Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialSpinal 2-chloroprocaine: minimum effective dose.
Recent studies using preservative-free 2-chloroprocaine (2-CP) for spinal anesthesia have shown it to be a reliable short-acting agent in the 30-mg to 60-mg range. Investigations of doses below this range have not been performed. ⋯ Spinal 2-CP 40 mg and 60 mg provide rapid and reliable sensory and motor block. Although the 20-mg and 30-mg doses can produce sensory anesthesia adequate for brief surgical procedures, less motor block and some sacral sparing should be anticipated. Because the 10-mg dose produces only brief and inconsistent sensory anesthesia, it can be considered a no-effect dose.
-
Reg Anesth Pain Med · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialAnesthetic techniques and postoperative emesis in pediatric strabismus surgery.
Postoperative emesis after pediatric strabismus surgery continues to be a problem, despite the use of antiemetics. The purpose of this study was to identify an anesthetic technique associated with the lowest incidence of vomiting after pediatric strabismus surgery. ⋯ Among the three techniques, peribulbar block with propofol-based anesthesia is the technique with the lowest incidence of postoperative emesis. Fentanyl-propofol is an equally acceptable alternative; however, meperidine-propofol is associated with a high incidence of postoperative emesis.
-
Reg Anesth Pain Med · Jan 2005
Case ReportsTwo cases of a wrong-site peripheral nerve block and a process to prevent this complication.
The purpose of this study was to develop a system to prevent laterality errors while performing peripheral nerve blockade. ⋯ The anesthesiologist plays an important role in preventing wrong-site peripheral nerve blockade and surgery. The protocol developed for "Pre-Anesthetic Site Verification" as a supplement to our preoperative site verification policy is invaluable in preventing wrong-site anesthesia and surgery.
-
Reg Anesth Pain Med · Jan 2005
Case ReportsUnintentional neuromuscular blocking agent injection during an axillary brachial plexus nerve block.
We describe the consequences of an unintentional injection of atracurium instead of ropivacaine during an axillary brachial plexus nerve block. ⋯ Unintentional injection of atracurium mixed with ropivacaine during axillary brachial plexus block leads to complete body paralysis that requires general anesthesia and mechanical ventilation. Recovery was complete without any neurological sequela. An analysis of the chain of events that led to the error suggests some recommendations to improve our daily practice.