Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2003
Randomized Controlled Trial Comparative Study Clinical TrialEfficacy of 1% ropivacaine at sacral segments in lumbar epidural anesthesia.
It is suggested that the potency of 1% ropivacaine is comparable to that of 0.75% bupivacaine and higher than that of 2% lidocaine. Alkalinized lidocaine reportedly enhances the block of sacral segments during lumbar epidural anesthesia. We hypothesized that 1% ropivacaine might also block at the lumbosacral segments adequately during lumbar epidural anesthesia. ⋯ We conclude that 1% ropivacaine does not improve block of sacral segments within 20 minutes following epidural ropivacaine administration.
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Reg Anesth Pain Med · May 2003
Randomized Controlled Trial Clinical TrialPosterior perineal block with ropivacaine 0.75% for pain control during and after hemorrhoidectomy.
As perioperative pain management is a difficult challenge during hemorrhoidectomy, we tested the hypothesis that posterior perineal block (PPB) with local anesthetics alone is able to provide adequate pain control during and after surgery. ⋯ The present study shows that PPB with 40 mL 0.75% ropivacaine (300 mg) was a simple, effective, and safe method to provide better postoperative analgesia than PCA alone following surgical hemorrhoidectomy. In addition, PPB was shown to significantly reduce opioid consumption intraoperatively and during the first postoperative day.
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Reg Anesth Pain Med · May 2003
Comparative StudyLipid emulsion infusion rescues dogs from bupivacaine-induced cardiac toxicity.
We previously demonstrated in rats that intravenous infusion of a lipid emulsion increases survival in resuscitation from severe bupivacaine cardiac toxicity. The present studies were undertaken to determine if this method is similarly effective in a non-rodent model using a larger animal. ⋯ We found that infusing a lipid emulsion during resuscitation from bupivacaine-induced cardiac toxicity substantially improved hemodynamics, pmO2, and pHm and increased survival in dogs.
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Reg Anesth Pain Med · May 2003
Case ReportsComplex regional pain syndrome type I after myocardial infarction treated with spinal cord stimulation.
A rare case of Complex Regional Pain Syndrome (CRPS) type I after myocardial infarction (MI) and significant comorbid illness with few treatment options for pain control was successfully managed with the placement of a spinal cord stimulator (SCS). ⋯ CRPS type I after MI can be difficult to treat because of other comorbid illnesses. SCS can be a safe and effective mode of therapy for patients facing limited treatment options.