Anaesthesia
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Case Reports
Transient radicular irritation after single subarachnoid injection of isobaric 2% lignocaine for spinal anaesthesia.
Several cases have been reported recently in which symptoms suggestive of transient radicular irritation occurred following the use of hyperbaric 5% lignocaine for spinal anaesthesia. We report on three patients in whom we observed similar symptoms attributable to this kind of radicular irritation following uneventful spinal anaesthesia using isobaric 2% lignocaine. All three patients underwent minor gynaecological procedures and developed burning pains in the buttocks within 24 h of surgery. The long-term outcome was not clear for all the patients, but in at least one the pain disappeared.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effect of tunnelling on epidural catheter migration.
A prospective, randomised study of 82 patients having postoperative epidural analgesia was performed to determine whether the tunnelling of an epidural catheter influences its migration. Tunnelling of the catheter subcutaneously for a distance of 5 cm reduced the incidence of inward migration of 1 cm or more (p < 0.01) compared to a standard method of fixation with a transparent adhesive dressing. ⋯ Sixty two percent (n = 26) of tunnelled catheters remained within 0.5 cm of their original position compared to 38% (n = 16) of non-tunnelled catheters, although this difference was not statistically significant. Outward catheter migration was not reduced by subcutaneous tunnelling.
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Randomized Controlled Trial Clinical Trial
The effect of alkalinisation of lignocaine on axillary brachial plexus anaesthesia.
Alkalinisation of local anaesthetic drugs is a controversial technique for improving regional blockade. Forty-two patients scheduled for upper limb surgery received axillary brachial plexus anaesthesia using a cannula technique. Patients were randomly allocated to receive either lignocaine 1.5% with 1 in 200,000 adrenaline (pH = 4.2) or lignocaine 1.5% with 1 in 200,000 adrenaline (pH = 7.2). ⋯ The percentage of patients with complete anaesthesia at 10, 20 and 30 min following injection was significantly increased in the alkalinized group with regard to the ulnar and median nerves, and the median cutaneous nerve of the arm (p < 0.05). In the alkalinized group, there was a significant reduction in the time to useful anaesthesia and a reduced requirement for adjuvants (p < 0.05). There was no effect on the duration of anaesthesia.