Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2000
Randomized Controlled Trial Comparative Study Clinical TrialCombined lumbar and sacral plexus block compared with plain bupivacaine spinal anesthesia for hip fractures in the elderly.
This prospective randomized study was designed to determine the hemodynamic effects and quality of combined lumbar and sacral plexus block compared with plain bupivacaine spinal anesthesia in the elderly for repair of proximal femoral fractures. ⋯ Plain bupivacaine spinal anesthesia and combined lumbar/sacral plexus block provided adequate anesthesia for repair of hip fracture in the elderly. Hypotension was induced by both the combined peripheral nerve block and plain bupivacaine spinal anesthesia in aged patients; hypotension was found to be longer lasting after spinal anesthesia and of a larger magnitude in patients over 85 years of age.
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Reg Anesth Pain Med · Mar 2000
Comparative StudySpinal anesthesia for postpartum tubal ligation after pregnancy complicated by preeclampsia or gestational hypertension.
The American College of Obstetricians & Gynecologists has opposed postpartum tubal ligation (PPTL) in patients whose pregnancies have been complicated by a medical condition, including hypertension. A prospective study was conducted to assess the appropriateness of spinal anesthesia for PPTL in patients with hypertensive disorders of pregnancy. ⋯ PPTL during spinal anesthesia in patients whose pregnancies have been complicated by hypertension had results comparable with patients with uncomplicated pregnancies; however, further studies are needed to ascertain its safety.
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Reg Anesth Pain Med · Mar 2000
Case ReportsRepeated subarachnoid catheter displacement as a complication of spinal infusion using an internal infusion pump.
To present and analyze the case of a woman receiving chronic spinal opioid therapy using an implanted infusion pump who experienced repeated displacement of the subarachnoid catheter despite the use of standard techniques for anchoring the catheter. The solution devised to avoid the problem is described. ⋯ The application of fibrin glue (Tissucol; Immuno AG, Vienna, Austria) may be considered as an adjuvant for the fixation of subarachnoid catheters used for intraspinal infusions.