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    The Efficacy and Safety of Ultrasound Guided Peripheral Nerve Blockade A Qualitative Systematic Review

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    Author
    Parisian, David Lynn
    Affiliation
    The University of Arizona College of Medicine - Phoenix
    Issue Date
    2011-03
    MeSH Subjects
    Anesthesia, Local
    Ultrasonography
    
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    Publisher
    The University of Arizona.
    Description
    A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
    URI
    http://hdl.handle.net/10150/183698
    Abstract
    The clinical application of regional anesthesia has grown dramatically in recent years in part due to the increasing adoption of ultrasound imaging for peripheral block placement. Ultrasound technology enables real-time visualization of nerves, surrounding structures and local anesthetic spread and therefore offers theoretical advantages over existing methods of nerve localization. This systematic analysis was conducted to assess the current state of evidence for improved block efficacy, safety and other patient related outcomes with ultrasound guided peripheral nerve blockade (UGPNB). A search of the PubMed database was conducted for all randomized controlled trials comparing UGPNB to peripheral blocks performed at the same anatomic site by an alternative method of nerve localization. Forty-four studies, 39 adult and 5 pediatric, were identified for analysis and the results presented in Appendix 1,2,3,4,5. There is increasing Level Ib Grade A evidence that UGPNB, when applied by clinicians with the appropriate skill set, can be performed faster than alternative techniques yielding blocks that are more effective, with quicker onset and longer duration, requiring less local anesthetic, and causing less vascular puncture and greater patient comfort. Improved safety with UGPNB remains largely theoretical due to the low complication rate of all techniques of peripheral nerve block, but there is Level III Grade
    Type
    text; Electronic Thesis
    Language
    en_US
    Collections
    College of Medicine - Phoenix, Scholarly Projects

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