Popliteal plexus block in total knee arthroplasty: a single-center randomized controlled double-blinded trial.

Introduction: Whether a popliteal plexus block improves postoperative pain following total knee arthroplasty remains debated. This randomized trial tested if adding a popliteal plexus block to a continuous femoral nerve block decreases postoperative opioid requirement.

Methods: We included 66 patients undergoing total knee arthroplasty.

Development and Preliminary Validation of LoAD Calc, a Mobile App for Calculating the Maximum Safe Single Dose of Local Anesthetics.

Local anesthetics systemic toxicity can lead to life-threatening situations. Correct calculation of the maximum safe dose is therefore paramount in preventing such complications. Different solutions have already emerged to support anesthesiologists but are seldom used in clinical practice as they require either access to a computer or specific documents to be at hand.

The international ENIGMA-II substudy on postoperative cognitive disorders (ISEP).

There is a large controversy as to whether nitrous oxide (NO) added to the anaesthetic gas mixture is harmful or harmless for postoperative cognitive function recovery. We performed a nested study in the ENIGMA-II trial and compared postoperative neurocognitive recovery of patients randomly receiving NO (70%) or Air (70%) in 30% O during anesthesia. We included adults having non cardiac surgery.

Learning process of ultrasound-guided Ilio-fascial compartment block on a simulator: a feasibility study.

Background: Ultrasound-guided fascia iliaca compartment block (US-FICB) is not part of the learning curriculum of the emergency physicians (EP) and is usually performed by anesthesiologists. However, several studies promote EP to use this procedure. The goal of this study was to assess the feasibility of a training concept for non-anesthesiologists for the US-FICB on a simulator based on a validating learning path.

Perioperative intravenous low-dose ketamine for neuropathic pain after major lower back surgery: A randomized, placebo-controlled study.

Background: Chronic pain after major lower back surgery is frequent. We investigated in adults the effect of perioperative low-dose ketamine on neuropathic lower back pain, assessed by the DN4 questionnaire, 6 and 12 months after major lower back surgery.

Methods: In this single-centre randomized trial, 80 patients received intravenous ketamine 0.

Ultrasound-guided continuous femoral nerve block: a randomized trial on the influence of femoral nerve catheter orifice configuration (six-hole versus end-hole) on post-operative analgesia after total knee arthroplasty.

Background: Multiorifice catheters have been shown to provide superior analgesia and significantly reduce local anesthetic consumption compared with end-hole catheters in epidural studies. This prospective, blinded, randomized study tested the hypothesis that, in continuous femoral nerve block (CFNB) under ultrasound guidance, multiorifice catheter would reduce local anesthetic consumption at 24 h compared with end-hole catheter.

Methods: Eighty adult patients (aged ≥18 years) scheduled to undergo primary total knee arthroplasty under a combination of CFNB, sciatic nerve block and general anesthesia were randomized to CFNB using either a 3-pair micro-hole (Contiplex, BRAUN®, 20G - 400 mm) or an end-hole (Silverstim VYGON®, 20G - 500 mm) catheter.

Cervical abscess complicating an ultrasound-guided interscalene catheter.

Perineural catheters are the technique of choice for postoperative analgesia after painful orthopedic surgery. Infectious complications associated with perineural catheters, although rare, are associated with increased morbidity and mortality, medical cost, and hospital length of stay. In this report, we describe a patient in whom a cervical abscess occurred after insertion of an ultrasound-guided interscalene catheter.

Ultrasound-guided continuous interscalene block: the influence of local anesthetic background delivery method on postoperative analgesia after shoulder surgery: a randomized trial.

Background: Automated bolus delivery has recently been shown to reduce local anesthetic consumption and improve analgesia, compared with continuous infusion, in continuous sciatic and epidural block. However, there are few data on the influence of local anesthetic delivery method on local anesthetic consumption following interscalene blockade. This randomized, double-blind trial was designed to determine whether hourly automated perineural boluses (4 mL) of local anesthesia delivered with patient-controlled pro re nata (PRN, on demand) boluses would result in a reduction in total local anesthesia consumption during continuous interscalene blockade after shoulder surgery compared with continuous perineural infusion (4 mL/h) plus patient-controlled PRN boluses.

Perineural clonidine does not prolong levobupivacaine 0.5% after sciatic nerve block using the Labat approach in foot and ankle surgery.

Background: There is controversy about the effectiveness of perineural clonidine used as an adjuvant to local anesthetics. This study investigated whether the addition of 150 μg clonidine to 0.5% levobupivacaine used for posterior sciatic nerve block would prolong the duration of analgesia.

Levobupivacaine 0.5% provides longer analgesia after sciatic nerve block using the Labat approach than the same dose of ropivacaine in foot and ankle surgery.

Background: Levobupivacaine and ropivacaine are 2 left enantiomeric molecules frequently used for peripheral nerve blocks because of their safe clinical profile. Levobupivacaine is more lipophilic and theoretically more potent than ropivacaine, but clinical studies show conflicting results in terms of anesthetic and analgesic characteristics. We hypothesized that the pure S-enantiomer of bupivacaine provides longer-lasting analgesia than ropivacaine.

A new anatomical technique to investigate nerves by imagery.

Introduction: We describe a novel post mortem technique that makes it possible to visualise the nerve structure of the brachial plexus using imaging.

Materials And Methods: We dissected in situ the brachial plexus of a cadaver preserved by formaldehyde. A preparation composed of a mixture of baryte powder, water and colorant, was applied to all sides of the brachial plexus and blood vessels of the region under study.

No differences between 20, 30, or 40 mL ropivacaine 0.5% in continuous lateral popliteal sciatic-nerve block.

Background And Objectives: The aim of this study was to compare the anesthetic and analgesic characteristics of the administration of an initial bolus of 20, 30, or 40 mL of ropivacaine 0.5% through a lateral popliteal sciatic catheter.

Methods: Sixty patients scheduled for foot surgery under continuous sciatic lateral popliteal nerve block were included in this double-blinded study.

Intrathecal sufentanil is more potent than intravenous for postoperative analgesia after total-hip replacement.

Background And Objectives: In our clinical experience, sufentanil is more effective when administered intrathecally than intravenously. To test this hypothesis, we compared the analgesic characteristics of 7.5 microg of intrathecal or intravenous sufentanil for pain relief after total-hip replacement.

Duration of analgesia is similar when 15, 20, 25 and 30 mL of ropivacaine 0.5% are administered via a femoral catheter.

Purpose: This dose-response study was designed to determine the most appropriate dose of ropivacaine 0.5% injected via an indwelling femoral catheter for perioperative peripheral analgesia for total knee replacement (TKR).

Methods: 84 patients were allocated randomly to four groups and received, via a femoral catheter, either 15, 20, 25 or 30 mL of ropivacaine 0.

Cerebrospinal fluid tau and Abeta42 concentrations in healthy subjects: delineation of reference intervals and their limitations.

Many limitations and conflicting results have cast serious doubts on the validity of cerebrospinal fluid tau and Abeta42 levels for the biological diagnosis of Alzheimer's disease, particularly extreme variations of the reference limits found by unrelated groups as a consequence of different reference populations used. In this study, we addressed the issue of defining reference limits for cerebrospinal fluid tau and Abeta42 in healthy adult individuals. One hundred and five neurologically intact subjects were enrolled according to strict inclusion criteria, 10 of them with autopsy confirmation of brain integrity.

Isobaric versus hypobaric spinal bupivacaine for total hip arthroplasty in the lateral position.

Unlabelled: Total hip arthroplasty (THA) is frequently performed under spinal anesthesia using either isobaric or hypobaric anesthetic solution. However, these two solutions have never been compared under similar surgical conditions. In the present study, we compared the anesthetic and hemodynamic effects of isobaric and hypobaric bupivacaine in 40 ASA physical status I-II patients undergoing THA in the lateral decubitus position under spinal anesthesia.

Cerebrospinal fluid density influences extent of plain bupivacaine spinal anesthesia.

Background: The attempts to explain the unpredictability of extent of spinal block provided by plain local anesthetic solutions have resulted in many clinical reports; however, causes of this uncertainty are as yet unknown. Recently, normal values of the human cerebrospinal fluid densities have been studied showing important interindividual variations, especially between females and males. The current study was designed to evaluate as primary endpoint the influence of cerebrospinal fluid density values on the extent of spinal block with plain bupivacaine.