Abstract:
BACKGROUND AND OBJECTIVES:Despite ultrasound (US) guidance, sciatic nerve block (SNB) remains among the least performed peripheral blocks. By targeting the tissue plane between the gluteus maximus and quadratus femoris muscles, the US-guided subgluteal space technique may facilitate the performance of US-guided SNB. We aimed to evaluate whether the subgluteal space technique shortens SNB performance time in overweight and obese patients compared with the conventional infragluteal technique. METHODS:Overweight and obese patients (body mass index, > 25 kg m ) undergoing US-guided SNB for knee arthroplasty received 30 mL admixture (1:2 lidocaine 2%; bupivacaine 0.5% with 1:200,000 epinephrine) in the tissue plane between the gluteus maximus and quadratus femoris (subgluteal space group) or around the sciatic nerve at the infragluteal level (infragluteal group). All patients received spinal anesthesia, continuous femoral nerve block, and postoperative multimodal analgesia. The primary outcome was SNB performance time defined as the time interval between placement of the US transducer on skin, and needle withdrawal after injection. Number of needle passes, procedural pain, SNB-related complications, SNB success, postoperative pain, and opioid consumption were also assessed. RESULTS:Twenty-seven patients were assessed (subgluteal space, 14; infragluteal, 13). Mean SNB performance time was 4.4 minutes (95% confidence interval, 3.7-5.0) for the subgluteal space group and 9.0 minutes (95% confidence interval, 7.7-10.3) for the infragluteal group (P < 0.0001). Number of needle passes and procedural pain scores were lower in the subgluteal space group. There were no differences in SNB success or analgesic outcomes. CONCLUSIONS:The subgluteal space technique may be performed 50% faster, with no detectable differences in block success and analgesic efficacy, compared with the infragluteal technique for US-guided SNB in overweight and obese patients receiving multimodal analgesia. Injection of local anesthetics along tissue planes may produce similar block characteristics to perineural injection for US-guided SNB.
journal_name
Reg Anesth Pain Medjournal_title
Regional anesthesia and pain medicineauthors
Abdallah FW,Chan VW,Koshkin A,Abbas S,Brull Rdoi
10.1097/AAP.0000000000000016subject
Has Abstractpub_date
2013-11-01 00:00:00pages
547-52issue
6eissn
1098-7339issn
1532-8651journal_volume
38pub_type
杂志文章,随机对照试验abstract:OBJECTIVES:The majority of intrathecal pumps are implanted by anesthesiologists. Despite a recent increase in case reports involving intrathecal catheter-tip inflammatory masses, this complication is rarely reported in the anesthesiology literature. The present case report describes a patient with spinal cord compressi...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1016/j.rapm.2004.01.012
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Practitioners mix faster-onset, intermediate-duration local anesthetics (LAs) with slower-onset, long-duration LAs to get fast peripheral nerve block (PNB) onset and long duration. We hypothesized that 1.5% mepivacaine (with epinephrine) (mepivacaine) or 1.5% mepivacaine (with epinephrine) mix...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e318236bc30
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Neosaxitoxin (NeoSTX) is a potent site-1 sodium-channel blocker being developed as a local anesthetic. Doses of 100 μg have been used by local infiltration in anesthetized adult humans without adverse effect. We hypothesized that similar doses could cause significant respiratory, neuromuscular, and cardiovas...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e3182424566
更新日期:2012-03-01 00:00:00
abstract::The surgeon August Gustav Bier significantly influenced surgery, general medicine, and especially anesthesia. He was the father of spinal anesthesia (1898) and intravenous regional anesthesia (1908). Both anesthetic techniques are still valuable and widely applied in everyday anesthesia practices throughout the world,...
journal_title:Regional anesthesia and pain medicine
pub_type: 传,历史文章,杂志文章
doi:10.1016/j.rapm.2008.04.011
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Detailed description of the tasks anesthetists undertake during the performance of a complex procedure, such as ultrasound-guided peripheral nerve blockade, allows elements that are vulnerable to human error to be identified. We have applied 3 task analysis tools to one such procedure, namely, ultrasound-gui...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e318228d1c0
更新日期:2011-09-01 00:00:00
abstract:UNLABELLED:Neurologic injury after regional anesthesia or pain medicine procedures is rare. Postprocedural neurologic deficits may create high levels of anxiety for the patient and practitioner, although most deficits are limited in severity and can be expected to fully resolve with time. Postoperative anesthesia-relat...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1097/AAP.0000000000000185
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Shortening the onset time of sensory block is a practical goal to improve the quality of epidural anesthesia. The addition of fentanyl to a local anesthetic solution is widely used during epidural anesthesia. This randomized double-blind study examined the onset time of sensory block during ep...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/rapm.2001.27852
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Bupivacaine is a racemic mixture of S(-)- and R(+)-enantiomers. Both isomers have similar potency as local anesthetics, but the S(-)-enantiomer produces less central nervous system and cardiovascular toxicity. Local anesthetic-induced convulsion is likely to be associated with not only sodium ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2005.09.004
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:A difficult neuraxial block (DNB) may be associated with complications. The aims of this study were to estimate the prevalence of DNB, assess patient-related and organizational factors associated with DNB, and evaluate the diagnostic accuracy of an accumulated risk score for predicting DNB. METHODS:A consec...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000293
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Subarachnoid blocks are considered routine anesthetic procedures important in the daily practices of most anesthesiologists. However, few data exist regarding modern failure rates or quality-compromising behaviors. METHODS:Sixty adult patients having orthopedic surgery under spinal anesthesia were enrolled ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e3182030863
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The aim of this study is to clarify the influence of acute cigarette smoking on vasodilation induced by sympathetic block. METHODS:We measured mean arterial pressure, heart rate, left brachial artery blood flow (BABF), right femoral artery blood flow (FABF), and plasma catecholamines in dogs ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1053/rapm.2001.16163
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:It has recently been proposed that an infraclavicular brachial plexus block (BPB) at the costoclavicular (CC) space may overcome some of the limitations of the lateral sagittal (LS) approach. In this study, we hypothesized that the CC approach will produce faster onset of sensory blockade of t...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000822
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Perineural dexamethasone or dexmedetomidine prolongs the duration of single-injection peripheral nerve block when added to the local anesthetic solution. In a randomized, controlled, double-blinded study in patients undergoing thoracoscopic pneumonectomy, we tested the hypothesis that combined...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-100221
更新日期:2019-08-08 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Glomangiomas are rare, vascular tumors consisting of an afferent artery, arteriovenous canal, neuro-reticular elements, collagen, and efferent veins, and are most often located in the soft tissue of the upper extremities. We describe how the use of ultrasound-guided nerve blockade altered the ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2007.10.003
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The term "Wrong-Site Surgery (WSS)" is commonly associated with surgical procedures; however, The Joint Commission (TJC) considers any invasive procedure, not just a surgical procedure, performed on the wrong side, at the wrong site, or on the wrong patient to be a WSS. For anesthesia providers, this means t...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-000033
更新日期:2019-01-13 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Local anesthetics in blood absorbed from the epidural space attenuate bronchial hyperreactivity to chemical stimuli. However, it is not documented whether local anesthetics at clinically relevant concentrations improve active wheezing in patients with bronchial asthma. CASE REPORT:We managed ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/s1098-7339(99)90015-9
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:We have investigated how the vascular components of the spine determine the resistance and capacitance of the spinal epidural space and determined the magnitude of the longitudinal pressure gradient in the space during fluid infusion. METHODS:Pigs were studied during isoflurane anesthesia. Tu...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e3181958fad
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:A variety of brachial plexus block techniques via the interscalene approach have been proposed. We describe here a new middle interscalene perivascular approach to the brachial plexus. To verify its effectiveness, we studied 719 patients scheduled for shoulder arthroscopy. Furthermore, to veri...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章
doi:10.1016/j.rapm.2006.05.015
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:There is increasing interest in local infiltration analgesia (LIA) to reduce postoperative pain with knee surgery. Despite widespread use of LIA, wide variations in drug combinations, infiltration techniques, and the concomitant use of systemic analgesics have made it difficult to determine th...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000353
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Peripheral nerve blocks reduce postoperative pain and enhance recovery after total knee arthroplasty (TKA). This study aims to assess the benefits of addition of intravenous dexmedetomidine (DexM) to intravenous dexamethasone on the analgesic duration of quadruple nerve blocks. METHODS:This d...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2020-101749
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Cholestasis has been proposed as a side effect of interpleural bupivacaine. Therefore, the effects of various application techniques on liver enzymes were studied following ethics committee approval and informed patient consent. METHODS:Patients following scheduled thoracotomy and laparoscopi...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1098-7339(98)90055-4
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Peripherally administered opioids, e.g., intra-articular morphine, exert their analgesic action on local opioid receptors. The present study investigated the safety and efficacy of intrabursal oxycodone and bupivacaine in comparison with bupivacaine infiltration and interscalene brachial plexu...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1098-7339(98)90030-x
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Cervical erector spinae plane (ESP) block has been described to anesthetize the brachial plexus (BP), however, the mechanism of its clinical effect remains unknown. As the prevertebral fascia encloses the phrenic nerves, BP and erector spinae muscles to form a prevertebral compartment, a local anesthetic inj...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-101154
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Perioperative systemic lidocaine provides postoperative analgesia, decreases opioid consumption, and facilitates rehabilitation in abdominal surgery. We hypothesized that systemic lidocaine has analgesic effects in women undergoing day-case laparoscopic sterilization. METHODS:Eighty women wer...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000398
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Demand is growing for objective assessment of manual skills and competencies of invasive procedures. The aim of this study was to validate an objective tool for assessing residents' skill in performing epidural anesthesia by use of a global assessment scale and a 3-scale, 27-stage checklist. W...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2006.04.006
更新日期:2006-07-01 00:00:00
abstract:INTRODUCTION:The posterior lumbar plexus block (LPB) has been used for decades to provide acute pain management after hip surgery. Unfamiliarity with the technique and its perceived difficulty, potential risks, and possible adverse effects such as quadriceps weakness have limited broader use. The quadratus lumborum blo...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2020-101915
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Arthroscopic anterior cruciate ligament (ACL) reconstruction of the knee is a painful procedure requiring intensive postoperative pain management. This prospective study investigates analgesic quality after a femoral block as compared with intra-articular injection of local anesthetic. METHOD...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/rapm.2003.50019
更新日期:2003-01-01 00:00:00
abstract::High-dose opioid administration is associated with significant adverse events. Evidence suggests that low-dose ketamine infusions improve perioperative analgesia over conventional opioid management, but usage is highly variable. Ketamine's adverse drug effects (ADEs) are well known, but their prevalence during low-dos...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000416
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Amitriptyline (AMI) is a lipophilic, tricyclic antidepressant with analgesic properties that could potentially be used for epidural (EPI) analgesia. However, no pharmacokinetic data are available for AMI in spinal spaces. The objective of this study was to evaluate the spinal disposition and intrathecal (IT)...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000322
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Cluster headache is an uncommon debilitating condition for which effective management remains a challenge. We describe the use of gabapentin in the treatment and prophylaxis of cluster headache in a patient who was refractory to other treatments. CASE REPORT:A 38-year-old man had a history of...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1053/rapm.2001.24404
更新日期:2001-07-01 00:00:00