S M Klein

..In addition, increasing the concentration of ropivacaine from 0.5% to 0.75% fails to improve the onset or duration of interscalene brachial plexus block...

..The rewards in reduced postoperative pain, improved patient satisfaction, and anesthesiologist professional development make this endeavor worthy of our attention...

..Consequently, regional anesthesia using large amounts of local anesthetic should be done in locations with resuscitation equipment and by individuals trained to recognize these complications and begin early treatment...

..Nerve blocks frequently produce unusual altered perceptions in the extremities. We examined perceptual changes experienced after peripheral blocks...

..We describe an endoscopic technique that permits imaging of the contents and boundaries of the thoracic paravertebral space in cadavers...

..Ultimately, having larger prospective data with a broader focus on outcome benefits would be more persuasive for anesthesiologists to perform procedures that are still viewed by many as technically challenging...

..We conclude that age may affect peripheral nerve blocks and that more investigation is needed to determine the pharmacologic, physiologic, and chronologic factors behind these findings...

..Vibration technology may be a useful adjunct while performing ultrasound-guided regional anesthesia. Further study evaluating its usefulness and safety in live tissue is warranted...

..Paravertebral somatic nerve blocks (PVB) have the potential to offer unilateral abdominal wall anesthesia and long-lasting pain relief with minimal side effects. We compared PVB with peripheral neural blocks for outpatient IH...

..5% mepivacaine and a continuous intraarticular infusion of 0.5% ropivacaine at 2 mL/h provides improved analgesia for minor surgery at 24 and 48 h versus a single-injection interscalene block with 0.5% ropivacaine...

..This method of analgesia may offer improved pain relief after outpatient rotator cuff repair...

..This case illustrates the use of lumbar plexus and sciatic nerve peripheral catheters for major knee surgery using intermittent bolus dosing for outpatient analgesia...

..The frequent incidence of pain at 7 days suggests that longer-acting local anesthetics are still needed...

..Discharge with an insensate upper extremity is common but discharge with an insensate lower extremity is not prevalent and remains controversial...

..CONCLUSIONS: CPNB using the insulated Tuohy catheter system offered acceptable anesthesia and prolonged pain relief postsurgery. There were few side effects. Reg Anesth Pain Med 2001;26:209-214...

..This case demonstrates a method for extended bilateral thoracic analgesia. The technique may offer an alternative to traditional outpatient analgesics for reduction mammoplasty...

..We describe the successful use of continuous paravertebral anesthesia in two patients undergoing major breast surgery. A novel needle system for paravertebral catheter insertion is also presented...

..We present two cases where electrical activation of pudendal nerve afferents was used to evoke excitatory bladder responses...

..IMPLICATIONS: In this prospective trial, small-dose ropivacaine with fentanyl was as effective as small-dose lidocaine with fentanyl for anorectal procedures in the ambulatory setting...

..The objective of the present investigation was to assess the impact of body mass index (BMI) on patient outcomes after ambulatory regional anesthesia...

..Rotator cuff repair may result in severe postoperative pain. We compared a continuous intra-articular infusion to a continuous interscalene block with ropivacaine for patients undergoing outpatient rotator cuff repair...

..Although promethazine is effective, commonly used doses are associated with sedation. This study investigates the combination of low doses of granisetron and promethazine for the prevention of PONV...

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..This is a case report of four patients on the efficacy and advantages of CIBPB for postoperative analgesia at home...

..This is of tremendous value in a modern health care system that stresses cost-effective use of resources and a continued shift toward shorter hospital stay as well as outpatient surgery...

..CONCLUSIONS: The results of this study demonstrate that the plasma ropivacaine concentrations increase quicker when a sciatic-nerve block is added to a lumbar-plexus block, but C(max) remains below the toxicity threshold...

..Differences in needle design may impact nerve localization. This study evaluates the electrical properties of two insulated Tuohy needles using computational finite element modeling...

..The authors present a mathematical framework to model the underlying electrophysiology, the development of software to implement that framework, and examples of simulation results...

..If these changes are not due to artifact, dosing of hypnotic or anesthetic drugs might be warranted. Use of these drugs during DCD based primarily on processed EEG values has never been addressed...

..001) and ASA physical status IV (P < 0.001) were significantly associated with higher block failure rates. CONCLUSION: High BMI and ASA IV are independent risk factors for block failure in ambulatory surgery patients...

..5 (range 3-10 days); patients who were not employed returned to regular activities in 5.8 days (range 1-14 days). Eighty-two percent of patients reported being "very satisfied" with the anesthetic technique...

..We describe the first successful application of CPNB in the pain management and surgical management of a combat casualty as he was evacuated from the Iraqi battlefield to the United States...