Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2003
Clinical TrialIs skin disinfection with 10% povidone iodine sufficient to prevent epidural needle and catheter contamination?
Epidural space infection is a potential complication of epidural catheter placement. In this study, we investigated the incidence of epidural needle and catheter contamination after skin surface disinfection with 10% povidone-iodine (PI). ⋯ Our results suggest that despite skin surface disinfection with PI, there is still significant risk for contamination of needles and catheters during epidural catheterization.
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Ambulatory perineural local anesthetic infusion is a relatively new method for providing postoperative analgesia, and many aspects of this technique remain in the domain of conjecture and speculation. This retrospective chart review and survey was undertaken to investigate patients' opinions on various aspects of their ambulatory perineural infusion experience. ⋯ This investigation suggests that perineural local anesthetic infusion is generally well tolerated by ambulatory patients.
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To describe the onset of phantom leg pain in an amputee with the performance of a lumbar plexus block and the subsequent alleviation after the performance of a sciatic nerve block. ⋯ The temporal relationship between the onset of the phantom leg pain and the lumbar plexus block suggests a causal relationship. In this case, it appears that ongoing peripheral input from the lumbar plexus may have been sufficient for the tonic inhibition of phantom pain in the sciatic distribution. The immediate reactivation of the phantom pain and its subsequent relief suggests dynamic processing of peripheral inputs by central neurons, which apparently is rapid and reversible in some cases of phantom pain.
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Reg Anesth Pain Med · Sep 2003
Altered perceptions after upper and lower extremity blocks: an initial investigation.
Nerve blocks frequently produce unusual altered perceptions in the extremities. We examined perceptual changes experienced after peripheral blocks. ⋯ The results of this study confirm and quantify the perceptions experienced by patients undergoing upper and lower extremity blocks. These perceptions are prevalent. This knowledge is helpful in providing patients with accurate preoperative preparation. Further investigation is warranted to determine the neurologic etiology of these observations.
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Reg Anesth Pain Med · Sep 2003
Case ReportsTransverse myelitis associated with Acinetobacter baumanii intrathecal pump catheter-related infection.
To describe a late neurologic complication of intrathecal pump implantation and show the methods used for the diagnosis and successful treatment of transverse myelitis in this setting. ⋯ Clinicians should recognize transverse myelitis as a possible late complication of intrathecal pump placement. Early medical intervention and removal of the intrathecal pump may be necessary to prevent irreversible spinal cord damage and may support good recovery.