Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2003
Randomized Controlled Trial Clinical TrialForearm rescue cuff improves tourniquet tolerance during intravenous regional anesthesia.
Tourniquet pain during intravenous regional anesthesia (IVRA) of the upper limb is common and can limit tourniquet inflation time. We hypothesize that a forearm rescue cuff is better tolerated than the traditional rescue cuff of a double-cuff tourniquet. ⋯ A forearm rescue cuff is better tolerated than an arm cuff double tourniquet during IVRA, allowing for longer tourniquet times. It is also associated with lower pain scores and shorter duration of local anesthetic side effects.
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Reg Anesth Pain Med · Mar 2003
Randomized Controlled Trial Clinical TrialThe effect of intrathecal epinephrine on epidural infused analgesics during labor.
In order to prolong labor analgesia, one may add intrathecal epinephrine to the combination of bupivacaine and fentanyl. In this study, we tested the hypothesis that the addition of intrathecal epinephrine would lessen the requirement for a rescue dose of epidural analgesia during labor. ⋯ The addition of epinephrine to intrathecal bupivacaine-fentanyl lessened the requirement for additional epidural analgesia without increasing hypotension, nausea, or pruritus. However, the incidence of motor block may be increased without labor prolongation.
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Reg Anesth Pain Med · Mar 2003
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of a single-stimulation lateral infraclavicular plexus block with a triple-stimulation axillary block.
A single-stimulation infraclavicular brachial plexus block (ICB) is safe and easy to perform, although underused. This technique was compared with a triple-stimulation axillary block (AxB). ⋯ A single shot ICB is equally effective as a triple-nerve stimulation AxB.
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Reg Anesth Pain Med · Mar 2003
Case Reports Clinical TrialContinuous lumbar plexus block: Use of radiography to determine catheter tip location.
The purpose of this article is to document where a lumbar plexus catheter introduced by the posterior approach will track and to evaluate the benefit of using systematic radiographic verification of catheter placement. ⋯ Epidural spread of local anesthetic during lumbar plexus block should be expected to be relatively common. It can be easily identified clinically with fractionated doses of local anesthetic. The catheter tip was identified in the epidural space by radiographic verification in only 1.8% of cases. This expensive procedure is therefore unnecessary except when an unusual location is suspected, but not necessary to confirm a catheter assumed to be correctly positioned.