Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2006
Randomized Controlled TrialPostoperative analgesia and recovery course after major colorectal surgery in elderly patients: a randomized comparison between intrathecal morphine and intravenous PCA morphine.
Intrathecal morphine is a widely used method for postoperative pain relief after major abdominal surgery. The aim of this randomized, double-blinded study was to compare intrathecal morphine and intravenous PCA morphine for postoperative analgesia and recovery course after major colorectal surgery in elderly patients. ⋯ Intrathecal morphine, as compared with intravenous PCA morphine alone, improves immediate postoperative pain and reduces parenteral morphine consumption but does not improve postoperative recovery in elderly patients after major colorectal surgery.
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Reg Anesth Pain Med · Nov 2006
Randomized Controlled TrialEffects of intrathecal midazolam on postoperative analgesia when added to a bupivacaine-clonidine mixture.
Previous clinical and experimental studies have shown that a midazolam-clonidine mixture has a synergistic antinociceptive effect. This study evaluated the postoperative analgesic effect of adding midazolam to an intrathecal bupivacaine-clonidine mixture. ⋯ Addition of midazolam to an intrathecal B-C mixture does not potentiate postoperative analgesia but prolongs the motor blockade.
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Reg Anesth Pain Med · Nov 2006
Randomized Controlled TrialA comparison of injection at the ulnar and the radial nerve in axillary block using triple stimulation.
A triple-stimulation technique for axillary block consists of the localization and injection of 2 nerves, median and musculocutaneous, which lie superior to the axillary artery, and of 1 nerve, the radial, which lies inferior. However, in some patients, the ulnar nerve is located first during the search for the radial nerve. The aim of this study was to verify if an ulnar motor response could be considered a satisfactory endpoint as a radial motor response. ⋯ Local anesthetic injection at the ulnar nerve significantly reduces the efficacy and prolongs the onset time of the radial-nerve block when triple-stimulation axillary block is performed.
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Reg Anesth Pain Med · Nov 2006
Detection of epithelial cell transfer in spinal areas by light microscopy and determining any tissue coring via cell culture during combined spinal-epidural interventions.
Epithelial tissue coring by spinal needles during subarachnoid injections may cause intraspinal epidermal tumors. Previous studies have investigated tissue transfer with different needle types during subarachnoid or epidural injection. This study deals with the transfer of epithelial tissue during combined spinal-epidural (CSE) anesthesia. ⋯ We could not reproduce the cells or cell debris obtained during the CSE interventions in vivo, which can be explained by a possible structural deformation of cells or the inadequacy of the amount of cells that were transferred.