Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2002
Case ReportsVertebral osteomyelitis and psoas abscess occurring after obstetric epidural anesthesia.
Back pain and infectious complications occasionally occur after epidural anesthesia in obstetrics, and accurate diagnosis can be difficult. We report a patient who developed low back pain soon after obstetric epidural anesthesia and was diagnosed 6 months later with lumbar vertebral osteomyelitis, discitis, and a psoas abscess. ⋯ Investigation of severe back pain after epidural anesthesia should include consideration of infectious causes, such as vertebral osteomyelitis and discitis, which may not be causally related to the epidural catheterization itself.
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Reg Anesth Pain Med · Mar 2002
Use of a charged lidocaine derivative, tonicaine, for prolonged infiltration anesthesia.
We tested the hypothesis that the duration of cutaneous anesthesia elicited by the permanently charged compound N-phenylethyl lidocaine (tonicaine) would be longer than that elicited by its parent structure, lidocaine, and that it would be less affected by epinephrine (epi), after subcutaneous injection in rats, as a model for infiltration anesthesia. ⋯ Tonicaine is a substantially longer lasting local anesthetic with a delayed onset of action compared with lidocaine and may be useful in situations where long duration of infiltration block is desirable.
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Reg Anesth Pain Med · Mar 2002
Distribution of solution in the epidural space: examination by cryomicrotome section.
The routes of distribution and barriers to flow of solutions in the epidural space are incompletely determined. This study examined macroscopic details of epidural injectate spread in postmortem humans by cryomicrotome imaging. ⋯ Distribution of solution in the epidural space is nonuniform. Rather than a uniform advancing front, spread is directed among paths between structures according to pressures by which they are compressed. No structural barriers block flow through the intervertebral foramina or spinal canal other than the fascia of the posterior longitudinal ligament.
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Personal digital assistants (PDAs) are being used more frequently by anesthesiologists. PDAs are pocket-sized electronic devices that, at their most basic level, store information. ⋯ More advanced features are increasingly common and blur the distinction between PDAs and personal computers (PCs). This article reviews the main options for PDAs, purchasing tips, and software applications, especially as they apply to anesthesiologists.