Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2001
Randomized Controlled Trial Comparative Study Clinical TrialRegional block and mexiletine: the effect on pain after cancer breast surgery.
Breast surgery for cancer is associated with chronic pain and sensory abnormalities. The present study investigates the effect of regional block, oral mexiletine, and the combination of both, on acute and chronic pain associated with cancer breast surgery. ⋯ Regional block reduced the analgesic requirements in the early postoperative period, while mexiletine combined with regional block reduced the total analgesic requirements during the next 5 postoperative days. Although chronic pain was not affected by these treatments late-abnormal sensation may be diminished by combination of these treatments. Reg Anesth Pain Med 2001;26:223-228.
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Reg Anesth Pain Med · May 2001
Randomized Controlled Trial Clinical TrialReversal of lidocaine with epinephrine epidural anesthesia using epidural saline washout.
Prolonged motor and sensory block following epidural anesthesia can be associated with extended postoperative care unit stays and patient dissatisfaction. Previous studies have demonstrated a more rapid motor recovery following the administration of epidural crystalloids in patients who had received plain bupivacaine and lidocaine epidural anesthesia. However, epinephrine is commonly added to local anesthetics to improve the quality and prolong the duration of the epidural block. The objective of this study was to determine the relationship of 0.9% NaCl epidural catheter flush volume (i.e., washout) to the recovery of motor and sensory block in patients undergoing 2% lidocaine with epinephrine epidural anesthesia. ⋯ A more rapid recovery of motor and sensory block in patients undergoing 2% lidocaine with epinephrine epidural anesthesia can be achieved with the use of 30 mL NS epidural washout. Reg Anesth Pain Med 2001;26:246-251.
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Continuous peripheral nerve block (CPNB) can provide surgical anesthesia, prolonged postoperative analgesia, and acceptable side effects. Despite these advantages, CPNB is not in widespread use. Recently a new CPNB catheter system (Contiplex, B. Braun, Bethlehem, PA) was developed based on an insulated Tuohy needle, which allows for injection of local anesthetic and catheter insertion without disconnection or needle movement. At present, no clinical studies exist describing this system. ⋯ CPNB using the insulated Tuohy catheter system offered acceptable anesthesia and prolonged pain relief postsurgery. There were few side effects. Reg Anesth Pain Med 2001;26:209-214.
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Reg Anesth Pain Med · May 2001
Randomized Controlled Trial Clinical TrialTopical delivery of lidocaine in healthy volunteers by electroporation, electroincorporation, or iontophoresis: an evaluation of skin anesthesia.
This study was designed to compare the onset, duration, and depth of local anesthesia after the topical delivery of lidocaine using electroporation (EP), electroincorporation (EI), and iontophoresis (IP) in healthy volunteers. EP and EI were performed with prototype devices and IP with a commercial drug/device product. ⋯ The transdermal delivery of lidocaine by IP, EP, and EI results in similar surface skin anesthesia; however, IP results in a greater depth of anesthesia. Reg Anesth Pain Med 2001;26:229-238.