Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 1998
Randomized Controlled Trial Comparative Study Clinical TrialUltrasonographic guidance reduces the amount of local anesthetic for 3-in-1 blocks.
Recently it has been demonstrated that the use of ultrasound (US) improves the onset time and the quality of sensory block for 3-in-1 blocks compared with conventional nerve stimulator (NS) techniques. The present study was designed to evaluate if US guidance for 3-in-1 blocks reduces the amount of local anesthetic compared to NS guidance. ⋯ The amount of local anesthetic for 3-in-1 blocks can be reduced by using US guidance compared with the conventional NS-guided technique.
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Reg Anesth Pain Med · Nov 1998
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative analgesia in children using preemptive retrobulbar block and local anesthetic infiltration in strabismus surgery.
Postoperative pain management in pediatric strabismus patients is infrequently studied. Pediatric patients can be mobilized earlier if postoperative pain is minimized. In this study, two different regional anesthetic techniques, retrobulbar block and local infiltration, were compared with a "no block" control group for the postoperative management of pain in pediatric patients undergoing elective strabismus surgery. ⋯ Because there was no significant difference in terms of postoperative analgesia in the retrobulbar block or subconjunctival local anesthetic infiltration groups compared with the control group, we suggest that conventional methods of pain treatment are adequate for postoperative analgesia in strabismus surgery.
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Reg Anesth Pain Med · Nov 1998
ReviewCommentary: neurotoxicity of local anesthetics--an issue or a scapegoat?
To evaluate the etiologies of cauda equina syndrome (CES) and transient radicular irritation (TRI) or transient neurologic symptoms (TNSs) following hyperbaric spinal anesthesia. ⋯ Cauda equina syndrome is, in all probability, explainable. Further investigation to pinpoint the etiology of TRI (TNSs) is needed.
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Epidural catheters are seldom difficult to remove from patients. In fact, a review of the literature demonstrates only a few cases pertaining to epidurals and the unusual complication of catheter entrapment. ⋯ This case report involves an uncomplicated obstetric patient who had an epidural placed for labor and in whom multiple attempts were needed to remove the catheter.
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Reg Anesth Pain Med · Nov 1998
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialComparative evaluation of four different infusion rates of ropivacaine (2 mg/mL) for epidural labor analgesia.
Previous studies have reported comparable efficacy for ropivacaine and bupivacaine when used for labor analgesia at concentrations of 2.5 mg/mL. In this multicenter study, we assessed ropivacaine at the commercially available concentration of 2 mg/mL (0.2%) for labor pain management. ⋯ The 2 mg/mL of ropivacaine produces satisfactory labor analgesia at epidural infusion rates of 4, 6, 8, and 10 mL/hour, provided supplemental bolus dosages are available. Clinically, a rate of 6 mL/hour may be the lowest effective rate that provides the best combination of pain relief, motor block, and rebolusing, although rates of 8 and 10 mL/hour produced similar results.