Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2004
Randomized Controlled Trial Comparative Study Clinical TrialProspective comparison of continuous femoral nerve block with nonstimulating catheter placement versus stimulating catheter-guided perineural placement in volunteers.
Stimulating catheter-guided perineural placement may potentially increase the success rate and quality of continuous femoral nerve block as compared with a nonstimulating catheter technique. These hypotheses have not been rigorously tested. ⋯ In this volunteer study, there was no statistically significant difference in block success between the two techniques. However, stimulating catheter-guided placement provided an increased overall quality of continuous femoral perineural blockade. Further studies are needed to verify these observations in the clinical setting.
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Reg Anesth Pain Med · May 2004
Randomized Controlled Trial Comparative Study Clinical TrialSpinal ropivacaine or bupivacaine for cesarean delivery: a prospective, randomized, double-blind comparison.
The aim of this prospective, randomized, double-blinded study was to compare clinical efficacy and safety of ropivacaine and bupivacaine given intrathecally in combination with morphine for cesarean delivery. ⋯ Spinal anesthesia produced with 20 mg ropivacaine plus 0.1 mg morphine is as effective and safe as that provided by 15 mg bupivacaine plus 0.1 mg morphine, with an earlier recovery of sensory and motor functions after surgery.
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Reg Anesth Pain Med · May 2004
Review Case ReportsSpinal cord compression from intrathecal catheter-tip inflammatory mass: case report and a review of etiology.
The majority of intrathecal pumps are implanted by anesthesiologists. Despite a recent increase in case reports involving intrathecal catheter-tip inflammatory masses, this complication is rarely reported in the anesthesiology literature. The present case report describes a patient with spinal cord compression as a result of an inflammatory mass and reviews the current literature as to the etiology of inflammatory mass formation. ⋯ Delivery of high-dose intrathecal opioids can result in the formation of an inflammatory mass, leading to poor pain control and neurologic complications. Anesthesiologists should be vigilant as to these complications when managing patients receiving intrathecal pump therapy.