Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2009
Ultrasound-guided supraclavicular block: outcome of 510 consecutive cases.
Supraclavicular brachial plexus block provides consistently effective anesthesia to the upper extremity. However, traditional nerve localization techniques may be associated with a high risk of pneumothorax. In the present study, we report block success and clinical outcome data from 510 consecutive patients who received an ultrasound-guided supraclavicular block for upper extremity surgery. ⋯ Ultrasound-guided supraclavicular block is associated with a high rate of successful surgical anesthesia and a low rate of complications and thus may be a safe alternative for both inpatients and outpatients. Severe underlying respiratory disease and coagulopathy should remain a contraindication for this brachial plexus approach.
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Reg Anesth Pain Med · Mar 2009
Hydrodynamics of the spinal epidural space in pigs: effects of death and exsanguinations.
We have investigated how the vascular components of the spine determine the resistance and capacitance of the spinal epidural space and determined the magnitude of the longitudinal pressure gradient in the space during fluid infusion. ⋯ There is a small longitudinal pressure gradient within the epidural space during fluid infusion. Hence, the major source of resistance occurs where fluid leaves the epidural space. Death reduced resistance, perhaps by depressurizing spinal arteries in the intervertebral foramina, but did not affect capacitance. Blood in epidural veins is a major determinant of late epidural capacitance.