Abstract:
BACKGROUND AND OBJECTIVES:This case series assesses the in vivo spread of contrast within the adductor canal in subjects who recently underwent a total knee arthroplasty. A previous analysis of profound leg weakness with a continuous adductor canal revealed contrast spread from the adductor canal to the femoral triangle with as little as 2 mL of volume. METHODS:We enrolled 10 American Society of Anesthesiologists class II-III subjects. Maximum voluntary isometric contraction was measured to assess quadriceps strength before and after surgery. Contrast was then injected continuously via electronic pump into the adductor canal, and fluoroscopy was used to capture images after 1-mL increments. For analysis, the femur was divided into 8 equidistant sectors between the lesser trochanter and medial epicondyle. RESULTS:Contrast did not reach the level of the lesser trochanter or the medial epicondyle of the femur in any subject. The greatest spread after 5 mL of contrast was 4 sectors. Sixty percent of subjects had contrast spread within either the same sector as the catheter tip or 1 sector distally. No subjects demonstrated additional proximal spread of contrast after 4 mL. CONCLUSIONS:This study reveals that in vivo continuous infusions within the adductor canal spread in both a cephalad and caudad direction in limited fashion. Although a previous report described proximal spread of injectate to the level of the common femoral nerve, this event is infrequent.
journal_name
Reg Anesth Pain Medjournal_title
Regional anesthesia and pain medicineauthors
Yuan SC,Hanson NA,Auyong DB,Choi DS,Coy D,Strodtbeck WMdoi
10.1097/AAP.0000000000000216subject
Has Abstractpub_date
2015-03-01 00:00:00pages
154-7issue
2eissn
1098-7339issn
1532-8651journal_volume
40pub_type
杂志文章abstract:BACKGROUND AND OBJECTIVES:The aim of this study was to compare the potency of bupivacaine, ropivacaine, and levobupivacaine in an equal dose and concentration for sympathetic block. METHODS:We measured mean arterial pressure, heart rate (HR), and right and left brachial artery blood flow (BABF) before and after cervic...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e3181e6acf1
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Many patients experience moderate to severe postoperative pain. Nitrous oxide (N₂O) exerts analgesia by inhibition of N-methyl-D-aspartate receptors. Ketamine, another N-methyl-D-aspartate receptor antagonist, reduces postoperative opioid consumption and pain. A similar effect of N₂O is plausi...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000039
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:This prospective, randomized, observer-blinded study compared ultrasound guidance and the conventional landmark-based technique for superficial cervical plexus blockade. METHODS:Forty patients were randomly allocated to receive a block of the superficial cervical plexus using ultrasound guidance (n = 20) or...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e3181faa11c
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Peripheral nerve stimulation (PNS) is analgesic for some lower extremity neuropathic pain syndromes. PNS currently involves open surgical placement of electrode(s). Increasingly, ultrasound guidance is used for perioperative neural block. Minimally invasive placement of PNS electrodes for lowe...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2008.04.007
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Quadratus lumborum (QL) block is a new regional analgesic technique for upper and lower abdominal surgeries as part of a multimodal analgesic regime. It has also been reported to relieve pain after total hip arthroplasty (THA). In this prospective, randomized, double-blind study, we compared Q...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-100804
更新日期:2019-10-25 00:00:00
abstract:BACKGROUND:Given the readily increasing membership of the pain physician community, efforts toward correcting notable gender disparities are instrumental. The under-representation of women is particularly prevalent within leadership roles in academic medicine, thought to be driven largely by diminished research efforts...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-100806
更新日期:2019-11-02 00:00:00
abstract:BACKGROUND:The perception of high resistance during injection of a local anesthetic during regional anesthesia may indicate intraneural injection. Anesthetists' ability to detect high resistance by "syringe feel" has been questioned in the past. The aim of our study was to investigate the anesthetist's ability to detec...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/aap.0b013e3181ac7f38
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Multimodal analgesia protocols have shortened hospitalizations after total joint arthroplasty. It is unclear whether individual components of these protocols are associated with respiratory depression during phase I postanesthesia recovery. OBJECTIVES:To test the hypothesis that sedating analgesics used in ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000257
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Peripheral nerve and spinal cord stimulation techniques have been used for many years. However, electrical stimulation methods rarely have been used to confirm epidural catheter placement. This study examines the practicality of this technique to confirm epidural catheter placement in obstetri...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章
doi:10.1016/s1098-7339(99)90160-8
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:For pain relief after total knee arthroplasty (TKA), an injection at the midthigh level may produce analgesia inferior to that of a femoral nerve block as the anterior femoral cutaneous nerves (intermediate femoral cutaneous nerve (IFCN) and medial femoral cutaneous nerve (MFCN)) are not anest...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-100904
更新日期:2019-12-10 00:00:00
abstract::The American Society of Regional Anesthesia and Pain Medicine (ASRA) periodically updates its practice advisories and associated cognitive aids. The 2020 version of the ASRA Local Anesthetic Systemic Toxicity checklist was created in response to user feedback, simulation studies and advances in medical knowledge. This...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2020-101986
更新日期:2021-01-01 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:OBJECTIVE:We report a case of perioperative management of a single-ventricle patient with Fontan-associated liver disease undergoing hepatectomy. CASE REPORT:A 12-year-old boy with Fontan circulation was scheduled for partial hepatectomy to remove a liver mass in segment 6. He received stent implantation to relieve co...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000316
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Whether patients titrate themselves to an individualized blood or plasma opioid concentration (the so-called minimum effective concentration or [MEC]) has been debated extensively. Nevertheless, there is consistent opinion that during patient controlled analgesia (PCA) patients balance accepta...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章
doi:10.1016/s1098-7339(00)90008-7
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Given the steep learning curve for neuraxial and peripheral nerve blocks, utilization of general anesthesia may increase as new house staff begin their residency programs. We sought to determine whether "July effect" affects the utilization of neuraxial anesthesia, peripheral nerve blocks, and opioid prescri...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2020-101318
更新日期:2020-05-01 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: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:Postoperative pain is the expected but nonetheless undesirable byproduct of all surgical procedures. Humanitarian concerns and recent quasi-governmental regulations have heightened awareness about the importance of treating postoperative pain. This guideline builds upon the foundation created ...
journal_title:Regional anesthesia and pain medicine
pub_type: 指南,杂志文章
doi:10.1016/s1098-7339(03)00035-x
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:S(-)-Bupivacaine has the pharmacotoxicological advantage over its antipode and racemate. The interaction with lipid membranes was compared between S(-)-, R(+)- and racemic bupivacaine. METHODS:The bupivacaine-induced changes in membrane property were determined by turbidity and fluorescence p...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2007.05.011
更新日期:2008-07-01 00:00:00
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...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000016
更新日期:2013-11-01 00:00:00
abstract::The blood-brain barrier (BBB) describes the unique properties of endothelial cells (ECs) that line the central nervous system (CNS) microvasculature. The BBB supports CNS homeostasis via EC-associated transport of ions, nutrients, proteins and waste products between the brain and blood. These transport mechanisms also...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2020-101403
更新日期:2020-09-01 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: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:Numerous factors are considered in the academic promotion of pain medicine physicians. In this study, we investigated the importance of research productivity, career duration, leadership, and gender on attaining professorship in chronic pain medicine fellowship programs in the USA. METHODS:We identified 98 ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-101139
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Histologic evidence of the comparative neurotoxicity of lidocaine, mepivacaine, and prilocaine is incomplete. We compared the intrathecal neurotoxicity in rats among these 3 drugs based on morphologic and neurofunctional findings. METHODS:Rats (n=169) randomly received 0.12 microL/g of 0%, 2%...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2004.06.013
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:We present an unusual complication of epidural analgesia used to facilitate postoperative pain relief while allowing mobilization of the patient. CASE REPORT:A 65-year-old woman with a history of chronic obstructive pulmonary disease, atherosclerotic cardiovascular disease, chronic renal failu...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1053/rapm.2001.22993
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:In order to prolong labor analgesia, one may add intrathecal epinephrine to the combination of bupivacaine and fentanyl. In this study, we tested the hypothesis that the addition of intrathecal epinephrine would lessen the requirement for a rescue dose of epidural analgesia during labor. METH...
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.2003.50026
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Stimulation of the radial nerve at the axilla may cause either a proximal movement (forearm extension) or distal movements (supination, wrist or finger extension). In the most recent studies on axillary block, only a distal twitch was accepted as valid. However, this approach was based only on...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rapm.2005.06.002
更新日期:2005-09-01 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::The Accreditation Council for Graduate Medical Education has shifted to competency-based medical education. This educational framework requires the description of educational outcomes based on the knowledge, skills and behaviors expected of competent trainees. It also requires an assessment program to provide formativ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2020-101480
更新日期:2020-08-01 00:00:00