Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2008
Randomized Controlled Trial Comparative StudyThe effects of an epidural infusion of ropivacaine versus saline on sensory block after spinal anesthesia.
Several investigators have described the effect of bolus injections on sensory block during combined spinal epidural anesthesia. This study investigates the effects of the immediate epidural infusion of 0.2% ropivacaine versus 0.9% saline on spinal anesthesia. ⋯ Epidural infusion of ropivacaine 0.2% initiated immediately after spinal anesthesia prolonged the regression of motor block but not the regression of sensory block when compared with saline infusion.
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Reg Anesth Pain Med · May 2008
Comparative StudySonoanatomy of the lumbar spine in patients with previous unintentional dural punctures during labor epidurals.
Preprocedural lumbar ultrasound is a valuable tool to assess anatomical landmarks and predict the depth of the epidural space. Variations of the ligamentum flavum sonoanatomy are occasionally observed; however, no literature is available as to their incidence or clinical significance. We hypothesize that abnormal sonoanatomy of the lumbar spine detected by ultrasound can be associated with an increase in unintentional dural punctures. This study was undertaken to determine if the sonoanatomy of the lumbar spine of patients who had documented unintentional dural punctures differs from that of patients with a history of uneventful epidural placement for labor analgesia. ⋯ Abnormal sonoanatomy of the ligamentum flavum may represent anatomical variations of this structure, which may be related to an increased incidence of unintentional dural punctures during epidural placements.