Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2016
Case ReportsIn-Plane Ultrasound-Guided Lumbar Plexus Block Using Catheter-Over-Needle Technique in a 14-Month-Old Baby.
This case report details the feasibility of a continuous lumbar plexus block obtained with a paramedian transverse scan of the lumbar paravertebral region, using a catheter-over-needle system, as a main postoperative orthopedic analgesia, in a 14-month-old patient undergoing surgical treatment of a localized Ewing family tumor of the right proximal femur. After surgery, the patient remained in the intensive care unit for 3 days; pain was assessed regularly using the Children's and Infants' Postoperative Pain Scale, and comfort was monitored. Analgesia was provided with continuous levobupivacaine 0.2% infusion 0.2 mL kg h, rectal paracetamol 15 mg kg, and oral ibuprofen 60 mg twice per day, with a dose of morphine 0.05 mg kg intravenously as rescue. ⋯ Nausea, vomiting, and disturbed sleep were not reported. Oral diet was resumed on the first postoperative day. In conclusion, this case represents successful postoperative management of orthopedic pain in a child using continuous posterior lumbar plexus infusion.
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Reg Anesth Pain Med · Jul 2016
Comparative StudyGiving Priority to Lipid Administration Can Reduce Lung Injury Caused by Epinephrine in Bupivacaine-Induced Cardiac Depression.
Epinephrine is usually administered in concert with a lipid emulsion during local anesthetic toxicity. However, the timing and role of epinephrine administration in combination with a lipid emulsion remain unclear. Specifically, the temporal association of epinephrine and lipid emulsion administration with related changes in pulmonary vascular pressures that may lead to pulmonary edema and hemorrhage needs to be determined. ⋯ Giving priority to the administration of a lipid emulsion before the administration of epinephrine can reduce lung injury in bupivacaine-induced cardiac depression in rats.