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Regional Anesthesia

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5 papers 0 to 25 followers
Terese T Horlocker, Denise J Wedel, John C Rowlingson, F Kayser Enneking, Sandra L Kopp, Honorio T Benzon, David L Brown, John A Heit, Michael F Mulroy, Richard W Rosenquist, Michael Tryba, Chun-Su Yuan
The actual incidence of neurologic dysfunction resulting from hemorrhagic complications associated with neuraxial blockade is unknown. Although the incidence cited in the literature is estimated to be less than 1 in 150,000 epidural and less than 1 in 220,000 spinal anesthetics, recent epidemiologic surveys suggest that the frequency is increasing and may be as high as 1 in 3000 in some patient populations.Overall, the risk of clinically significant bleeding increase with age,associated abnormalities of the spinal cord or vertebral column, the presence of an underlying coagulopathy, difficulty during needle placement,and an indwelling neuraxial catheter during sustained anticoagulation( particularly with standard heparin or low-molecular weight heparin)...
January 2010: Regional Anesthesia and Pain Medicine
Roger H Emerson, John W Barrington, Oluseun Olugbode, Scott Lovald, Heather Watson, Kevin Ong
Multimodal wound infiltration analgesic techniques have attracted growing interest for applications in total knee arthroplasty (TKA). A benefit of using wound infiltration instead of femoral nerve block (FNB) in a multimodal pain control regimen is the limitation of muscle strength impairment to the surgical area, which will focus the pain control effort and may provide the opportunity for easier rehabilitation and earlier discharge from the hospital. The current study directly compares patients undergoing TKA who are given a continuous FNB with those who were administered an injection of liposomal bupivacaine infiltration...
May 1, 2016: Orthopedics
Monakshi Sawhney, Hossein Mehdian, Brian Kashin, Gregory Ip, Maurice Bent, Joyce Choy, Mark McPherson, Richard Bowry
BACKGROUND: Total knee arthroplasty is a painful surgery that requires early mobilization for successful joint function. Multimodal analgesia, including spinal analgesia, nerve blocks, periarticular infiltration (PI), opioids, and coanalgesics, has been shown to effectively manage postoperative pain. Both adductor canal (AC) and PI have been shown to manage pain without significantly impairing motor function. However, it is unclear which technique is most effective. This 3-arm trial examined the effect of AC block with PI (AC + PI) versus AC block only (AC) versus PI only (PI)...
June 2016: Anesthesia and Analgesia
Nabil M Elkassabany, Sean Antosh, Moustafa Ahmed, Charles Nelson, Craig Israelite, Ignacio Badiola, Lu F Cai, Rebekah Williams, Christopher Hughes, Edward R Mariano, Jiabin Liu
BACKGROUND: Adductor canal block (ACB) has emerged as an appealing alternative to femoral nerve block (FNB) that produces a predominantly sensory nerve block by anesthetizing the saphenous nerve. Studies have shown greater quadriceps strength preservation with ACB compared with FNB, but no advantage has yet been shown in terms of fall risk. The Tinetti scale is used by physical therapists to assess gait and balance, and total score can estimate a patient's fall risk. We designed this study to test the primary hypothesis that FNB results in a greater proportion of "high fall risk" patients postoperatively using the Tinetti score compared with ACB...
May 2016: Anesthesia and Analgesia
Faraj W Abdallah, Tim Dwyer, Vincent W S Chan, Ahtsham U Niazi, Darrell J Ogilvie-Harris, Stephanie Oldfield, Rajesh Patel, Justin Oh, Richard Brull
BACKGROUND: Perineural and IV dexmedetomidine have each been suggested to prolong the duration of analgesia when administered in conjunction with peripheral nerve blocks. In the first randomized, triple-masked, placebo-controlled trial to date, the authors aimed to define and compare the efficacy of perineural and IV dexmedetomidine in prolonging the analgesic duration of single-injection interscalene brachial plexus block (ISB) for outpatient shoulder surgery. METHODS: Ninety-nine patients were randomized to receive ISB using 15 ml ropivacaine, 0...
March 2016: Anesthesiology
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