Journal of clinical anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative analgesia and intraoperative inhalational anesthetic requirements during umbilical herniorrhaphy in children: postincisional local infiltration versus preincisional caudal epidural block.
To determine the postoperative analgesic efficacy of, and the effects on, intraoperative inhalational anesthetic requirements of preincisional caudal epidural block versus postincisional infiltration of local anesthetic following umbilical herniorrhaphy in children. ⋯ Preincisional caudal epidural block is more effective in controlling pain following umbilical herniorrhaphy than is postincisional local infiltration.
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Multiple reports of cauda equina syndrome and transient radicular nerve root irritation have suggested that lidocaine spinal anesthesia may be responsible. In this case report, a patient with a preexisting diabetic neuropathy received a partial block following a tetracaine spinal, which was followed by a lidocaine spinal. ⋯ The preexisting diabetic neuropathy may have predisposed this patient to neurologic injury. The choice of a different local anesthetic drug with less neurotoxic potential such as bupivacaine may have prevented this injury.
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An abrupt decrease in end-tidal carbon dioxide (CO2) occurred in an anesthetized male who was placed in the head down position during radical perineal prostatectomy. The end-tidal CO2 was restored after insertion of a wet pack into the operative site, which strongly indicated venous air embolism as the cause. Predisposing factors, detection, and treatment of venous air embolism in this setting are discussed.