Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2001
Case ReportsClonidine in preterm-infant caudal anesthesia may be responsible for postoperative apnea.
Regional anesthesia without adjunctive general anesthesia or sedation has been recommended for preterm infants to decrease the risk of postoperative apnea. Single-dose caudal local anesthetic has a limited duration, which may be insufficient for long surgery. Addition of clonidine to local anesthetics has been shown to prolong the duration of surgical analgesia. However, respiratory depression related to clonidine may occur in adults. Respiratory depression has not been reported after caudal administration of clonidine in preterm infants. Here we report a case of early postoperative apnea in a waking preterm infant after caudal anesthesia performed with lidocaine, bupivacaine, and clonidine. ⋯ Our report suggests that clonidine may be responsible for postoperative apnea in a preterm neonate. Further studies are required to determine the useful safe dose of clonidine for single-injection caudal anesthesia in those infants.
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Reg Anesth Pain Med · Jan 2001
Randomized Controlled Trial Clinical TrialUltrasound imaging facilitates localization of the epidural space during combined spinal and epidural anesthesia.
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Reg Anesth Pain Med · Jan 2001
Case ReportsA case of reversible paraparesis following celiac plexus block.
Permanent and acute reversible paraplegia following celiac plexus block (CPB) have been reported. We report a case of prolonged reversible paraparesis after alcohol celiac plexus block. ⋯ Paraparesis following alcohol celiac plexus block may be reversible over an extended period of time.
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Reg Anesth Pain Med · Jan 2001
Clinical TrialCombined spinal and epidural anesthesia with low doses of intrathecal bupivacaine in women with severe preeclampsia: a preliminary report.
The purpose of our study was to evaluate the quality of anesthesia for cesarean delivery (CD), analgesia for labor (LA), hemodynamic changes, and neonatal effects of combined spinal and epidural anesthesia (CSE) with low intrathecal doses of bupivacaine and fentanyl in patients with severe preeclampsia. ⋯ The results indicate that CSE with low intrathecal doses of bupivacaine and epidural supplementation, when needed, produces adequate anesthesia for CD and analgesia for labor in patients with severe preeclampsia. The maximum decreases in MAP after CSE were modest and quite similar in the 2 groups.
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Reg Anesth Pain Med · Jan 2001
Acute cigarette smoking reduces vasodilative effect induced by sympathetic block in dogs.
The aim of this study is to clarify the influence of acute cigarette smoking on vasodilation induced by sympathetic block. ⋯ Sympathetic block induces a significant increase of peripheral blood flow, but smoking produces a significant decrease in the blood flow in the SGB-induced dilated vessels.