Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2009
Case ReportsNeuraxial anesthesia and intraoperative bilevel positive airway pressure in a patient with severe chronic obstructive pulmonary disease and obstructive sleep apnea undergoing elective sigmoid resection.
This case report describes the anesthetic management of a patient with severe chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) who underwent elective sigmoid resection under combined spinal-epidural anesthesia and bilevel positive airway pressure (BiPAP). ⋯ Combined spinal-epidural anesthesia was successfully used in a patient with COPD and OSA undergoing sigmoid resection. Perioperative administration of BiPAP, excellent pain control by continuous epidural infusion of local anesthetic, and the avoidance of endotracheal intubation may have contributed to this patient's uncomplicated postoperative course.
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Reg Anesth Pain Med · Jan 2009
Ultrasound-guided posterior approach for the placement of a continuous interscalene catheter.
The posterior approach to performing a continuous brachial plexus block at the level of the nerve roots has been described using traditional superficial landmarks. We describe an ultrasound-guided approach for the placement of a continuous interscalene brachial plexus catheter at the level of the nerve roots using a posterior approach. In addition, we provide the clinical characteristics of the first 16 catheters placed at our institution utilizing this approach. ⋯ Results suggest the use of ultrasound for placing a continuous interscalene nerve catheter via the posterior approach is a viable technique that offers an alternative to the more conventional non-image-guided superficial landmark techniques.
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Reg Anesth Pain Med · Jan 2009
Anatomic variations of the obturator nerve in the inguinal region: implications in conventional and ultrasound regional anesthesia techniques.
This study was conducted to provide a thorough description of the variability in the obturator nerve branching pattern in the inguinal region. ⋯ High anatomic variability in the obturator nerve's divisions and subdivisions does exist, and explains the difficulty frequently encountered in the application of regional anesthetic techniques.