Survey of the utilization of regional and general anesthesia in a tertiary teaching hospital.

Background: Although the subspecialty of regional anesthesiology has become an important focus during residency training, there are many factors that might influence a resident's experience in regional anesthesia (RA). There are few data examining the utilization of regional techniques in an anesthesiology residency program. We undertook a prospective observational study to determine the frequency and reasons for not choosing RA in cases for which it was considered an option.

Efficacy of bicarbonate in decreasing pain on intradermal injection of local anesthetics: a meta-analysis.

Objective: Intradermal injection of local anesthetic often results in pain on injection due in part to the acidic pH of commercially prepared solutions, which are optimized to prolong shelf life. Although there are other possible explanations (eg, noxious properties of local anesthetics, pressure effect of infiltration), the etiology is most likely multifactorial. Although addition of bicarbonate to local anesthetics may decrease pain on intradermal injection, the extent of this analgesic effect is uncertain.