Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2001
Randomized Controlled Trial Comparative Study Clinical TrialRandomized prospective study comparing preoperative epidural and intraoperative perineural analgesia for the prevention of postoperative stump and phantom limb pain following major amputation.
Acute stump pain and phantom limb pain after amputation is a significant problem among amputees with a reported incidence of phantom limb pain in the first year following amputation as high as 70%. Epidural analgesia before limb amputation is commonly used to reduce postamputation acute stump pain in the immediate postoperative period and phantom pain in the first year. We investigated whether immediate postamputation stump pain and phantom pain in the first year is reduced by preoperative epidural block with bupivacaine and diamorphine compared with intraoperative placement of a perineural catheter infusing bupivacaine. ⋯ Using our regimen, perioperative epidural block started 24 hours before the amputation is not superior to infusion of local anaesthetic via a perineural catheter in preventing phantom pain, but gives better relief of stump pain in the immediate postoperative period.
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Reg Anesth Pain Med · Jul 2001
Clinical usefulness, safety, and plasma concentration of ropivacaine 0.5% for inguinal hernia repair in regional anesthesia.
The aim of this study was to evaluate the pharmacokinetics, feasibility, and clinical effects of ropivacaine in regional anesthesia (ilioinguinal-iliohypogastric blocks [IIB], genitofemoral block plus local infiltration) for inguinal hernia repair. ⋯ A ropivacaine dose of 60 to 70 mL of 0.5% appears adequate for regional anesthesia for inguinal hernia repair regarding conditions for surgery, safety, ambulation, and postoperative pain relief.
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Reg Anesth Pain Med · Jul 2001
Randomized Controlled Trial Clinical TrialEffects of gabapentin in acute inflammatory pain in humans.
The aim of the study was to examine the analgesic effects of the anticonvulsant, gabapentin, in a validated model of acute inflammatory pain. ⋯ The study indicates that gabapentin has no analgesic effect in normal skin, but may reduce primary mechanical allodynia in acute inflammation following a thermal injury. These observations suggest a clinical potential of gabapentin in the treatment of postoperative pain.
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Reg Anesth Pain Med · Jul 2001
Case ReportsRepeated psoas compartment blocks for the management of long-standing hip pain.
The psoas compartment block is used to produce analgesia of the lumbar plexus mainly for hip and knee surgery. It has also been used for the management of a long-standing pain due to hip joint degeneration. ⋯ We successfully performed repeated psoas compartment blocks with a local anesthetic and subsequently with added opioids, which produced substantial pain relief, especially after the addition of opioids.