Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 1998
Clinical TrialHigh-dose ropivacaine wound infiltration for pain relief after inguinal hernia repair: a clinical and pharmacokinetic evaluation.
Early data on ropivacaine, a recently introduced local anesthetic, indicate a longer duration of skin analgesia than with bupivacaine, along with lower toxicity. The objective of this study was to evaluate ropivacaine 7.5 mg/mL for wound infiltration pain relief after hernia surgery, in higher doses than used before, in an open, nonrandomized design. ⋯ Infiltration of ropivacaine 7.5 mg/mL during hernia surgery can be employed safely in doses of 300 mg and 375 mg to control pain after hernia surgery. The lower dose is recommended, since the higher one did not give any clinically relevant advantages.
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Reg Anesth Pain Med · Mar 1998
Does spinal anesthesia affect cerebral oxygenation during transurethral prostatectomy?
Transurethral resection of the prostate (TURP) is associated with the unique complication of transurethral resection of prostate syndrome (TURS), which is attributed to the absorption of irrigating fluid. This study was initiated to investigate the effects of spinal anesthesia and TURP on cerebral oxygen balance. ⋯ The neurologic symptoms in patients undergoing TURP during spinal anesthesia might not only be caused by absorption of irrigating fluid but also by impairment of cerebral oxygenation.
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Reg Anesth Pain Med · Mar 1998
Randomized Controlled Trial Clinical TrialThe recovery profile of hyperbaric spinal anesthesia with lidocaine, tetracaine, and bupivacaine.
Surgical procedures previously considered too lengthy for the ambulatory surgery setting are now being performed during spinal anesthesia. The complete recovery profile of tetracaine and bupivacaine are now of interest but are not available in the literature. This study was conducted to compare times to ambulation, voiding, and complete block resolution, as well as the incidence of back and radicular pain, after spinal anesthesia with lidocaine, bupivacaine, and tetracaine. ⋯ Among individual subjects, lidocaine exhibited the shortest recovery profile. However, the recovery profiles of the three anesthetics were very variable between subjects. Time to meeting discharge criteria after bupivacaine or tetracaine was faster in a few subjects than that after lidocaine in other subjects. For ambulatory anesthesia, times to two- and four-segment regression do not accurately predict time to readiness for discharge after spinal anesthesia.
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Reg Anesth Pain Med · Mar 1998
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative analgesia following total knee arthroplasty: a study comparing spinal anesthesia and combined sciatic femoral 3-in-1 block.
The quality of analgesia and subsequent morphine requirements following spinal anesthetic block (SAB) or combined sciatic and femoral (3-in-1) block (SFB) for total knee arthroplasty were compared. ⋯ In comparison with SAB, SFB resulted in superior analgesia and reduced morphine consumption for the first 24 hours following total knee arthroplasty.
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Reg Anesth Pain Med · Mar 1998
Case ReportsPerisciatic injection of steroid for the treatment of sciatica due to piriformis syndrome.
Piriformis syndrome causing sciatica is sometimes refractory to conventional treatments including physical therapy, piriformis injections, and even caudal epidural steroid injections. Surgical release of the piriformis muscle has been described for difficult cases of piriformis syndrome, but is occasionally accompanied by morbidity. Another approach to treating piriformis syndrome is presented. ⋯ Patients with piriformis syndrome who were refractory to conventional treatments but responded to perisciatic injections of steroid are presented.