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 obstetric patients. METHODS:Thirty-nine obstetric patients in labor were studied. An electrocardiography (ECG) adapter (Arrow-Johans) was attached to the proximal end of the epidural catheter (19-gauge Arrow Flextip plus). Then, the lowest milliamperage (1-10 mA) necessary to produce a motor response (truncal or limb movement) was applied using this setup. A positive motor response indicated that the catheter was in the epidural space. This test was performed initially after catheter insertion and repeatedly after incremental local anesthetic doses. RESULTS:The sensitivity and specificity of the new test was 100% and 100%, respectively, with 38 true positive tests and 1 true negative test. The threshold current required to produce a positive test increased after incremental doses of local anesthetic. A case of intravascular epidural catheter migration was detected using this new test. In this case, the patient's increased threshold milliamperage returned to the baseline value within 1 hour, despite having received local anesthetic. Intravascular epidural catheter migration was subsequently confirmed by a positive epinephrine test dose. Thus, this test appears to be a potentially useful method to detect intravascular catheter placement. CONCLUSION:This study demonstrates that this test may have a role in improving the success rate of epidural anesthesia.
journal_name
Reg Anesth Pain Medjournal_title
Regional anesthesia and pain medicineauthors
Tsui BC,Gupta S,Finucane Bdoi
10.1016/s1098-7339(99)90160-8subject
Has Abstractpub_date
1999-01-01 00:00:00pages
17-23issue
1eissn
1098-7339issn
1532-8651pii
S1098-7339(99)90160-8journal_volume
24pub_type
临床试验,杂志文章abstract:BACKGROUND AND OBJECTIVES:Epidural anesthesia is a technically challenging regional anesthetic technique that can be difficult to teach to novices. Epidural simulators are now available to allow realistic training within a safe and controlled environment before attempting the procedure on patients. Potentially, this ma...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e3181a34345
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:No study has compared cervical interlaminar epidural steroid injection (CIESI) with epidural catheter advancement to the side and level of pathology versus standard C7-T1 CIESI. This study investigated whether cervical radicular pain is more effectively treated by CIESI with a targeted epidura...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000521
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:This report describes the effects of ganglionic local opioid application (GLOA) in patients with chronic headache and persistent idiopathic facial pain. CASE REPORT:We present 2 patients with chronic headaches and 1 patient with persistent idiopathic facial pain who were refractory to medical treatment. Thes...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2006.03.011
更新日期:2006-09-01 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:Peripheral nerve blocks can be successfully utilized in infants for neurosurgical procedures. Our objective was utilizing a series of peripheral nerve blocks for a neurosurgical procedure in a very low-birth-weight neonate. CASE REPORT:We report the use of supraorbital, great auricular, and g...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2003.09.008
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:A common analgesic technique for total knee arthroplasty (TKA) is to inject local anesthetic into the periarticular tissue during surgery, known as local infiltration analgesia (LIA). Since the solution used typically contains a large amount of local anesthetic, concerns arise about exceeding ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-100043
更新日期:2019-01-11 00:00:00
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:Several studies have evaluated the effect of pectoral nerve blocks to improve postoperative analgesia following breast cancer surgery resulting in contradictory findings. The aim of this study was to examine the effect of Pecs blocks on postoperative analgesia in women following mastectomies. ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-100658
更新日期:2019-08-09 00:00:00
abstract:BACKGROUND:The ideal spread of local anesthetic for effective, rapid, and safe sciatic nerve block is debated. We hypothesized that subparaneural ultrasound-guided injection results in faster onset and has a better success rate than extraneural circumferential spread. METHODS:Patients undergoing elective tibial, foot,...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000095
更新日期:2014-07-01 00:00:00
abstract::Reports exist of severe upper back pain of unknown etiology after administration of large volumes into the epidural space. We present a case of an otherwise healthy parturient who developed severe upper back and neck pain after receiving only a small volume of epidural medication. Magnetic resonance imaging revealed a...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000493
更新日期:2016-11-01 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 the study was to examine the analgesic effects of the anticonvulsant, gabapentin, in a validated model of acute inflammatory pain. METHODS:Twenty-two volunteers were investigated in a double-blind, randomized, placebo-controlled cross-over study. Gabapentin 1,200 mg or placebo was ...
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.2001.25070
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:In addition to their blockade of voltage-dependent sodium channels, the action of local anesthetics at 5-hydroxytryptamine-3 (5-HT3) receptors may be clinically relevant. Because local anesthetics have different clinical properties, we have tested the hypothesis that differences in interaction...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2007.06.391
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Because of the uncertainty and limitations in available randomized controlled trials, we performed an analysis of the Medicare claims database to determine whether an association exists between postoperative epidural analgesia and mortality. METHODS:A 5% nationally random sample of Medicare beneficiaries fr...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2004.07.002
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:The underlying mechanisms of neuropathic pain remain unclear. This work aimed to investigate the role of Sirtuin3 (SIRT3), an nicotinamide adenosine dinucleotide+-dependent histone deacetylase, in the development of neuropathic pain induced by type 2 diabetes mellitus (T2DM) and to explore the associated mec...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2020-101918
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Central sensitization is often seen in chronic pain. A relevant and potent mechanism of central sensitization is the central integration of nociceptive impulses. Temporal summation in humans and the wind-up process in animals share common features of central integration. This preclinical and c...
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::As anesthesiologists and acute pain medicine specialists, we will care for patients in the perioperative period who use cannabinoids for chronic pain and/or marijuana recreationally. We will have to address difficult questions from patients regarding the potential applications for cannabinoids in acute pain management...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2020-101475
更新日期:2020-07-01 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: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
abstract:BACKGROUND AND OBJECTIVES:The aim of this study is to examine the effects of head-up tilt (70 degrees ) 30 minutes after right or left stellate ganglion block (SGB) on RR interval, QT interval, the rate-corrected QT (QTc) interval, QT dispersion (QTD), and the rate-corrected QT dispersion (QTcD) using computerized meas...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2004.03.009
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:We hypothesized that ultrasound-guided wrist blocks may be faster to perform, and may increase success rate, compared with nerve stimulation-guided wrist blocks. METHODS:Sixty patients undergoing ambulatory endoscopic carpal tunnel release were randomly allocated to receive median and ulnar n...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rapm.2008.01.004
更新日期:2008-07-01 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:BACKGROUND AND OBJECTIVES:This prospective, randomized, double-blind study compared the effects of the ultrasound-guided popliteal sciatic nerve block performed by either intraneural or subparaneural approach followed by an electrophysiological evaluation. We hypothesized that intraneural injection provides a faster on...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000413
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:A sublingual sufentanil tablet is being developed as a potential alternative to intravenous (IV) opioids for the management of postoperative pain. The objective of these studies was to evaluate the pharmacokinetics, efficacy, and safety of sublingual sufentanil tablets for postoperative pain m...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e3182791157
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:Femoral nerve block (FNB) is increasingly used as an analgesic modality in patients with femoral fracture both in the emergency department and preoperatively. We describe an occurrence of unexpected dislocation of the fracture after FNB. CASE REPORT:An FNB was administered to treat pain in a 48-year-old pati...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000049
更新日期:2014-03-01 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:Success in performing ultrasound-guided peripheral nerve blockade (PNB) demands sound knowledge of sonoanatomy, good scanning techniques, and proper hand-eye coordination. The objectives of our study were to evaluate whether simulator training aids success of novice operators in ultrasound-gui...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e31823dc340
更新日期:2012-01-01 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 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: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