Journal ArticleJ Shoulder Elbow Surg · July 20, 2024
BACKGROUND: Regional anesthesia is a valuable component of multimodal pain control in total shoulder arthroplasty (TSA), and multiple interscalene block anesthetic options exist, including nonliposomal interscalene bupivacaine (NLIB) and liposomal intersca ...
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Journal ArticleReg Anesth Pain Med · July 8, 2024
INTRODUCTION: Erector spinae plane (ESP) blocks can be used to provide analgesia following thoracoabdominal and lumbar spine surgical procedures. However, the influence of injectate volume and injection location on the spread of anesthetic with ESP blocks ...
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Journal ArticleJ Clin Anesth · June 2024
STUDY OBJECTIVE: To investigate the efficacy, safety, pharmacodynamics, and pharmacokinetics of liposomal bupivacaine (LB) administered via ultrasound-guided sciatic nerve block in the popliteal fossa in participants undergoing bunionectomy. DESIGN: Two-pa ...
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Journal ArticleReg Anesth Pain Med · May 21, 2024
Single-injection, ultrasound-guided nerve block procedures involve puncturing the skin in close proximity to an ultrasound transducer, creating a potential vector for transmission of microbial organisms when skin flora and blood come into contact with the ...
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ConferenceAnesthesiology · May 1, 2024
BACKGROUND: Anesthesia and/or surgery accelerate Alzheimer's disease pathology and cause memory deficits in animal models, yet there is a lack of prospective data comparing cerebrospinal fluid (CSF) Alzheimer's disease-related biomarker and cognitive traje ...
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Journal ArticleBraz J Anesthesiol · 2024
BACKGROUND: The costoclavicular approach to brachial plexus block may have a more favorable anatomy than the classic infraclavicular approach. However, there are conflicting results in the literature regarding the comparative effectiveness of these two tec ...
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Journal ArticleReg Anesth Pain Med · November 22, 2023
BACKGROUND: Inconsistent nomenclature and anatomical descriptions of regional anesthetic techniques hinder scientific communication and engender confusion; this in turn has implications for research, education and clinical implementation of regional anesth ...
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Journal ArticleCureus · November 2023
The interscalene block (ISB) is the standard regional anesthesia for shoulder arthroscopy. However, the superior trunk block (STB) is an alternative with a potentially safer profile. This meta-analysis aimed to compare the incidence and degree of hemidiaph ...
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Journal ArticleOrthop Clin North Am · October 2023
A delayed acute compartment syndrome (ACS) diagnosis often results in devastating complications; however, the sensitivity of the classic signs and symptoms is very low. All analgesic modalities have been implicated in delaying the diagnosis, but there is v ...
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Journal ArticleWorld Neurosurg · August 2023
OBJECTIVE: There is increasing interest in performing awake spinal fusion under spinal anesthesia (SA). Evidence supporting SA has been positive, albeit limited. The authors set out to investigate the effects of SA versus general anesthesia (GA) for spinal ...
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Journal ArticleNeurochirurgie · May 2023
BACKGROUND: Annually, hundreds of thousands of patients undergo surgery for degenerative spine disease (DSD). This represents only a fraction of patients that present for surgical consideration. Procedures are often avoided due to comorbidities that make p ...
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Journal ArticleJ Shoulder Elbow Surg · October 2022
BACKGROUND: Multimodal pain regimens in total shoulder arthroplasty (TSA) now include regional anesthetic techniques. Historically, regional anesthesia for extended postoperative pain control in TSA was administered using a continuous interscalene catheter ...
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Journal ArticleJ Shoulder Elbow Surg · July 20, 2024
BACKGROUND: Regional anesthesia is a valuable component of multimodal pain control in total shoulder arthroplasty (TSA), and multiple interscalene block anesthetic options exist, including nonliposomal interscalene bupivacaine (NLIB) and liposomal intersca ...
Full textLink to itemCite
Journal ArticleReg Anesth Pain Med · July 8, 2024
INTRODUCTION: Erector spinae plane (ESP) blocks can be used to provide analgesia following thoracoabdominal and lumbar spine surgical procedures. However, the influence of injectate volume and injection location on the spread of anesthetic with ESP blocks ...
Full textLink to itemCite
Journal ArticleJ Clin Anesth · June 2024
STUDY OBJECTIVE: To investigate the efficacy, safety, pharmacodynamics, and pharmacokinetics of liposomal bupivacaine (LB) administered via ultrasound-guided sciatic nerve block in the popliteal fossa in participants undergoing bunionectomy. DESIGN: Two-pa ...
Full textLink to itemCite
Journal ArticleReg Anesth Pain Med · May 21, 2024
Single-injection, ultrasound-guided nerve block procedures involve puncturing the skin in close proximity to an ultrasound transducer, creating a potential vector for transmission of microbial organisms when skin flora and blood come into contact with the ...
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ConferenceAnesthesiology · May 1, 2024
BACKGROUND: Anesthesia and/or surgery accelerate Alzheimer's disease pathology and cause memory deficits in animal models, yet there is a lack of prospective data comparing cerebrospinal fluid (CSF) Alzheimer's disease-related biomarker and cognitive traje ...
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Journal ArticleBraz J Anesthesiol · 2024
BACKGROUND: The costoclavicular approach to brachial plexus block may have a more favorable anatomy than the classic infraclavicular approach. However, there are conflicting results in the literature regarding the comparative effectiveness of these two tec ...
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Journal ArticleReg Anesth Pain Med · November 22, 2023
BACKGROUND: Inconsistent nomenclature and anatomical descriptions of regional anesthetic techniques hinder scientific communication and engender confusion; this in turn has implications for research, education and clinical implementation of regional anesth ...
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Journal ArticleCureus · November 2023
The interscalene block (ISB) is the standard regional anesthesia for shoulder arthroscopy. However, the superior trunk block (STB) is an alternative with a potentially safer profile. This meta-analysis aimed to compare the incidence and degree of hemidiaph ...
Full textLink to itemCite
Journal ArticleOrthop Clin North Am · October 2023
A delayed acute compartment syndrome (ACS) diagnosis often results in devastating complications; however, the sensitivity of the classic signs and symptoms is very low. All analgesic modalities have been implicated in delaying the diagnosis, but there is v ...
Full textLink to itemCite
Journal ArticleWorld Neurosurg · August 2023
OBJECTIVE: There is increasing interest in performing awake spinal fusion under spinal anesthesia (SA). Evidence supporting SA has been positive, albeit limited. The authors set out to investigate the effects of SA versus general anesthesia (GA) for spinal ...
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Journal ArticleNeurochirurgie · May 2023
BACKGROUND: Annually, hundreds of thousands of patients undergo surgery for degenerative spine disease (DSD). This represents only a fraction of patients that present for surgical consideration. Procedures are often avoided due to comorbidities that make p ...
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Journal ArticleJ Shoulder Elbow Surg · October 2022
BACKGROUND: Multimodal pain regimens in total shoulder arthroplasty (TSA) now include regional anesthetic techniques. Historically, regional anesthesia for extended postoperative pain control in TSA was administered using a continuous interscalene catheter ...
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Journal ArticleReg Anesth Pain Med · May 2022
BACKGROUND AND OBJECTIVES: Documentation is important for quality improvement, education, and research. There is currently a lack of recommendations regarding key aspects of documentation in regional anesthesia. The aim of this study was to establish recom ...
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Journal ArticleAnesth Analg · May 1, 2022
BACKGROUND: Regional anesthesia (RA) has been used to reduce pain and opioid usage in elective orthopedic surgery. The hypothesis of this study was that RA would be associated with decreased opioid demand in tibial plateau fracture surgery. METHODS: Inpati ...
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Journal ArticleAnn Clin Transl Neurol · February 2022
OBJECTIVE: Numerous investigators have theorized that postoperative changes in Alzheimer's disease neuropathology may underlie postoperative neurocognitive disorders. Thus, we determined the relationship between postoperative changes in cognition and cereb ...
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Journal ArticleBr J Anaesth · December 2021
BACKGROUND: Cognitive dysfunction after surgery is a major issue in older adults. Here, we determined the effect of APOE4 on perioperative neurocognitive function in older patients. METHODS: We enrolled 140 English-speaking patients ≥60 yr old scheduled fo ...
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Journal ArticleReg Anesth Pain Med · October 2021
INTRODUCTION: Local anesthetic blockade of the genicular nerves, known targets of radiofrequency ablative techniques for knee pain, has not previously been studied in a randomized controlled trial evaluating acute pain after knee arthroplasty. We hypothesi ...
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Journal ArticleReg Anesth Pain Med · July 2021
BACKGROUND: There is heterogeneity in the names and anatomical descriptions of regional anesthetic techniques. This may have adverse consequences on education, research, and implementation into clinical practice. We aimed to produce standardized nomenclatu ...
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Journal ArticleA A Pract · March 30, 2021
A 48-year-old woman with a history of cardiac surgery developed severe dyspnea and anxiety following right-sided supraclavicular nerve block for hand surgery. In this case, right phrenic nerve blockade from a supraclavicular block unmasked a subclinical he ...
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Journal ArticleReg Anesth Pain Med · March 2021
INTRODUCTION: Prolonged tourniquet inflation during surgery frequently leads to tourniquet hypertension (TH), which is thought to arise from compression of A-δ fibers leading to sympathetically mediated C fiber activation. In the lower extremity, C fibers ...
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Journal ArticleSci Rep · February 4, 2021
Arachidonic acid (AA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA) derived lipids play key roles in initiating and resolving inflammation. Neuro-inflammation is thought to play a causal role in perioperative neurocognitive disorders, yet th ...
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Journal ArticleAnaesthesia · January 2021
With the widespread use of ultrasound for localising nerves during peripheral nerve blockade, the value of electrical nerve stimulation of evoked motor responses has been questioned. Studies continue to show that, compared with nerve stimulation, ultrasoun ...
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Journal ArticleJ Alzheimers Dis · 2021
BACKGROUND: Postoperative cognitive dysfunction (POCD), a syndrome of cognitive deficits occurring 1-12 months after surgery primarily in older patients, is associated with poor postoperative outcomes. POCD is hypothesized to result from neuroinflammation; ...
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Journal ArticleAnesth Analg · December 2020
BACKGROUND: In women undergoing cesarean delivery under spinal anesthesia with intrathecal morphine, transversus abdominis plane (TAP) block with bupivacaine hydrochloride (HCl) may not improve postsurgical analgesia. This lack of benefit could be related ...
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Journal ArticleKorean J Anesthesiol · October 2020
BACKGROUND: Multiple comparative studies report that adductor canal blocks provide similar pain relief to femoral nerve blocks following total knee arthroplasty. However, adductor canal blockade fails to anesthetize several important femoral nerve branches ...
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Journal ArticleJ Neurol · July 2020
OBJECTIVE: Lumbar punctures (LPs) are important for obtaining CSF in neurology studies but are associated with adverse events and feared by many patients. We determined adverse event rates and pain scores in patients prospectively enrolled in two cohort st ...
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Journal ArticleAANA J · April 2020
The presence of gastric content before induction of general anesthesia is the primary modifiable risk factor in the prevention of pulmonary aspiration. The purpose of this project was to determine if ultrasonography could be routinely used to measure gastr ...
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Journal ArticlePain Med · February 1, 2020
OBJECTIVE: The utility of single-injection and continuous peripheral nerve blocks is limited by short duration of analgesia and catheter-related complications, respectively. This double-blind, multicenter trial evaluated the efficacy, safety, and pharmacok ...
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Journal ArticleJ Alzheimers Dis · 2020
BACKGROUND: Perioperative neurocognitive disorders (PND) are common complications in older adults associated with increased 1-year mortality and long-term cognitive decline. One risk factor for worsened long-term postoperative cognitive trajectory is the A ...
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Journal ArticleAnesth Analg · November 2019
Animal models suggest postoperative cognitive dysfunction may be caused by brain monocyte influx. To study this in humans, we developed a flow cytometry panel to profile cerebrospinal fluid (CSF) samples collected before and after major noncardiac surgery ...
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Journal ArticleAANA J · June 2019
The primary purpose of this proof-of-concept quality improvement effort was to evaluate the practicality of using near-infrared spectroscopy (NIRS) to measure tissue oxygen saturation (Sto2) during total knee arthroplasty (TKA) with use of a tourniquet. NI ...
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Journal ArticleJ Am Geriatr Soc · April 2019
BACKGROUND/OBJECTIVES: Every year, up to 40% of the more than 16 million older Americans who undergo anesthesia/surgery develop postoperative cognitive dysfunction (POCD) or delirium. Each of these distinct syndromes is associated with decreased quality of ...
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Journal ArticleBest Pract Res Clin Anaesthesiol · March 2019
Nerve injury is a relatively rare but devastating complication of peripheral nerve blockade (PNB). Monitoring injection pressure during PNB is one method advocated to prevent injury by detecting needle tip placement in a noncompliant position (intraneural ...
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Journal ArticleAnesthesiol Clin · September 2018
Enhanced recovery after surgery (ERAS) programs for orthopedics involve a multidisciplinary approach to accelerating return to function, reducing pain, improving patient comfort and satisfaction, reducing complications from the surgical procedure, reducing ...
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Journal ArticleExpert Rev Med Devices · August 2018
INTRODUCTION: Peripheral nerve blocks are generally safe. However, there is a small but real associated risk of needle-related complications such as nerve injury. Nerve injury has been associated with high pressure injections in animals, and some data supp ...
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Journal ArticleA A Pract · May 1, 2018
The erector spinae plane block is a novel interfascial plane block that can provide thoracic and abdominal analgesia. We describe a patient with opioid intolerance scheduled for breast surgery who received an erector spinae plane block with liposomal bupiv ...
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Journal ArticlePlast Reconstr Surg Glob Open · September 2017
Enhanced recovery after surgery is a multidisciplinary perioperative clinical pathway that uses evidence-based interventions to improve the patient experience as well as increase satisfaction, reduce costs, mitigate the surgical stress response, accelerate ...
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Journal ArticleReg Anesth Pain Med · 2017
Abdominal wall blocks rely on the spread of local anesthetic within musculofascial planes to anesthetize multiple small nerves or plexuses, rather than targeting specific nerve structures. Ultrasonography is primarily responsible for the widespread adoptio ...
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Journal ArticleFront Syst Neurosci · 2017
Each year over 16 million older Americans undergo general anesthesia for surgery, and up to 40% develop postoperative delirium and/or cognitive dysfunction (POCD). Delirium and POCD are each associated with decreased quality of life, early retirement, incr ...
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Journal ArticleReg Anesth Pain Med · 2017
INTRODUCTION: Patients undergoing minimally invasive cardiac surgery have the potential for significant pain from the thoracotomy site. We report the successful use of pectoral nerve block types I and II (Pecs I and II) as rescue analgesia in a patient und ...
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Journal ArticleJ Clin Anesth · December 2016
Peripheral nerve blocks (PNBs) are increasingly used as a component of multimodal analgesia and may be administered as a single injection (sPNB) or continuous infusion via a perineural catheter (cPNB). We undertook a qualitative review focusing on sPNB and ...
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Journal ArticleReg Anesth Pain Med · 2016
BACKGROUND AND OBJECTIVES: High opening injection pressures (OIPs) have been shown to predict sustained needle tip contact with the roots of the brachial plexus. Such roots have a uniquely high ratio of fascicular versus connective tissue. It is unknown if ...
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Journal ArticleOpen Orthop J · 2016
BACKGROUND: Liposome bupivacaine is a prolonged-release bupivacaine formulation indicated for single-dose administration into the surgical site to produce postsurgical analgesia. METHODS: An overview of time to onset of analgesia observed with liposome bup ...
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Journal ArticleExpert Rev Med Devices · May 2015
Ultrasound-guided procedures are increasingly common in a variety of acute care settings, such as the operating room, critical care unit and emergency room. However, accurate judgment of needle tip position using traditional ultrasound technology is freque ...
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Journal ArticleLocal Reg Anesth · 2015
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 bro ...
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Journal ArticleLocal Reg Anesth · 2015
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 ...
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Chapter · January 1, 2015
Objectives Review the anesthetic considerations for complex musculoskeletal injuries including pelvic and long-bone fractures, traumatic amputations, and crush syndrome. Discuss issues related to the timing of surgical fixation of specific fractures. Discu ...
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Journal ArticleAnesthesiology · May 2014
BACKGROUND: Needle trauma may cause neuropathy after nerve blockade. Even without injection, nerve injury can result from forceful needle-nerve contact (NNC). High opening injection pressures (OIPs) have been associated with intrafascicular needle tip plac ...
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Journal ArticleJ Surg Orthop Adv · 2014
Total ankle arthroplasty is a procedure that has been shown to greatly improve patient quality of life. However, it is associated with moderate to severe postoperative pain. Commonly used strategies for pain control include opioids, multimodal analgesia wi ...
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Journal ArticleCurr Opin Anaesthesiol · August 2013
PURPOSE OF REVIEW: Pain management in the trauma patient can be challenging, especially outside the operating room setting. Traditional analgesics such as opioids and NSAIDs are also problematic in trauma care. In this review, the use of regional anestheti ...
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Journal ArticleReg Anesth Pain Med · 2013
BACKGROUND AND OBJECTIVES: Adductor canal block (ACB) has been suggested as an analgesic alternative to femoral nerve block (FNB) for procedures on the knee, but its effect on quadriceps motor function is unclear. We performed a randomized, blinded study t ...
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Journal ArticleReg Anesth Pain Med · 2013
BACKGROUND AND OBJECTIVES: Fascia iliaca block (FIB) is often used to treat pain after total hip arthroplasty (THA), despite a lack of randomized trials to evaluate its efficacy for this indication. The objective of this study was to assess the analgesic b ...
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Journal ArticleAnesth Analg · October 2012
BACKGROUND: During peripheral nerve blockade, different local anesthetics may be sequentially administered. Typically, a short- or intermediate-acting local anesthetic is administered before a long-acting local anesthetic to achieve a block with rapid onse ...
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Book · January 1, 2012
The management of pain from acute injuries is a priority in trauma care. Regional analgesic techniques are very effective at treating acute pain and are gaining in popularity as recognition of their beneficial effects on morbidity increases. Regional Anest ...
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Chapter · January 1, 2012
General anesthesia has become increasingly safe over the last two decades, largely due to improvements in monitoring such as pulse oximetry and capnography [1]. These technologies, which allow for early detection of potentially catastrophic adverse events ...
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Journal ArticleJ Clin Anesth · December 2011
STUDY OBJECTIVE: To test the hypothesis that, if the femoral nerve is correctly localized using ultrasound (US) guidance, the type of perineural catheter used has no effect on catheter success. DESIGN: Randomized controlled trial. SETTING: Post-anesthesia ...
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Journal ArticleAnesth Analg · February 2011
BACKGROUND: Short- and long-acting local anesthetics are commonly mixed to achieve nerve blocks with short onset and long duration. However, there is a paucity of data on advantages of such mixtures. We hypothesized that a mixture of mepivacaine and bupiva ...
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Journal ArticleCurr Opin Anaesthesiol · October 2010
PURPOSE OF REVIEW: Objective monitors to warn against adverse events specific to the performance of nerve blockade are relatively unsophisticated compared with monitors used during general anesthesia. The purpose of this review is to outline the various mo ...
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Journal ArticleAcad Med · May 2010
PURPOSE: To determine the degree of knowledge that medical students applying to the St. Luke's-Roosevelt Hospital Center anesthesiology residency program had regarding the core physician competencies mandated by the Accreditation Council for Graduate Medic ...
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Journal ArticleAnesth Analg · August 2009
BACKGROUND: Prevention of an intraneural injection of a local anesthetic during peripheral nerve blockade is considered important to avoid neurologic injury. However, the needle-nerve relationship during low-current electrical nerve localization is not wel ...
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Journal ArticleJ Clin Anesth · March 2009
STUDY OBJECTIVE: To determine whether interscalene brachial plexus block (ISB) provides adequate anesthesia for surgery on or about the elbow. STUDY DESIGN: Case series. SETTING: Operating room of an academic teaching hospital. PATIENTS: 78 patients schedu ...
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Journal ArticleAnesthesiology · October 2008
BACKGROUND: The main advantage of lumbar plexus block over neuraxial anesthesia is unilateral blockade; however, the relatively common occurrence of bilateral spread (up to 27%) makes this advantage unpredictable. The authors hypothesized that high injecti ...
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Journal ArticleAnesth Analg · November 2005
Post-cesarean delivery pain relief is important. Good pain relief will improve mobility and can reduce the risk of thromboembolic disease, which is increased during pregnancy. Pain may also impair the mother's ability to optimally care for her infant in th ...
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Journal ArticleAnesth Analg · May 2004
UNLABELLED: We conducted a survey to explore the surgical attitudes and preferences regarding regional anesthesia among Canadian orthopedic surgeons. Surveys were returned by 468 (61%) of 768 surgeons. Forty-eight percent of respondents directed their pati ...
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Journal ArticleCan J Anaesth · November 2003
PURPOSE: Adverse reactions to local anesthetics are widely reported. We report a case of acute upper airway angioedema presumed to be due to the local anesthetic articaine, which was subsequently diagnosed as acquired C1 esterase inhibitor deficiency. CLIN ...
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