Anaesthesia
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One hundred and fifty women in labour provided with extradural analgesia were monitored and an incidence of Horner's syndrome of 1.33% was noted. Fifty women undergoing Caesarean section under extradural analgesia were also monitored and an incidence of Horner's syndrome of 4% was noted. From the results we found it impossible to predict which patients would develop a Horner's syndrome.
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Twelve patients have undergone unilateral coeliac plexus block using needle localisation by computed tomography and the technique is described. Computed tomography has the advantage that the needle route to the coeliac axis can be accurately planned, avoiding damage to other organs. In this study nine out of twelve patients had significant pain relief. Most success was achieved in patients with carcinoma of the pancreas.
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Case Reports
Restricted spread of analgesia following epidural blood patch. Case report with a review of possible complications.
A complete restriction of upward spread of local analgesic solution in the epidural space is reported in a patient who three years earlier had received an epidural blood patch for post-spinal headache. Organisation of the blood clot with fibrous tethering of the dura to the wall of the spinal canal is suggested as the most likely cause of this apparent obstruction to spread. Other potential complications of epidural blood patch are presented. It is concluded from the literature on the subject that there is a need for a multi-centre analysis of the factors which might influence the incidence of inadvertent dural tap with an epidural needle.