Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 1998
Randomized Controlled Trial Comparative Study Clinical TrialThe paravertebral nerve root block for inguinal herniorrhaphy--a comparison with the field block approach.
Our objective was to evaluate the efficacy of the paravertebral block for inguinal herniorrhaphy by comparison with the well-established field block. ⋯ The paravertebral nerve root block proved to be superior to the field block, to be devoid of side effects, and was acceptable to the patients.
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Reg Anesth Pain Med · Sep 1998
Intrathecal local anesthetic distribution with the new spinocath catheter.
Microcatheters have been linked in some cases to the development of cauda equina syndrome, which may be further traced to the maldistribution of the local anesthetic. A long injection time via the microcatheters contributes to the inadequate mixing. With the new Spinocath catheter, considerably shorter injection times can be achieved due to larger internal size. This study examined whether this leads to more homogeneous intrathecal distribution without causing greater trauma to the dura. ⋯ The new Spinocath catheter allows a better mixing of the local anesthetic with the cerebrospinal fluid. Because of significantly shortened injection times, hyperbaric solutions also show a more homogeneous distribution. Although the Spinocath catheter has a larger inner diameter than the other microcatheters, it appeared to cause less trauma to the dura.
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Reg Anesth Pain Med · Sep 1998
Case ReportsContinuous sciatic nerve infusion: expanded case report describing a new approach.
Severe pain following extensive reconstructive foot surgery is difficult to manage effectively. Sciatic nerve block provides excellent analgesia for a limited duration. I wanted to determine an approach to sciatic nerve block enabling an infusion of a local anesthetic for a prolonged period without loss of efficacy due to catheter displacement. ⋯ The described "in line" technique of continuous sciatic nerve infusion of a local anesthetic solution gives prolonged and effective analgesia following foot surgery.
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Reg Anesth Pain Med · Sep 1998
Randomized Controlled Trial Comparative Study Clinical TrialComparison of intravenous nalbuphine infusion versus naloxone in the prevention of epidural morphine-related side effects.
Epidural morphine is accepted as an efficient means of postoperative pain management. However, development of side effects such as nausea and vomiting and pruritus has been reported. This study compared the efficacy of intravenous infusions of nalbuphine or naloxone in the prevention of epidural morphine-related side effects. ⋯ We found that coadministration of either nalbuphine or naloxone with epidural morphine reduces the incidence of morphine-related side effects. However, unlike naloxone, nalbuphine did not attenuate the analgesic effect of epidural morphine.