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Optimal Point of Insertion and Needle Angle in Neuraxial Blockade Using a Midline Approach: A Study in Computed Tomography Scans of Adult Patients
Conclusions: Our study has resulted in practical suggestions—based on accurate, reproducible measurements in patients—as to where to insert the needle and how to angulate the needle when performing neuraxial anesthesia using a midline approach. (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - August 22, 2017 Category: Anesthesiology Tags: Regional Anesthesia and Acute Pain: Original Articles Source Type: research

Antioxidation Role of Different Lateral Stellate Ganglion Block in Isoproterenol-Induced Acute Myocardial Ischemia in Rats
Conclusions: These findings suggest that SGB could have antioxidative effects against AMI, and the protective effect of right SGB was more effective than that of left SGB. Thus, the right SGB could be an effective and safe method of local anesthesia to protect against cardiac damage due to oxidative stress. (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - August 22, 2017 Category: Anesthesiology Tags: Regional Anesthesia and Acute Pain: Original Articles Source Type: research

Serum Bupivacaine Concentration After Periarticular Injection With a Mixture of Liposomal Bupivacaine and Bupivacaine HCl During Total Knee Arthroplasty
Conclusions: Total serum concentrations of bupivacaine after periarticular administration of liposomal bupivacaine mixed with bupivacaine HCl remained below the described toxicity threshold (2.5 μg/mL) within the first 48 hours, and no patients demonstrated signs or symptoms of toxicity. However, peak serum concentration time was not achieved within the 48-hour interval. Additional studies are needed to describe the course of serum bupivacaine levels after 48 hours and to ascertain the risk of toxicity when combining this method of periarticular injection with peripheral nerve blocks. (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - August 22, 2017 Category: Anesthesiology Tags: Regional Anesthesia and Acute Pain: Original Articles Source Type: research

Single-Injection Versus Multiple-Injection Technique of Ultrasound-Guided Paravertebral Blocks: A Randomized Controlled Study Comparing Dermatomal Spread
The objective of this study was to investigate the extent of dermatomal spread following an ultrasound-guided thoracic paravertebral block (PVB) when equal volumes of local anesthetic are injected at 1 versus 5 vertebral levels. Methods: Seventy patients undergoing a unilateral mastectomy were randomized to receive either single or multiple injections of a PVB under real-time ultrasound guidance using a parasagittal approach. The patients in the single-injection group received a PVB at T3–T4 level with 25 mL of 0.5% ropivacaine and 4 subcutaneous sham injections. Patients in the multiple-injection group received 5 injec...
Source: Regional Anesthesia and Pain Medicine - August 22, 2017 Category: Anesthesiology Tags: Regional Anesthesia and Acute Pain: Original Articles Source Type: research

Minimum Effective Volume of Lidocaine for Ultrasound-Guided Costoclavicular Block
Conclusions: For ultrasound-guided costoclavicular block, the MEV90 of lidocaine 1.5% with epinephrine 5 μg/mL is 34 mL. Further dose-finding studies are required for other concentrations of lidocaine, other local anesthetic agents, and multiple-injection techniques. (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - August 22, 2017 Category: Anesthesiology Tags: Regional Anesthesia and Acute Pain: Original Articles Source Type: research

Cadaveric Study of the Articular Branches of the Shoulder Joint
Conclusions: Articular branches from the SN, AN, and LPN were identified. Articular branches of the SN and AN insert into the capsule overlying the glenohumeral joint posteriorly. Articular branches of the LPN exist and innervate a portion of the anterior shoulder joint. (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - August 22, 2017 Category: Anesthesiology Tags: Regional Anesthesia and Acute Pain: Original Articles Source Type: research

Beyond Ultrasound Guidance for Regional Anesthesiology
Abstract: Despite its popularity, ultrasound (US)–guided regional anesthesiology is associated with significant limitations. The latter can be attributed to either the US machine (ie, decreased ability to insonate deep neural structures, as well as the thoracic spine) or the operator. Shortcomings associated with the operator can be explained by errors in perception (ie, ambiguous criteria for needle/catheter tip–to–nerve proximity and subparaneural local anesthetic injection) or interpretation. Perhaps the greatest confusion afflicting US-guided regional anesthesiology originates from an intellectual misconception p...
Source: Regional Anesthesia and Pain Medicine - August 22, 2017 Category: Anesthesiology Tags: Regional Anesthesia and Acute Pain: Daring Discourse Source Type: research

Precise Anatomical Targeting: Location, Location, Location!
No abstract available (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - August 22, 2017 Category: Anesthesiology Tags: Editorials Source Type: research

Regional Anesthesia “Block Rooms”: Should They Be Universal? Look to Goldilocks (and Her 3 Bears) for the Answer
No abstract available (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - August 22, 2017 Category: Anesthesiology Tags: Editorials Source Type: research

Reply to Dr Choquet et al
No abstract available (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - June 22, 2017 Category: Anesthesiology Tags: Letters to the Editor Source Type: research

Quadratus Lumborum 1 and Transversalis Fascia Blocks: Different Names for the Same Posterior Pararenal Space Block
No abstract available (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - June 22, 2017 Category: Anesthesiology Tags: Letters to the Editor Source Type: research

“Don't Throw the Baby Out With the Bath Water: ” A Reply to Dr. Onwochei et al
No abstract available (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - June 22, 2017 Category: Anesthesiology Tags: Letters to the Editor Source Type: research

If Wishes Were Horses, Beggars Would Ride
No abstract available (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - June 22, 2017 Category: Anesthesiology Tags: Letters to the Editor Source Type: research

Reply to Dr Bansal et al
No abstract available (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - June 22, 2017 Category: Anesthesiology Tags: Letters to the Editor Source Type: research

Diaphragm-Sparing Nerve Blocks for Shoulder Surgery: An Alternative Approach
No abstract available (Source: Regional Anesthesia and Pain Medicine)
Source: Regional Anesthesia and Pain Medicine - June 22, 2017 Category: Anesthesiology Tags: Letters to the Editor Source Type: research