Anesthesia and analgesia
-
Anesthesia and analgesia · Dec 2006
Randomized Controlled Trial Comparative StudyThe posterior approach to the sciatic nerve in the popliteal fossa: a comparison of single- versus double-injection technique.
We compared single-injection and double-injection of the sciatic nerve with nerve stimulation in the posterior popliteal approach using mepivacaine 1% in a prospective, randomized and single-blind study to evaluate effectiveness, delay of onset, and complications in patients undergoing foot and ankle surgery. In the single-injection group (Group S, n = 30), 25 mL of mepivacaine 1% was administered after eliciting foot inversion or plantar flexion. In the double-injection group (Group D, n = 30), 12.5 mL of the solution was injected after eversion or dorsiflexion and 12.5 mL after plantar flexion of the foot. ⋯ Complete analgesia of the deep peroneal nerve was achieved in 80% and 97% in Group S and D, respectively; P < 0.05. There were more paresthesias during block procedure in Group D (17% vs 40%) (P < 0.05). We conclude that double-nerve stimulation of the sciatic nerve gives similar complete onset times and overall success rate to single-nerve stimulation and more paresthesias during block performance.
-
Anesthesia and analgesia · Dec 2006
Randomized Controlled Trial Comparative StudyCombined spinal epidural does not cause a higher sensory block than single shot spinal technique for cesarean delivery in laboring women.
The combined spinal epidural (CSE) technique has been shown to result in a higher sensory block than an equivalent single shot spinal (SSS) in women undergoing elective cesarean delivery. We tested whether this is true also in laboring women who may have variable epidural pressures. ⋯ As compared with previous reports in nonlaboring parturients, the block characteristics of CSE in our study were indistinguishable from those of SSS in laboring parturients for cesarean delivery.
-
Anesthesia and analgesia · Dec 2006
The impact of service-specific staffing, case scheduling, turnovers, and first-case starts on anesthesia group and operating room productivity: a tutorial using data from an Australian hospital.
In this tutorial, we consider the impact of operating room (OR) management on anesthesia group and OR labor productivity and costs. Most of the tutorial focuses on the steps required for each facility to refine its OR allocations using its own data collected during patient care. ⋯ Reducing surgical and/or turnover times and delays in first-case-of-the-day starts generally provides small reductions in OR labor costs. Results vary widely because they are highly sensitive both to the OR allocations (i.e., staffing) and to the appropriateness of those OR allocations.