanyl bolus of 15 μg with a 10-minute lockout and a maximum hourly dose of 90 μg, and an IVPCA + TAP group that additionally received TAP block (15 mL of 0. Read More

    Computed tomography-guided bupivacaine and corticosteroid injection for the treatment of symptomatic calcification in the great toe tendon.
    Local Reg Anesth 2014 29;7:23-5. Epub 2014 May 29.
    Department of Orthopedic Surgery, Istanbul Florence Nightingale Hospital, Istanbul Turkey.
    Background: Calcification in the great toe tendon is a rare disorder that is characterized by the deposition of calcium on degenerative collagen fibrils.

    Case Presentations: IN THIS REPORT, WE PRESENT TWO CASES OF CALCIFIC TENDONITIS: one in the adductor hallucis and the other in the flexor hallucis longus tendon. We preferred computed tomography-guided steroid injection in our cases because of pain unresponsive to conservative treatment. Read More

    Preventive analgesia for postoperative pain control: a broader concept.
    Local Reg Anesth 2014 29;7:17-22. Epub 2014 May 29.
    Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA.
    Pain from surgical procedures occurs as a consequence of tissue trauma and may result in physical, cognitive, and emotional discomfort. Almost a century ago, researchers first described a possible relationship between intraoperative tissue damage and an intensification of acute pain and long-term postoperative pain, now referred to as central sensitization. Nociceptor activation is mediated by chemicals that are released in response to cellular or tissue damage. Read More

    Ultrasound-guided transversus abdominis plane blocks for patients undergoing laparoscopic hand-assisted nephrectomy: a randomized, placebo-controlled trial.
    Local Reg Anesth 2014 25;7:11-6. Epub 2014 May 25.
    Division of Health Sciences Research, Section of Biostatistics, Jacksonville, FL, USA.
    Postoperative pain is a common complaint following living kidney donation or tumor resection using the laparoscopic hand-assisted technique. To evaluate the potential analgesic benefit of transversus abdominis plane blocks, we conducted a randomized, double-blind, placebo-controlled study in 21 patients scheduled to undergo elective living-donor nephrectomy or single-sided nephrectomy for tumor. Patients were randomized to receive either 20 mL of 0. Read More

    Perineural but not systemic low-dose dexamethasone prolongs the duration of interscalene block with ropivacaine: a prospective randomized trial.
    Local Reg Anesth 2014 5;7:5-9. Epub 2014 Apr 5.
    Division of Orthopedics, Tokushima Red Cross Hospital, Komatsushima, Japan.
    Purpose: To determine the effects of intravenous and perineural dexamethasone on the duration of interscalene brachial plexus block (ISB) with ropivacaine in patients undergoing arthroscopic shoulder surgery.

    Patients And Methods: In this prospective, randomized, placebo-controlled trial, patients presenting for arthroscopic shoulder surgery with an ISB were randomized to receive ropivacaine 0.75% (group C), ropivacaine 0. Read More

    Posterior reversible encephalopathy syndrome following an inadvertent dural puncture during an emergency laparotomy for ischemic colitis - a case report.
    Local Reg Anesth 2014 20;7:1-4. Epub 2014 Jan 20.
    Yeovil District Hospital, Yeovil, UK.
    Posterior reversible encephalopathy syndrome (PRES) is a clinico-neuroradiological syndrome characterized by various symptoms of neurological disease. It has commonly been reported in association with acute hypertension, pre-eclampsia, eclampsia, sepsis, and exposure to immunosuppressants. Here, we report on a normotensive woman who developed a severe frontal headache, visual disturbances, and hypertension 3 days after undergoing an emergency laparotomy for ischemic colitis during which she suffered an inadvertent dural puncture. Read More

    Unusual case of contralateral Horner's syndrome following stellate-ganglion block: a case report and review of the literature.
    Local Reg Anesth 2013 10;6:31-3. Epub 2013 Oct 10.
    Department of Anesthesiology, Detroit Medical Center, Detroit, MI, USA.
    Stellate-ganglion block (SGB) is a commonly performed procedure for the treatment of numerous conditions, including upper-extremity complex regional pain syndromes and arterial insufficiency. The appropriate response to SGB includes ipsilateral Horner's syndrome and temperature elevation of affected extremity. Contralateral and bilateral Horner's syndrome following SGB are rarely seen, with only six prior cases reported. Read More

    Predicting early epidurals: association of maternal, labor, and neonatal characteristics with epidural analgesia initiation at a cervical dilation of 3 cm or less.
    Local Reg Anesth 2013 28;6:25-9. Epub 2013 Aug 28.
    Department of Anaesthesia, Mcgill University health centre, Royal Victoria hospital, Montreal, Quebec, Canada.
    Background: Retrospective studies have associated early epidural analgesia with cesarean delivery, but prospective studies do not demonstrate a causal relationship. This suggests that there are other variables associated with early epidural analgesia that increase the risk of cesarean delivery. This study was undertaken to determine the characteristics associated with early epidural analgesia initiation. Read More

    Survey of international regional anesthesia fellowship directors.
    Local Reg Anesth 2013 1;6:17-24. Epub 2013 Jul 1.
    Department of Anesthesia, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada ; University of Sydney, Sydney, NSW, Australia.
    Background: The scope of regional anesthesia fellowship programs has not been analyzed but may provide insights that could improve fellowship training and standards.

    Methods: Regional anesthesia fellowship directors across the world were asked to complete a comprehensive survey that detailed the range of educational and practical experience and attitudes as well as assessment procedures offered in their programs.

    Results: The survey response rate was 66% (45/68). Read More

    Saphenous nerve innervation of the medial ankle.
    Local Reg Anesth 2013 6;6:13-6. Epub 2013 Mar 6.
    Department of Anesthesiology, Mayo Clinic, Jacksonville, FL, USA.
    Background: The distal saphenous nerve is commonly known to provide cutaneous innervation of the medial side of the ankle and distally to the base of the great toe. We hypothesize that the saphenous nerve innervates the periosteum of the medial malleolus and joint capsule.

    Methods: Five fresh limbs were dissected and the saphenous nerve was traced distally with magnification. Read More

    A new, lateral, continuous, combined, femoral-sciatic nerve approach via a single skin puncture for postoperative analgesia in intramedullary tibial nail insertion.
    Local Reg Anesth 2013 15;6:9-12. Epub 2013 Feb 15.
    Faculdade de Medicina Nova Esperança, João Pessoa, Brazil ; Institute for Regional Anesthesia, João Pessoa, Brazil.
    Background: The prevalence of anterior knee pain following intramedullary tibial nail insertion is high. Continuous peripheral nerve blockade is an alternative method of pain control to opiods. This case illustrates the use of femoral nerve and sciatic nerve peripheral catheters with an elastomeric infusion pump for major intramedullary nailing surgery. Read More

    The efficacy of the semi-blind approach of transversus abdominis plane block on postoperative analgesia in patients undergoing inguinal hernia repair: a prospective randomized double-blind study.
    Local Reg Anesth 2013 18;6:1-7. Epub 2013 Jan 18.
    Anesthesiology and Reanimation Department.
    Purpose: In this prospective, randomized, double-blind study, our aim was to compare the analgesic efficacy of the semi-blind approach of transversus abdominis plane (TAP) block with a placebo block in patients undergoing unilateral inguinal hernia repair.

    Methods: After receiving hospital ethical committee approval and informed patient consents, American Society of Anesthesiologists (ASA) I-III patients aged 18-80 were enrolled in the study. Standard anesthesia monitoring was applied to all patients. Read More

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