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Serratus Plane Block: A Cadaveric Study to Evaluate Optimal Injectate Spread
Conclusions Our data showed that a high-volume double-injection technique provides extensive and consistent dye spread in the anterior chest wall and axilla, regardless of the plane of injection relative to the SAM. This technique likely provides more reliable analgesic coverage for breast procedures especially those that involve the axilla, pending confirmation in future clinical studies. (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - October 22, 2018 Category: Anesthesiology Tags: REGIONAL ANESTHESIA AND ACUTE PAIN: ORIGINAL ARTICLES Source Type: research

Thirty-Day Acute Health Care Resource Utilization Following Outpatient Anterior Cruciate Ligament Surgery
Background and Objectives The need for hospital-based acute care following outpatient surgical procedures is expensive and measured as marker for quality. However, little information is available about events leading to emergency department visit or inpatient admission after ambulatory anterior cruciate ligament (ACL) surgery. Methods We studied adult patients who underwent outpatient ACL surgery in New York State between 2009 and 2013 using the Healthcare Cost and Utilization Project database. Emergency department visits and inpatient admissions within 30 days of surgery were identified by cross-matching 2 additional...
Source: Regional Anesthesia and Pain Medicine - October 22, 2018 Category: Anesthesiology Tags: REGIONAL ANESTHESIA AND ACUTE PAIN: ORIGINAL ARTICLES Source Type: research

Pectoral Block Failure May Be Due to Incomplete Coverage of Anatomical Targets: A Dissection Study
Conclusions The MPN branches that innervate the lower part of the pectoralis major muscle are asymmetrical and variable in location and length; all located in a triangular area easily defined by sonographic landmarks, lateral to the TAA. (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - October 22, 2018 Category: Anesthesiology Tags: REGIONAL ANESTHESIA AND ACUTE PAIN: ORIGINAL ARTICLES Source Type: research

Lipid Emulsion Pretreatment Decreased the Maximum Total and Free Plasma Concentration of Levobupivacaine for Femoral and Sciatic Nerve Block in Below-Knee Fracture Surgery
Background and Objectives Although intravenous lipid emulsion has been proved a powerful antidote for local anesthetic toxicity, there are few pharmacokinetic data on using lipid infusion as a pretreatment for other clinical applications. We assessed the influence of lipid pretreatment on the pharmacodynamics and pharmacokinetics of levobupivacaine. Methods Altogether, 12 patients undergoing below-knee surgery for a fracture were randomly assigned to 2 groups (6 patients per group): pretreatment with 1.5 mL/kg lipid infusion (lipid group) or saline infusion (control subjects) followed by complete femoral and sciatic n...
Source: Regional Anesthesia and Pain Medicine - October 22, 2018 Category: Anesthesiology Tags: REGIONAL ANESTHESIA AND ACUTE PAIN: ORIGINAL ARTICLES Source Type: research

Ultrasound-Guided Selective Versus Conventional Block of the Medial Brachial Cutaneous and the Intercostobrachial Nerves: A Randomized Clinical Trial
Background and Objectives For superficial surgery of anteromedial and posteromedial surfaces of the upper arm, the medial brachial cutaneous nerve (MBCN) and the intercostobrachial nerve (ICBN) must be selectively blocked, in addition to an axillary brachial plexus block. We compared efficacy of ultrasound-guided (USG) versus conventional block of the MBCN and the ICBN. Methods Eighty-four patients, undergoing upper limb surgery, were randomized to receive either USG (n = 42) or conventional (n = 42) block of the MBCN and the ICBN with 1% mepivacaine. Sensory block was evaluated using light-touch on the upper and lowe...
Source: Regional Anesthesia and Pain Medicine - October 22, 2018 Category: Anesthesiology Tags: REGIONAL ANESTHESIA AND ACUTE PAIN: ORIGINAL ARTICLES Source Type: research

Ultrasound-Guided Infraclavicular Brachial Plexus Block: Prospective Randomized Comparison of the Lateral Sagittal and Costoclavicular Approach
In this study, we hypothesized that the CC approach will produce faster onset of sensory blockade of the 4 major terminal nerves of the brachial plexus than the LS approach. Methods Forty patients undergoing elective upper extremity surgery under a BPB were randomized to receive either the LS (Gp-LS, n = 20) or CC approach (Gp-CC, n = 20) for infraclavicular BPB. Twenty-five milliliters of 0.5% ropivacaine was used for the BPB in both study groups. Sensory-motor blockade of the ipsilateral median, radial, ulnar, and musculocutaneous nerves was assessed by a blinded observer at regular intervals for 45 minutes after the ...
Source: Regional Anesthesia and Pain Medicine - October 22, 2018 Category: Anesthesiology Tags: REGIONAL ANESTHESIA AND ACUTE PAIN: ORIGINAL ARTICLES Source Type: research

Improving Clinical Proficiency Using a 3-Dimensionally Printed and Patient-Specific Thoracic Spine Model as a Haptic Task Trainer
Conclusions By using patient-specific, 3-dimensionally printed, thoracic spine models, we demonstrated a significant improvement in clinical proficiency as compared with traditional teaching models. (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - October 22, 2018 Category: Anesthesiology Tags: REGIONAL ANESTHESIA AND ACUTE PAIN: ORIGINAL ARTICLES Source Type: research

Esmolol, Antinociception, and Its Potential Opioid-Sparing Role in Routine Anesthesia Care
β-Adrenergic blockade is an important mechanism for reducing morbidity and mortality in patients with hypertension and heart failure. Esmolol has been used widely for its chronotropic and antihypertensive effects. However, there has been recent inquiry regarding perioperative esmolol use and nociceptive modulation. Conventional postoperative analgesic treatment has relied primarily on opioids, which present their own adverse effects and pharmacoepidemiologic repercussions. Esmolol, to date, has not shown any direct analgesic or anesthetic properties; however, recent studies suggest that esmolol may have antinociceptive an...
Source: Regional Anesthesia and Pain Medicine - October 22, 2018 Category: Anesthesiology Tags: REGIONAL ANESTHESIA AND ACUTE PAIN: DARING DISCOURSE Source Type: research

Perioperative Esmolol and Opioids: Is More Really Less?
No abstract available (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - October 22, 2018 Category: Anesthesiology Tags: EDITORIAL Source Type: research

In Memoriam: L. Donald Bridenbaugh, MD, 1923–2018
No abstract available (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - October 22, 2018 Category: Anesthesiology Tags: SPECIAL ARTICLE Source Type: research

Microanatomical Nerve Architecture of 6 Mammalian Species: is Trans-species Translational Anatomic Extrapolation Valid? Erratum
No abstract available (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - September 22, 2018 Category: Anesthesiology Tags: Erratum Source Type: research

#WomeninPainMedicine: We Are Here
No abstract available (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - September 22, 2018 Category: Anesthesiology Tags: Letters to the Editor Source Type: research

Reply to Dr Chin et al
No abstract available (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - September 22, 2018 Category: Anesthesiology Tags: Letters to the Editor Source Type: research

Understanding ESP and Fascial Plane Blocks: A Challenge to Omniscience
No abstract available (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - September 22, 2018 Category: Anesthesiology Tags: Letters to the Editor Source Type: research

Combined Retroclavicular Approach for Shoulder Surgery: A New Description Technique of 3-in-1 Combined Block
No abstract available (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - September 22, 2018 Category: Anesthesiology Tags: Letters to the Editor Source Type: research