Abstract:
BACKGROUND:In this prospective, randomized, observer-blinded trial, we compared ultrasound-guided subparaneural popliteal sciatic nerve blocks performed either at or proximal to the neural bifurcation (B). We hypothesized that the total anesthesia-related time (sum of performance and onset times) would be decreased with the prebifurcation (PB) technique. METHODS:Ultrasound-guided posterior popliteal sciatic nerve block was performed in 68 patients. All subjects received an identical volume (30 mL) and mix of local anesthetic agent (1% lidocaine-0.25% bupivacaine-5 µg/mL epinephrine). In the PB group, the local anesthetic solution was deposited at the level of the common sciatic trunk, just distal to the intersection between its circular and elliptical sonographic appearances, inside the paraneural sheath. In the B group, the injection was performed inside the sheath between the tibial and peroneal divisions. A blinded observer recorded the success rate (complete tibial and peroneal sensory block at 30 minutes) and onset time. The performance time, number of needle passes, and adverse events (paresthesia, neural edema) were also recorded. All subjects were contacted 7 days after the surgery to inquire about the presence of persistent numbness or motor deficit. RESULTS:Both techniques resulted in comparable success rates (85%-88%; 95% confidence interval [CI] of the intergroup difference, -14% to 19%) and required similar performance times (8.1 minutes; 95% CI of the difference, -1.65 to 1.71 minutes), onset times (15.0-17.7 minutes; 95% CI of the difference, -7.65 to 2.31 minutes), and total anesthesia-related times (23.4-26.0 minutes; 95% CI of the difference, -7.83 to 2.74 minutes). The number of needle passes and incidence of paresthesia (25%-34%) were also similar between the 2 groups. Sonographic neural swelling was detected in 2 and 3 subjects in the PB and B groups, respectively. In all 5 cases, the needle was carefully withdrawn and the injection completed uneventfully. Patient follow-up 1 week after the surgery revealed 2 patients with residual numbness. In both instances, the latter had resolved by 1 month. CONCLUSION:When local anesthetic is injected inside the paraneural sheath, B and PB posterior popliteal sciatic nerve blocks result in comparable success and total anesthesia-related times. However, in light of the 95% CIs, we cannot exclude the possibility that an intergroup difference of 19% and 7.83 minutes might have gone undetected for success rate and total time, respectively.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Tran DQ,González AP,Bernucci F,Pham K,Finlayson RJdoi
10.1213/ANE.0b013e31828a73besubject
Has Abstractpub_date
2013-05-01 00:00:00pages
1170-5issue
5eissn
0003-2999issn
1526-7598pii
ANE.0b013e31828a73bejournal_volume
116pub_type
杂志文章,随机对照试验abstract::Persistent postoperative opioid use is thought to contribute to the ongoing opioid epidemic in the United States. However, efforts to study and address the issue have been stymied by the lack of a standard definition, which has also hampered efforts to measure the incidence of and risk factors for persistent postopera...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,实务指引
doi:10.1213/ANE.0000000000003941
更新日期:2019-08-01 00:00:00
abstract:UNLABELLED:The use of catheters for continuous nerve blocks has been established in children, although in most series only one catheter was used. We report a case of a 3-yr-old child who underwent a toe-to-finger transfer managed with 2 regional catheters: axillary and sciatic. A pain score of 0 was noted during the en...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000114084.01266.e5
更新日期:2004-06-01 00:00:00
abstract::The effects of continuous epidural anesthesia and of general anesthesia on the incidence of thromboembolism following total hip replacement were studied. Sixty patients were randomly allotted to one of two groups receiving either epidural or general anesthesia. Epidural anesthesia (N = 30) consisted of 0.5% bupivacain...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1983-02-01 00:00:00
abstract:BACKGROUND:As the use of pulse oximeters increases, the needs for higher performance and wider applicability of pulse oximetry have increased. To realize the full potential of pulse oximetry, it is indispensable to increase the number of optical wavelengths. To develop a multiwavelength oximetry system, a physical theo...
journal_title:Anesthesia and analgesia
pub_type: 历史文章,杂志文章
doi:10.1213/01.ane.0000268716.07255.2b
更新日期:2007-12-01 00:00:00
abstract::In this prospective randomized, double-blind study, we investigated the effect of ondansetron on the lidocaine subarachnoid block. Fifty-four male patients scheduled for transurethral surgery under subarachnoid anesthesia received oral ondansetron 4 mg the evening before surgery and 4 mg IV 15 min before subarachnoid ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/01.ANE.0000152616.57107.F6
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine, a selective α2-adrenergic agonist currently approved for continuous intensive care unit sedation, is being widely evaluated for its role as a potential anesthetic. The closed-loop anesthesia delivery system (CLADS) is a method to automatically administer propofol total intravenous anesthesia...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000003470
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:In this study, we sought to determine whether a simplified ultrasound measurement of the largest transverse diameter, using a standard ultrasound machine, could be used to diagnose postoperative urinary retention (POUR). This method may replace expensive bladder volume measuring devices or a more complex ult...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/ANE.0000000000000595
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:In this pilot study, we hypothesized that velocity parameters obtained from changes in clot amplitude (A) and clot elasticity (E) measured with thromboelastometry (ROTEM, Tem International GmbH, Munich, Germany) could improve detection of fibrinolysis in whole blood obtained from children undergoing surgery ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000795
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Studies in a variety of disciplines have shown that the readability of Web-based patient education materials is above that of the sixth grade reading level recommended by the U.S. Department of Health and Human Services. The aim of this study was to evaluate the readability, content, and quality of English- ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究
doi:10.1213/ANE.0000000000000888
更新日期:2015-11-01 00:00:00
abstract:UNLABELLED:Sudden profound hypotensive and/or bradycardic events (HBE) have been reported in >20% of patients undergoing shoulder arthroscopy in the sitting position under interscalene block anesthesia. Retrospective studies suggest that the administration of beta-blockers is safe and may decrease the incidence of thes...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199812000-00020
更新日期:1998-12-01 00:00:00
abstract::Pregnancy is associated with an increased sensitivity to both general and local anesthetics. The exact reason is uncertain, but increased concentrations of progesterone and endogenous opiates have been implicated. Therefore, we tested the ability of intrathecally administered progesterone to produce analgesia and to p...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199304000-00010
更新日期:1993-04-01 00:00:00
abstract:UNLABELLED:Nitric oxide (NO) may play an important role in central and peripheral nociceptive processes. However, its contribution to peripheral antinociception is still not clear. In the present study, we investigated the effect of peripherally administered FK409, a spontaneous NO releaser, and its interaction with pe...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199802000-00028
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Whether intraoperative analgesics have an impact on postoperative cancer recurrence is unknown. Some investigations suggest that the opioids could favor relapse and that regional analgesia and nonsteroidal antiinflammatory drugs could improve cancer prognosis. We retrospectively reviewed our series of breast...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181d2ad07
更新日期:2010-06-01 00:00:00
abstract::Prior studies have suggested that the antifibrinolytic drug aprotinin increases the infarct size after ischemia and reperfusion (I/R) and attenuates the effect of ischemic preconditioning (IPC). Aprotinin was replaced by tranexamic acid (TXA) in clinical practice. Here, we investigated whether TXA influences I/R injur...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000002230
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:The blood/gas partition coefficient of a certain volatile anesthetic is of clinical importance because it determines its velocity of uptake into and elimination from the body of a patient and thus its pharmacokinetic behavior. To date, the blood/gas partition coefficients of isoflurane, sevoflurane, and desf...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0000000000000516
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Synergistic neuromuscular blocking effects have been observed clinically with certain pairs of nicotinic acetylcholine receptor (nAChR) competitive antagonists. The mechanism for synergy has not been elucidated. We tested the hypothesis that synergy arises from a differential selectivity of antagonists for t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e31817b4469
更新日期:2008-08-01 00:00:00
abstract:UNLABELLED:We investigated the direct effects of midazolam and diazepam on cardiac excitation-contraction coupling in adult rat ventricular myocytes. Freshly isolated rat ventricular myocytes were loaded with fura-2/AM and field-stimulated at 28 degrees C. Intracellular Ca(2+) transients (340:380 ratio) and myocyte sho...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200212000-00030
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Long-term exposure to opiates induces tolerance to the analgesic effect. The neurobiological mechanism of this phenomenon is not completely clear. In this study, we evaluated the effects of central administration of minocycline (a tetracycline derivative) and riluzole (an antiglutamatergic drug) on morphine-...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181ae5f13
更新日期:2009-09-01 00:00:00
abstract::The existence of a dose-response relation between nitrous oxide concentration and regional dysfunction in compromised myocardium, and whether or not halothane-induced myocardial depression alleviated this regional dysfunction was examined. Nitrous oxide was administered to eight dogs with experimentally induced left a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::Prostaglandin E(2) receptors, subtype EP(1) (PGE(2)EP(1)) have been linked to several physiologic responses, such as fever, inflammation, and mechanical hyperalgesia. Local anesthetics modulate these responses, which may be due to direct interaction of local anesthetics with PGE(2)EP(1) receptor signaling. We sought t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200109000-00019
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:The intrathoracic blood volume index (ITBVI) and central venous pressure (CVP) are routinely used to predict fluid responsiveness in critically ill patients with acute circulatory failure (systolic blood pressure < 90 mm Hg or vasopressor requirement). However, they have never been compared. METHODS:In this...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e31817e6618
更新日期:2008-08-01 00:00:00
abstract::The effect of vasoconstrictors on the duration of lidocaine spinal anesthesia is controversial. We conducted a double-blind study of 28 neurologically normal ASA Class I or II patients to determine the effect of vasoconstrictors (epinephrine and phenylephrine) on the duration of lidocaine spinal anesthesia. The patien...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1986-04-01 00:00:00
abstract:BACKGROUND:Twenty percent of patients born with congenital heart disease present with right ventricular outflow tract abnormalities. These patients require multiple surgical procedures in their lifetime. Transcatheter pulmonary valve replacement (TPVR) has become a viable alternative to conventional pulmonary valve and...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000002904
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:We compared two antiemetic prophylaxis regimens, their efficacy for preventing postdischarge nausea and vomiting, and their impact on quality of living, during recovery. METHODS:Sixty-four women undergoing outpatient gynecological surgery and at high risk for emesis were randomized into one of two groups. T...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ane.0b013e318172f992
更新日期:2008-08-01 00:00:00
abstract::Many inhaled anesthetics and intravenous analgesics have been alleged to produce both proconvulsant and anticonvulsant activity in humans. The reasons for these contrasting actions on the CNS are poorly understood at the present time. However, biologic variability plays an important role in determining individual pati...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/00000539-199003000-00013
更新日期:1990-03-01 00:00:00
abstract::The management of postoperative nausea and vomiting (PONV) remains a persistent problem. Despite the use of prophylactic antiemetics, breakthrough nausea and vomiting still frequently occur. There have been no published studies comparing dolasetron and ondansetron for the treatment of PONV. This was a prospective, ran...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/01.ANE.0000144421.96275.D1
更新日期:2005-02-01 00:00:00
abstract::Noma (cancrum oris) is a disease of poverty and malnutrition, which predominantly affects children younger than 10 years in developing countries. Although the majority of sufferers die of sepsis at the time of the initial infection, or of subsequent starvation due to severe trismus and an inability to eat, a small min...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3182908e6f
更新日期:2013-07-01 00:00:00
abstract:UNLABELLED:Linking physiological pharmacokinetic models to models of the cardiovascular system requires knowledge of the sites in the body that mediate a drug's cardiovascular effects. We examined the role of the coronary concentrations of propofol. Nine sheep anesthetized with isoflurane (2%) were instrumented acutely...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000060561.16583.a7
更新日期:2003-06-01 00:00:00
abstract:UNLABELLED:Labor epidural analgesia (LEA) is allegedly associated with maternal fever and an increase in the newborn sepsis work-up (SWU) rate. In this study, we evaluated whether LEA causes an increase in the SWU rate compared with a Control group given parenteral narcotics for labor pain. Maternal and neonatal data w...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200110000-00038
更新日期:2001-10-01 00:00:00
abstract::It remains questionable whether local anesthetics can interact with membrane lipids at clinically relevant concentrations to show the difference between enantiomers. We compared the effects of bupivacaine stereoisomers on biomimetic membranes containing cardiolipin and cholesterol. Bupivacaine interacted with the memb...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31823ed410
更新日期:2012-02-01 00:00:00