Abstract:
BACKGROUND:No studies have examined the long-term benefits of regional anesthesia (RA) for pain management after combat-related injury. The objective of this prospective cohort study was to examine the relationship between RA administration and patient-reported pain-related outcomes among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) service members sustaining a combat-related extremity injury. METHODS:Between 2007 and 2013, n=358 American military personnel injured in OEF/OIF were enrolled at two military treatment facilities. Individuals were followed for up to 2 years after injury. Cohorts were defined based on whether participants were administered RA within 7 days after sustaining a combat-related injury, or not. Linear mixed effects models examined the association between RA and average pain intensity. Secondary outcomes included pain relief, pain interference, neuropathic pain symptoms, treatment outcomes related to pain management, and mental health symptoms. RESULTS:Receiving early RA was associated with improved average pain over the first 6 months after injury (β=-0.57; p=0.012) adjusting for injury severity and length of stay at the primary treatment facility. This difference was observed up to 24 months after injury (β=-0.36; p=0.046). Individuals receiving early RA reported greater pain relief, improved neuropathic pain intensity, and higher satisfaction with pain outcomes; however, by 24 months, mean scores did not significantly differ between cohorts. CONCLUSION:Findings indicate that when administered soon after traumatic injury, RA is a valuable pain management intervention. Future longitudinal studies investigating the timely delivery of RA for optimal pain management in civilian trauma settings are needed. TRIAL REGISTRATION NUMBER:NCT00431847.
journal_name
Reg Anesth Pain Medjournal_title
Regional anesthesia and pain medicineauthors
Gallagher RM,Polomano RC,Giordano NA,Farrar JT,Guo W,Taylor L,Oslin D,Goff BJ,Buckenmaier CCdoi
10.1136/rapm-2019-100773subject
Has Abstractpub_date
2019-09-27 00:00:00eissn
1098-7339issn
1532-8651pii
rapm-2019-100773pub_type
杂志文章abstract:BACKGROUND AND OBJECTIVES:Posterior lumbar plexus block is a well established anesthetic technique for lower limb surgeries. Both magnetic resonance imaging and clinical prospective studies were performed to verify if a new palpable landmark could be used for lumbar plexus block in pediatric patients. METHODS:Twenty-f...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2007.06.395
更新日期:2007-11-01 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: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:We describe a new therapeutic modality for sacroiliac joint syndrome that represents an alternative to other treatment modalities. We report on four cases of sacroiliac joint syndrome with severe pain. METHODS:Three patients had undergone operative treatment of the lumbar spine and one patien...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/s1098-7339(99)90170-0
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Epidural anesthesia (EA) is known to reduce postoperative thromboembolic complications, but mechanisms are incompletely understood. In this study, we tested the hypothesis that local anesthetics (LA) prevent postoperative hypercoagulability without affecting physiologic aggregation and coagula...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1053/rapm.2001.23209
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:This prospective, randomized, and multicentered study was undertaken to evaluate the success rate of coracoid infraclavicular nerve block performed with a nerve stimulator when either 1 or 3 motor responses were sought. METHODS:Eighty patients who presented for elbow, forearm, or wrist surger...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1053/rapm.2002.36456
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:In ambulatory lower limb surgery, spinal anesthesia with rapid onset and a short duration of block is preferable. We hypothesized that the use of 2-chloroprocaine would be associated with a faster motor block recovery compared with prilocaine in knee arthroscopy. A difference of 15 min was considered clinica...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-100673
更新日期:2019-08-21 00:00:00
abstract:BACKGROUND:Although infrequent, subdural block is a complication of epidural anesthesia with obvious implications. Knowledge of the spinal subdural compartment (dura-arachnoid interface) may help elucidate controversies arising from evidence that subdural catheter placement is feasible and may be difficult to identify ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e31822e0e8c
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The effect of intravenous dexamethasone on the duration of axillary plexus block performed using ropivacaine is not described. The aim of this study is to assess the effect of intravenous dexamethasone on the duration of axillary plexus block analgesia after distal upper arm surgery. METHODS:...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1136/rapm-2018-100035
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:This prospective randomized trial compared ultrasound-guided single-injection (SI) and triple-injection (TI) subparaneural popliteal sciatic nerve block. We hypothesized that multiple injections are not required when local anesthetic (LA) is deposited under the paraneurium because the latter e...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/AAP.0000000000000253
更新日期:2015-07-01 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 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 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 AND OBJECTIVES:Patients treated with regional anesthesia often require concomitant medication for comfort and sedation. Propofol is widely used for this purpose. Remifentanil, a new ultra-short-acting opioid, exhibits at low doses distinct sedative properties that may be useful for supplementation of regiona...
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)90112-2
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Ivor-Lewis esophagectomy is associated with significant postoperative analgesic requirements and perioperative complications. A dual-epidural technique may improve perioperative outcomes compared with single thoracic epidural analgesia. METHODS:This study identified all cases of Ivor-Lewis esophagectomy ove...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e318276a714
更新日期:2013-01-01 00:00:00
abstract::As the epidemics of obesity and diabetes expand, there are more patients with these disorders requiring elective surgery. For surgery on the extremities, peripheral nerve blocks have become a highly favorable anesthetic option when compared with general anesthesia. Peripheral blocks reduce respiratory and cardiac stre...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1097/AAP.0b013e3181ac9e42
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVE:We present an occurrence of a severe but transient neurologic complication after intraneural injection during an ultrasound-guided interscalene block. CASE REPORT:A 36-year-old man underwent ultrasound-guided interscalene nerve blockade before shoulder incision and drainage. On postoperative day 1, he exhibi...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/aap.0b013e3181e8a35f
更新日期:2010-07-01 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: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: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 triangl...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000216
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Several types of quadratus lumborum block (QLB) are used for postoperative analgesia and are believed to be effective against both somatic and visceral pain via a local anesthetic (LA) effect in the paravertebral space (PVS). However, it remains unclear whether all QLB techniques result in LA ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000735
更新日期:2018-05-01 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:OBJECTIVE:Our objective was to describe the first reported use of an axillary brachial plexus block to treat the entrapment of a transradial artery catheter due to vasospasm. CASE REPORT:A 42-year-old man undergoing transradial arterial cardiac catheterization suffered arterial vasospasm causing the catheter to become...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000595
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Dorsal root ganglion stimulation is an emerging therapy in the treatment of chronic pain. Compared with traditional spinal cord stimulation, it allows a discretely targeted stimulation profile and may act via differing mechanisms of action. Despite these advantages, little is known about the c...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-000007
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:0.1% bupivacaine for obstetric epidural analgesia is given by infusion, using a loading dose of a higher concentration alone or in combination with opioid analgesics. A single dose of 0.1% without any additive for relief of first-stage labor pain has not yet been documented. METHODS:Fifty-eig...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章
doi:10.1097/00115550-199823020-00004
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The posterior approach to performing a continuous brachial plexus block at the level of the nerve roots has been described using traditional superficial landmarks. We describe an ultrasound-guided approach for the placement of a continuous interscalene brachial plexus catheter at the level of ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/AAP.0b013e3181933a53
更新日期:2009-01-01 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::In March of 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act, ushering in an era of health care reform. Section 6002 of the bill, the Physician Payment Sunshine Act, requires manufacturers of drugs, devices, biological therapeutics, and medical supplies to disclose to the Cen...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000074
更新日期:2014-05-01 00:00:00
abstract::This article qualitatively assesses and summarizes randomized, controlled studies regarding benefits of ultrasound (US) for brachial plexus block and also examines those studies that have compared different brachial plexus block techniques using US.Studies were identified by a search of PUBMED and EMBASE databases usi...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1097/AAP.0b013e3181d25675
更新日期:2010-03-01 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