Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study Clinical Trial
Ropivacaine plasma concentrations are similar during continuous lumbar plexus blockade using the anterior three-in-one and the posterior psoas compartment techniques.
To compare ropivacaine blood concentrations obtained after a continuous lumbar plexus block performed either by the anterior three-in-one femoral (FEM) technique or the posterior (psoas compartment; PSOAS) technique. ⋯ Although the posterior PSOAS block results in higher early plasma concentrations of local anesthetic than the anterior three-in-one FEM block, both techniques are equivalent with regards to their potential toxicity when a continuous infusion is administered. Local anesthetic accumulation occurs with an infusion of ropivacaine 0.2% at 12 mL.hr(-1) and can lead to potentially dangerous concentrations at 48 hr.
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Randomized Controlled Trial Comparative Study Clinical Trial
The posterior lumbar plexus (psoas compartment) block and the three-in-one femoral nerve block provide similar postoperative analgesia after total knee replacement.
To compare the efficacy of a continuous posterior lumbar plexus (PSOAS) block to a continuous three-in-one femoral nerve (FEM) block in patients undergoing primary total knee replacement (TKR). ⋯ Both continuous PSOAS block and continuous three-in-one FEM block provided better analgesia than PCA but no differences were seen between the two regional techniques.
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Case Reports
Massive hemorrhage in a previously undiagnosed abdominal pregnancy presenting for elective Cesarean delivery.
To report a case of previously undiagnosed abdominal pregnancy diagnosed at the time of Cesarean section for persistent oblique lie. Delivery of the fetus was followed by near catastrophic hemorrhage. The management of massive hemorrhage in the context of the obstetric patient is discussed. ⋯ Massive hemorrhage in obstetric patients is a major test for the anesthetic and obstetric teams. As our experience shows, a multidisciplinary team based approach helped manage this crisis. Obstetric patients are often young and have great physiological reserve. In this case we feel that the MAST suit significantly contributed to the positive outcome.