Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 1999
Randomized Controlled Trial Clinical TrialThe addition of epinephrine increases intensity of sensory block during epidural anesthesia with lidocaine.
Little is known about the effect of adding epinephrine to local anesthetic solutions on the intensity of sensory block during epidural anesthesia. This study examined development of sensory block during lumbar epidural anesthesia using a cutaneous current perception threshold (CPT) quantitative sensory testing device. ⋯ These results suggest that lumbar epidural anesthesia using 10 mL 1% lidocaine with epinephrine produces a more intense block of both large and small diameter sensory nerve fibers than that with plain lidocaine. It appears, therefore, that the addition of epinephrine improves the quality of sensory block during epidural anesthesia with lidocaine.
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Reg Anesth Pain Med · Nov 1999
Randomized Controlled Trial Clinical TrialContinuous psoas compartment block for anesthesia and perioperative analgesia in patients with hip fractures.
The perioperative use of continuous psoas compartment block (CPCB) was compared with traditional pain management for patients with fracture of the femur. The anatomy of CPCB was also tested in cadavers. ⋯ The CPCB seems to be an appropriate technique for efficient and safe perioperative pain control. However, in our dissections, the psoas compartment was not well defined in all patients, thus, using this route for anesthesia may result in only partial success.
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Reg Anesth Pain Med · Nov 1999
Randomized Controlled Trial Clinical TrialDouble-injection method using peripheral nerve stimulator is superior to single injection in axillary plexus block.
Axillary block using a single-injection method does not always provide effective analgesia. This study examined whether a double axillary block injection technique is superior to a single injection axillary block. ⋯ A double-injection method in axillary block provides excellent analgesia and motor block compared with a single-injection method. Moreover, the need for supplemental nerve blocks is significantly decreased.
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Reg Anesth Pain Med · Nov 1999
The incidence of tissue coring during the performance of caudal injection in children.
The performance of caudal injection (CI) has become a routine part of pediatric anesthesia. The intraoperative and immediate postoperative complications of CIs have been reported extensively. Although the long-term consequences of CI are unknown, they may include the development of epidermoid tumors in the spinal canal. Such tumors have been attributed to tissue coring (the process by which pieces of tissue are removed by a needle as it passes through the tissue) and the subdural deposition of such tissue. ⋯ These findings suggest that technical modifications may improve patient safety. The results also have implications for long-term follow-up of caudal anesthetics. Techniques for reducing the incidence of tissue coring during the performance of CI are discussed.
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Reg Anesth Pain Med · Sep 1999
ReviewA systematic review of intra-articular local anesthesia for postoperative pain relief after arthroscopic knee surgery.
In a systematic review, we have evaluated double-blind, randomized, controlled trials of intra-articular local anesthesia compared with placebo or no treatment in the control of postoperative pain after arthroscopic knee surgery. ⋯ There is a weak evidence for a reduction of postoperative pain after intra-articular local anesthesia in patients undergoing arthroscopic knee surgery, which although being sinall to moderate and of short duration, may be of clinical significance in day-case surgery.