Regional anesthesia and analgesia in critically ill patients: a systematic review. O.M. Stundner, S.G. Memtsoudis Table S2 – level of evidence for included studies Submitted as supplemental digital content. No Author, Year Evid. a) core search 1 Lu CH et al. Effect of epidural neuraxial blockade-dependent sedation on the 1b Ramsay Sedation Scale and the composite auditory evoked potentials index in surgical intensive care patients. J Formos Med Assoc. 2010 Aug;109(8):589-95. 2 Niraj G et al. Application of the transversus abdominis plane 4 block in the intensive care unit. Anaesth Intensive Care. 2009 Jul;37(4):650-2. 3 Karabinis A et al. Ultrasound-guided 5 techniques provide serendipitous diagnostic information in anaesthesia and critical care patients. Anaesth Intensive Care. 2008 Sep;36(5):748-9. 4 Malchow RJ and Black IH. The evolution of pain management in the critically ill R trauma patient: Emerging concepts from the global war on terrorism. Crit Care Med. 2008 Jul;36(7 Suppl):S346-57 5 Wiebalck A and Grau T. Ultrasound imaging techniques for regional blocks in R intensive care patients. Crit Care Med. 2007 May;35(5 Suppl):S268-74. 6 Evans N, Skowno J, Hodgson E. The anaesthesiologist in the intensive care R unit. Curr Opin Anaesthesiol. 2003 Aug;16(4):401-7. 7 Schulz-Stübner S. The critically ill patient and regional anesthesia. Curr R Opin Anaesthesiol. 2006 Oct;19(5):538-44. 8 Schulz-Stübner S et al. Regional analgesia in the critically R ill. Crit Care Med. 2005 Jun;33(6):1400-7 9 Clark F and Gilbert HC. Regional analgesia in the intensive care unit. R Principles and practice. Crit Care Clin. 2001 Oct;17(4):943-66. 10 Burton AW and Eappen S. Regional anesthesia techniques for pain control in the intensive care unit. Crit Care Clin. 1999 Jan;15(1):77-88, vi. R 11 Darchy B et al. Clinical and 2b bacteriologic survey of epidural analgesia in patients in the intensive care unit. Anesthesiology. 1996 Nov;85(5):988-98. 12 Tobias JD and Rasmussen GE. Pain management and sedation in the pediatric R intensive care unit. Pediatr Clin North Am. 1994 Dec;41(6):1269-92. 13 Tobias JD. Continuous femoral nerve block to provide analgesia following 4 femur fracture in a paediatric ICU population. Anaesth Intensive Care. 1994 Oct;22(5):616-8. 14 Rung GW, Marshall WK. Nerve blocks in the critical care environment. Crit 5 Care Clin. 1990 Apr;6(2):343-67. b) additional studies included 15 Werawatganon T and Charuluxanun S. Patient controlled intravenous opioid 1a analgesia versus continuous epidural analgesia for pain after intra-abdominal surgery. Cochrane Database Syst Rev 2005;(1):CD004088. 16 Richman JM et al. Does continuous peripheral nerve block provide superior pain 1a control to opioids? A meta-analysis. Anesth Analg 2006;102:248-257. 17 Block BM et al. Efficacy of postoperative epidural analgesia: a meta-analysis. 1a JAMA 2003;290:2455-2463. 18 Rodgers A et al. Reduction of postoperative mortality and morbidity with epidural 1a or spinal anaesthesia: results from overview of randomised trials. BMJ 2000;321:1493. 19 Wijeysundera DN et al. Epidural anaesthesia and survival after intermediate-to- 2b high risk non-cardiac surgery: a population-based cohort study. Lancet 2008;372:562-569. 20 Macfarlane AJ et al. Does regional anaesthesia improve outcome after total hip 1a arthroplasty? A systematic review. Br J Anaesth 2009;103:335-345. 21 Foss NB et al. Fascia iliaca compartment blockade for acute pain control in hip 1b fracture patients: a randomized, placebo-controlled trial. Anesthesiology 2007;106:773-778. 22 Beaudoin FL et al. Ultrasound-guided femoral nerve blocks in elderly patients with 2b hip fractures. Am J Emerg Med 2010;28:76-81. 23 Mutty CE et al. Femoral nerve block for diaphyseal and distal femoral fractures in 1b the emergency department. J Bone Joint Surg Am 2007;89:2599-2603. 24 Elkhodair S, Mortazavi J, Chester A, Pereira M. Single fascia iliaca compartment 2b block for pain relief in patients with fractured neck of femur in the emergency department: a pilot study. Eur J Emerg Med 2011;18:340-343. 25 Barker R et al. Femoral nerve blockade administered preclinically for pain relief in 1b severe knee trauma is more feasible and effective than intravenous metamizole: a randomized controlled trial. J Trauma 2008;64:1535-1538. 26 Phillips WJ et al. Nerve stimulator-assisted sciatic nerve block for painful 2c procedures in the ED. Am J Emerg Med 2011;29:1130-1135. 27 Chong AK et al. Comparison of forearm and conventional Bier's blocks for 1b manipulation and reduction of distal radius fractures. J Hand Surg Eur Vol 2007;32:57-59. 28 Frenkel O et al. Supracondylar radial nerve block for treatment of distal radius 4 fractures in the emergency department. J Emerg Med 2011;41:386-388. 29 Blaivas M et al. A prospective comparison of procedural sedation and ultrasound- 1b guided interscalene nerve block for shoulder reduction in the emergency department. Acad Emerg Med 2011;18:922-927. 30 Herring AA, et al. Ultrasound-guided suprascapular nerve block for shoulder 4 reduction and adhesive capsulitis in the ED. Am J Emerg Med 2011;29:963.e1963.e3. 31 Stewart B et al. Emergency department use of a continuous femoral nerve block for 4 pain relief for fractured femur in children. Emerg Med J 2007;24:113-114. 32 Tobias JD. Continuous femoral nerve block to provide analgesia following femur 4 fracture in a paediatric ICU population. Anaesth Intensive Care 1994;22:616-618. 33 Carrier FM et al. Effect of epidural analgesia in patients with traumatic rib 1a fractures: a systematic review and meta-analysis of randomized controlled trials. Can J Anaesth 2009;56:230-242. 34 Karmakar MK, Critchley LA, Ho AM, Gin T, Lee TW, Yim AP. Continuous 4 thoracic paravertebral infusion of bupivacaine for pain management in patients with multiple fractured ribs. Chest 2003;123:424-431. 35 Mohta M et al. Prospective, randomized comparison of continuous thoracic 1b epidural and thoracic paravertebral infusion in patients with unilateral multiple fractured ribs--a pilot study. J Trauma 2009;66:1096-1101. 36 Osinowo OA et al. Effect of intercostal nerve block with 0.5% bupivacaine on peak 4 expiratory flow rate and arterial oxygen saturation in rib fractures. J Trauma 2004;56:345-347. 37 Keskinbora K and Aydinli I. Perineural morphine in patients with chronic ischemic 1b lower extremity pain: efficacy and long-term results. J Anesth 2009;23:11-18. 38 Richter A et al. Effect of thoracic epidural analgesia on refractory angina pectoris: 2b long-term home self-treatment. J Cardiothorac Vasc Anesth 2002;16:679-684. 39 Cuignet O et al. The efficacy of continuous fascia iliaca compartment block for 1b pain management in burn patients undergoing skin grafting procedures. Anesth Analg 2004;98:1077-81, table of contents. 40 Cuignet O et al. The long-term analgesic efficacy of a single-shot fascia iliaca 1b compartment block in burn patients undergoing skin-grafting procedures. J Burn Care Rehabil 2005;26:409-415. 41 Kocum A et al. Femoral and sciatic nerve block with 0.25% bupivacaine for 4 surgical management of diabetic foot syndrome: an anesthetic technique for highrisk patients with diabetic nephropathy. J Clin Anesth 2010;22:363-366. 42 Yohena T et al. Successful treatment of a compromised patient with intractable 4 pneumothorax using a semiflexible thoracofiberscope under local anesthesia: A case report. Ann Thorac Cardiovasc Surg 2010;16:442-444. 43 Cabrini L et al. Percutaneous tracheostomy, a systematic review. Acta Anaesthesiol 1a Scand 2012;56:270-281. 42 Reed AP. Successful transesophageal echocardiography in an unsedated critically 4 ill patient with superior laryngeal nerve blocks. Am Heart J 1991;122:1472-1474. 43 Harris T et al. The use of pre-cannulation local anaesthetic and factors affecting pain perception in the emergency department setting. Emerg Med J 2001;18:175- 1b 177. 44 Fry C and Aholt D. Local anesthesia prior to the insertion of peripherally inserted 1b central catheters. J Infus Nurs 2001;24:404-408. 45 Choi S and Brull R. Neuraxial techniques in obstetric and non-obstetric patients 3a with common bleeding diatheses. Anesth Analg 2009;109:648-660. 46 Wisplinghoff H et al. Nosocomial bloodstream infections in US hospitals: analysis 2c of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 2004;39:309-317. 47 Gritsenko K et al. Meningitis or epidural abscesses after neuraxial block for 2c removal of infected hip or knee prostheses. Br J Anaesth 2011;108:485-490. 48 Cuvillon P et al. The continuous femoral nerve block catheter for postoperative 2c analgesia: bacterial colonization, infectious rate and adverse effects. Anesth Analg 2001;93:1045-1049. 49 Nseir S et al. Fatal streptococcal necrotizing fasciitis as a complication of axillary 4 brachial plexus block. Br J Anaesth 2004;92:427-429. 50 Adam F et al. Psoas abscess complicating femoral nerve block catheter. 4 Anesthesiology 2003;99:230-231. 51 Pottecher J et al. Does thoracic epidural analgesia improve outcome after lung 2a transplantation? Interact Cardiovasc Thorac Surg 2011;12:51-53. 52 Di Gregorio G et al. Clinical presentation of local anesthetic systemic toxicity: a 4 review of published cases, 1979 to 2009. Reg Anesth Pain Med 2010;35:181-187. 53 Moore JM et al. Premedication with fentanyl and midazolam decreases the 1b reliability of intravenous lidocaine test dose. Anesth Analg 1998;86:1015-1017. 54 Benumof JL. Permanent loss of cervical spinal cord function associated with 4 interscalene block performed under general anesthesia. Anesthesiology 2000;93:1541-1544. 55 Visser WA et al. Continuous positive airway pressure breathing increases the 1b spread of sensory blockade after low-thoracic epidural injection of lidocaine. Anesth Analg 2006;102:268-271. 56 Visser WA et al. Continuous positive airway pressure breathing increases cranial 2b spread of sensory blockade after cervicothoracic epidural injection of lidocaine. Anesth Analg 2007;105:868-871. 57 Casati A et al. Effects of ultrasound guidance on the minimum effective anaesthetic 1b volume required to block the femoral nerve. Br J Anaesth 2007;98:823-827. 58 Orebaugh SL et al. Adverse outcomes associated with stimulator-based peripheral 2c nerve blocks with versus without ultrasound visualization. Reg Anesth Pain Med 2009;34:251-255. 59 Neal JM. Ultrasound-guided regional anesthesia and patient safety: An evidence- 1a based analysis. Reg Anesth Pain Med 2010;35:S59-67. 60 Al-mustafa MM et al. The effect of low serum bicarbonate values on the onset of 3b action of local anesthesia with vertical infraclavicular brachial plexus block in patients with end-stage renal failure. Saudi J Kidney Dis Transpl 2010;21:494-500. 61 Rodriguez J et al. High doses of mepivacaine for brachial plexus block in patients 2b with end-stage chronic renal failure. A pilot study. Eur J Anaesthesiol 2001;18:171176. 62 Belyamani L et al. Paraplegia after inadvertent epidural administration of potassium 4 chloride. Ann Fr Anesth Reanim 2008;27:111-113. 63 Merino I and Perez J. Inadvertent epidural infusion of acetaminophen during 4 labour. Int J Obstet Anesth 2011;20:192-194. 64 Kal JE et al. Inadvertent epidural administration of insulin. Anaesthesia 4 2007;62:621-623. 65 Bajwa SJ et al. Dexmedetomidine and clonidine in epidural anaesthesia: A 1a comparative evaluation. Indian J Anaesth 2011;55:116-121. 66 Joshi GP et al. A systematic review of randomized trials evaluating regional 1a techniques for postthoracotomy analgesia. Anesth Analg 2008;107:1026-1040. 67 Kramer S et al. Continuous spinal anesthesia versus continuous femoral nerve 2b block for elective total knee replacement. Minerva Anestesiol 2011;77:394-400. 68 Abdallah FW et al. Transversus abdominis plane block: a systematic review. Reg 1a Anesth Pain Med 2012;37:193-209. 69 Niraj G et al. Application of the transversus abdominis plane block in the intensive 4 care unit. Anaesth Intensive Care 2009;37:650-652. 70 Silomon M et al. Interpleural analgesia does not influence postthoracotomy pain. 1b Anesth Analg 2000;91:44-50. 71 Capdevila X et al. Continuous peripheral nerve blocks in hospital wards after 2b orthopedic surgery: a multicenter prospective analysis of the quality of postoperative analgesia and complications in 1,416 patients. Anesthesiology 2005;103:1035-1045. 72 Neuburger M et al. Inflammation and infection complications of 2285 perineural 2b catheters: a prospective study. Acta Anaesthesiol Scand 2007;51:108-114. 73 Tran DQ and Finlayson RJ. Use of stellate ganglion block to salvage an ischemic 4 hand caused by the extravasation of vasopressors. Reg Anesth Pain Med 2005;30:405-408. 74 Bindra A et al. Stellate ganglion block for relieving vasospasms after coil 4 embolization of basilar tip aneurysms. J Neurosurg Anesthesiol 2011;23:379. 75 Jain V et al. Stellate ganglion block for treatment of cerebral vasospasm in patients 2b with aneurysmal subarachnoid hemorrhage - A preliminary study. J Anaesthesiol Clin Pharmacol 2011;27:516-521. 76 Patel RA et al. Left stellate ganglion blockade for the management of drug-resistant 4 electrical storm. Pain Med 2011;12:1196-1198. 77 Loyalka P et al. Left stellate ganglion block for continuous ventricular arrhythmias during percutaneous left ventricular assist device support. Tex Heart Inst J 2011;38:409-411. 1a = systematic review of randomized, controlled trials 1b = individual randomized, controlled trial 2a = systematic review of cohort studies 2b = individual cohort study (including low-quality RCT) 2c = outcomes research 4 3a = systematic review of case-control study 3b = individual case-control study 4 = case series, case report 5 = expert opinion R = review