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 anesthetized. The IFCN can be selectively anesthetized in the subcutaneous tissue above the sartorius muscle and the MFCN by an injection in the proximal part of the femoral triangle (FT). The primary aim was to investigate the area of cutaneous anesthesia in relation to the surgical incision for TKA and anteromedial knee area after intermediate femoral cutaneous nerve blockade (IFCNB) in combination with an injection in the proximal or distal part of the FT (proximal vs distal femoral triangle block (FTB)). METHODS:The study was carried out as two separate investigations: first, dissection of nine cadaver sides to verify a technique for IFCNB; second, a volunteer study with 40 healthy volunteers. The surgical midline incision for TKA was drawn bilaterally. All volunteers received an active distal FTB combined with a placebo proximal FTB on one side and vice versa on the other side. All volunteers were randomized to an active IFCNB on one side and placebo IFCNB on the contralateral side. RESULTS:Identification of IFCN was successful in all cadaver sides. Fifteen out of 20 volunteers had complete anesthesia of the incision line after IFCNB combined with proximal FTB, which was significantly higher compared with proximal FTB alone and with distal FTB+IFCNB. A gap at the anteromedial knee area was present in 2/20 volunteers with proximal FTB compared with 17/20 with distal FTB when all volunteers had active IFCNB. CONCLUSION:Ultrasound-guided blockade of the IFCN and MFCN anesthetize the surgical midline incision and the anteromedial area of the knee relevant for TKA. In contrast, an injection at the midthigh level produces insufficient cutaneous anesthesia not covering the areas of interest. TRIAL REGISTRATION NUMBER:EudraCT: 2018-004986-15.
journal_name
Reg Anesth Pain Medjournal_title
Regional anesthesia and pain medicineauthors
Bjørn S,Nielsen TD,Moriggl B,Hoermann R,Bendtsen TFdoi
10.1136/rapm-2019-100904subject
Has Abstractpub_date
2019-12-10 00:00:00eissn
1098-7339issn
1532-8651pii
rapm-2019-100904pub_type
杂志文章abstract:BACKGROUND AND OBJECTIVES:Ischemic preconditioning of tissue that is to undergo procedure-induced underperfusion has been used in a number of surgical settings to reduce the subsequent inflammatory response and its sequelae. The objective of this prospective, randomized study was to evaluate the effect of ischemic prec...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/aap.0b013e3181e82e8e
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The study goal was to compare the effect of epinephrine in different doses on pulmonary gas exchange in a rat model of bupivacaine-induced cardiac depression. METHODS:Twenty-four adult male Sprague-Dawley rats were divided into 4 groups (n = 6), and each group received a bupivacaine infusion (...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000541
更新日期:2017-05-01 00:00:00
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000687
更新日期:2018-01-01 00:00:00
abstract::Contemporary nonmalignant pain treatment algorithms commence with conservative non-invasive strategies, later progressing from minimally invasive interventions to invasive techniques or implantable devices. The most commonly used implantable devices are spinal cord stimulation (SCS) systems or targeted drug delivery (...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-100859
更新日期:2020-01-12 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:Lipid infusion reverses systemic local anesthetic toxicity. The acceptable upper limit for lipid administration is unknown and has direct bearing on clinical management. We hypothesize that high volumes of lipid could have undesirable effects and sought to identify the dose required to kill 50% of the animal...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/aap.0b013e3181c6f5aa
更新日期:2010-03-01 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:Cervical medial branch blocks are used to treat patients with chronic neck pain. The aim of this study was to clarify the anatomical aspects of the cervical medial branches to improve the accuracy and safety of radiofrequency denervation. METHODS:Twenty cervical specimens were harvested from ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000175
更新日期:2014-11-01 00:00:00
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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:Morphine may elicit potent antinociceptive effects by binding and activating peripheral opioid receptors. However, the results in clinical studies have varied. We examined the postoperative analgesic effects of incisional morphine in patients undergoing lumpectomies and axillary node dissectio...
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(99)90075-5
更新日期:1999-03-01 00:00:00
abstract::Perioperative outcomes research has gained widespread interest and is viewed as increasingly important among different specialties, including anesthesiology. Outcomes research studies serve to help in the adjustment of risk, allocation of resources, and formulation of hypotheses to guide future research. Pursuing high...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1097/AAP.0000000000000110
更新日期:2014-09-01 00:00:00
abstract::The use of ultrasound to facilitate regional anesthesia is an evolving area of clinical, education, and research interests. As our community's experience grows, it has become evident that anesthesiologists performing "routine" ultrasound-guided blocks may very well be confronted with atypical or even pathologic anatom...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1097/AAP.0b013e3181ddd21f
更新日期:2010-05-01 00:00:00
abstract::Shoulder surgery is associated with significant postoperative pain in many patients. The use of an interscalene nerve block offers good analgesia but is associated with a high incidence of an ipsilateral phrenic nerve block. Several strategies to avoid this adverse effect have been studied. Possible strategies are (1)...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e318272195d
更新日期:2013-01-01 00:00:00
abstract::Potassium (K+) channels form the largest family of ion channels with more than 70 such genes identified in the human genome. They are organized in 3 superfamilies according to their predicted membrane topology: (1) subunits with 6 membrane-spanning segments and 1-pore domain, (2) subunits with 2 membrane-spanning segm...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1016/j.rapm.2004.12.001
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Continuous spinal anesthesia via a spinal catheter allows adjusting the duration and extent of anesthesia to surgical needs, maintenance of hemodynamic stability, and good postoperative analgesia. This study was designed to determine the median effective local anesthetic dose of plain ropivaca...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rapm.2007.06.396
更新日期:2008-01-01 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: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::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 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
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更新日期:1998-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The American College of Obstetricians & Gynecologists has opposed postpartum tubal ligation (PPTL) in patients whose pregnancies have been complicated by a medical condition, including hypertension. A prospective study was conducted to assess the appropriateness of spinal anesthesia for PPTL i...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1053/rapm.2000.0250170
更新日期:2000-03-01 00:00:00
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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
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e31822b0db0
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Anesthesia and analgesia with paravertebral block are reportedly variable. Existence of an endothoracic fascia has been proposed as one of the possible mechanisms leading to variability. We undertook an electron-microscopy imaging study to investigate the endothoracic fascia in the thoracic pa...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e31824451cb
更新日期:2012-03-01 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 AND OBJECTIVES:The aim of this study was to compare the antinociceptive and motor-blocking effects of epidurally administered IQB-9302 (C18H26N2O.HCl) and bupivacaine in the dog. METHODS:Twelve adult female Beagle dogs were used. Each animal received 3 concentrations (0.25%, 0.50%, and 0.75%) of either IQB-...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Chronic hip pain from osteoarthritis and other degenerative conditions is a common problem. A few publications have recently reported analgesic success of radiofrequency (RF) procedures on nerves innervating the hip, but interpretation is hampered by lack of clarity regarding indications, clin...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1097/AAP.0000000000000694
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Gabapentin is an anticonvulsant that has been shown to be effective in the treatment of neuropathic and inflammatory pain in animal and human studies. The analgesic effect of its perioperative use has not been fully elucidated. METHODS:This systematic review (meta-analysis) included 12 random...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,meta分析
doi:10.1016/j.rapm.2006.01.005
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Spontaneous intracranial hypotension is a postural headache syndrome unrelated to dural puncture. Due to the apparent failure of epidural blood patch to relieve headache in spontaneous intracranial hypotension, we investigated the epidemiologic features and treatment outcomes of this condition...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1053/rapm.2001.28275
更新日期:2001-11-01 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 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