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OBJECTIVES The American Society of Regional Anesthesia and Pain Medicine charged an expert panel to examine the evidence basis for ultrasound guidance as a nerve localization tool in the clinical practices of regional anesthesia and interventional pain medicine. METHODS The panel searched, examined, and assessed the literature of ultrasound-guided(More)
In the stationary hand, static joint-position sense originates from multimodal somatosensory input (e.g., joint, skin, and muscle). In the moving hand, however, it is uncertain how movement sense arises from these different submodalities of proprioceptors. In contrast to static-position sense, movement sense includes multiple parameters such as motion(More)
UNLABELLED We summarized the evidence for ultrasound (US) guidance for truncal blocks in 2010 by performing a systematic literature review and rating the strength of evidence for each block using a system developed by the United States Agency for Health Care Policy and Research. Since then, numerous studies of US guidance for truncal blocks have been(More)
OBJECTIVE The use of ultrasound (US) for localization of neural structures allows real-time visualization of anatomy; however, variability in the arrangement of structures has been observed. The impact of these variations on the performance and outcome of regional anesthetic techniques remains unclear. We discuss possible anatomic explanations and(More)
STUDY OBJECTIVE To determine the effectiveness of a short educational video and simulation on improvement of ultrasound (US) image acquisition and interpretation skills. DESIGN Prospective, randomized study. SETTING University medical center. SUBJECTS 28 anesthesia residents and community anesthesiologists with varied ultrasound experience were(More)
We performed a systematic search of the medical literature and reviewed the evidence examining success rates and incidence of complications of ultrasound (US) guidance relative to traditional techniques for the following blocks: paravertebral, intercostal, transversus abdominis plane, rectus sheath, and ilioinguinal/iliohypogastric. We included studies of(More)
INTRODUCTION The use of the transversus abdominis plane (TAP) block is increasing in abdominally based autologous tissue breast reconstruction as a method to provide postoperative donor site analgesia. The purpose of this study was to evaluate the efficacy of the TAP block in the immediate postoperative period. METHODS A retrospective analysis of all(More)
The progression of sensory blockade in the hand following a forearm Bier block with ropivacaine is currently unknown. The hands of 10 healthy adult human subjects were anesthetized with ropivacaine, and their sensitivities to cold and touch were tested until the completion of anesthesia. On average, insensitivity to cold occurred uniformly throughout the(More)
BACKGROUND AND OBJECTIVES Successful blockade of the saphenous nerve using surface landmarks can be challenging. We evaluated the anatomic basis of performing a saphenous nerve block with ultrasound (US) using its relationship to the saphenous branch of descending genicular artery, sartorius muscle, and the adductor hiatus as defined by cadaveric(More)
BACKGROUND Previous clinical and experimental studies have shown that a midazolam-clonidine mixture has a synergistic antinociceptive effect. This study evaluated the postoperative analgesic effect of adding midazolam to an intrathecal bupivacaine-clonidine mixture. METHODS One hundred ten patients scheduled to undergo elective lower-extremity surgery(More)