Regional anesthesia and pain medicine
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Epidural catheters are seldom difficult to remove from patients. In fact, a review of the literature demonstrates only a few cases pertaining to epidurals and the unusual complication of catheter entrapment. ⋯ This case report involves an uncomplicated obstetric patient who had an epidural placed for labor and in whom multiple attempts were needed to remove the catheter.
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Reg Anesth Pain Med · Nov 1998
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialComparative evaluation of four different infusion rates of ropivacaine (2 mg/mL) for epidural labor analgesia.
Previous studies have reported comparable efficacy for ropivacaine and bupivacaine when used for labor analgesia at concentrations of 2.5 mg/mL. In this multicenter study, we assessed ropivacaine at the commercially available concentration of 2 mg/mL (0.2%) for labor pain management. ⋯ The 2 mg/mL of ropivacaine produces satisfactory labor analgesia at epidural infusion rates of 4, 6, 8, and 10 mL/hour, provided supplemental bolus dosages are available. Clinically, a rate of 6 mL/hour may be the lowest effective rate that provides the best combination of pain relief, motor block, and rebolusing, although rates of 8 and 10 mL/hour produced similar results.
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Reg Anesth Pain Med · Nov 1998
Randomized Controlled Trial Comparative Study Clinical TrialClonidine added to bupivacaine-epinephrine-sufentanil improves epidural analgesia during childbirth.
A double-blind study was conducted to assess the efficacy and the side effects of a low dose of clonidine added to an epidural injection of bupivacaine and epinephrine, with or without sufentanil. ⋯ The addition of a low dose of clonidine to an epidural injection of bupivacaine with epinephrine and sufentanil provides better analgesia during labor, while keeping the side effects minimal and of minor clinical importance.
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Reg Anesth Pain Med · Nov 1998
Randomized Controlled Trial Clinical TrialPre-incision infiltration with lidocaine reduces pain and opioid consumption after reduction mammoplasty.
To determine the analgesic efficacy of preoperative tumescent infiltration with lidocaine for reduction mammoplasty. ⋯ Preoperative tumescent infiltration with lidocaine results in reduced pain and lower postoperative opioid requirements in the initial hours after reduction mammoplasty.