Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 1999
Case ReportsAcute herpetic neuralgia and postherpetic neuralgia in the head and neck: response to gabapentin in five cases.
The clinical presentations and pharmacologic management of three patients with acute herpetic neuralgia (AHN) and two patients with postherpetic neuralgia (PHN), confined to the head and neck region, are described. ⋯ In view of the results in these patients, blinded, controlled studies are needed to determine the efficacy of gabapentin for treating AHN and PHN.
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Reg Anesth Pain Med · Mar 1999
Randomized Controlled Trial Comparative Study Clinical TrialEvaluation of the analgesic efficacy of EMLA cream in volunteers with differing skin pigmentation undergoing venipuncture.
Lidocaine/prilocaine cream (EMLA) applied to intact skin for 60 minutes has been shown to reduce venipuncture pain. Recent studies have suggested that lidocaine/prilocaine cream is less effective on heavily pigmented skin. The objective of this study was to evaluate the topical anesthetic efficacy of lidocaine/prilocaine cream in volunteers with varying skin pigmentation types. ⋯ Lidocaine/prilocaine cream is a safe and effective topical anesthetic for reducing pain associated with venipuncture in individuals, regardless of skin pigmentation.
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Reg Anesth Pain Med · Mar 1999
Randomized Controlled Trial Clinical TrialEvaluation of peripheral morphine analgesia for lumpectomy and axillary node dissection: a randomized, double-blind, placebo-controlled study.
Morphine may elicit potent antinociceptive effects by binding and activating peripheral opioid receptors. However, the results in clinical studies have varied. We examined the postoperative analgesic effects of incisional morphine in patients undergoing lumpectomies and axillary node dissections for breast cancer. For this purpose, a concentration of morphine within the range (0.25-0.6%) of those utilized in previous studies for postarthroscopy analgesia was chosen (0.6%). ⋯ These results suggest that under the conditions of the study protocol, there is no value in utilizing morphine in solution at the surgical site for postoperative lumpectomy and axillary node dissection analgesia.
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Reg Anesth Pain Med · Mar 1999
The safety and efficacy of combined spinal and epidural analgesia/anesthesia (6,002 blocks) in a community hospital.
This study examined the safety and efficacy of combined spinal and epidural (CSE) analgesia/anesthesia performed in a community hospital. ⋯ This review of 6,002 CSE blocks performed in a community hospital has demonstrated that CSE labor analgesia, surgical anesthesia are safe and efficacious. We believe that patient observation and continuous pulse oximetry for 1-2 hours after administration of ITS and prompt treatment with intravenous naloxone for severe drowsiness, low oxygen saturation (PaO2 < 90% unresponsive to mask oxygen), or dysphagia should be used to minimize the risk of apnea.