Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2003
Case ReportsHypothermia and excessive sweating following intrathecal morphine in a parturient undergoing cesarean delivery.
Intrathecal morphine has been used for the relief of postoperative pain following cesarean delivery. We report a case of postoperative hypothermia down to 33.6 degrees C associated with excessive sweating in patient undergoing elective cesarean delivery under spinal bupivacaine anesthesia who received intrathecal morphine for postoperative pain management. ⋯ Intrathecal morphine may cause disruption of thermoregulation resulting in hypothermia associated with excessive sweating.
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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
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.
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Reg Anesth Pain Med · Mar 2003
Clinical TrialIntervertebral epidural anesthesia in 2,050 infants and children using the drip and tube method.
Pediatric epidural anesthesia has increased in popularity in the last 2 decades, but its success rate and the frequency of complications has not been fully elucidated. We therefore reviewed our experience with 2,050 cases of epidural anesthesia in infants and children. ⋯ Intervertebral epidural anesthesia using the "drip and tube" method is safe and practical in infants and children.