Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 1998
Case ReportsDelayed severe airway obstruction due to hematoma following stellate ganglion block.
Delayed onset of airway obstruction following stellate ganglion block (SGB) may be life threatening. We treated a patient who developed a severe airway obstruction caused by a large hematoma several hours after an SGB. ⋯ We believe that the SGB needle injured the vertebral artery and caused massive hemorrhage anterior to the cervical vertebra, subsequently inducing pharyngolaryngeal edema by obstructing the venous and lymphatic drainage of the cervical region.
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Reg Anesth Pain Med · Sep 1998
Randomized Controlled Trial Meta Analysis Comparative Study Clinical TrialRegional anesthesia does not significantly change surgical time versus general anesthesia--a meta-analysis of randomized studies.
The major determinant of variable operating room costs is surgical time. A number of factors contribute to surgical time. This study was designed to determine whether regional anesthesia decreases surgical time when compared with general anesthesia over several surgical procedures. ⋯ Overall, the use of regional anesthesia does not significantly decrease surgical time.
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Reg Anesth Pain Med · Sep 1998
Randomized Controlled Trial Comparative Study Clinical TrialThe paravertebral nerve root block for inguinal herniorrhaphy--a comparison with the field block approach.
Our objective was to evaluate the efficacy of the paravertebral block for inguinal herniorrhaphy by comparison with the well-established field block. ⋯ The paravertebral nerve root block proved to be superior to the field block, to be devoid of side effects, and was acceptable to the patients.
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Reg Anesth Pain Med · Sep 1998
Intrathecal local anesthetic distribution with the new spinocath catheter.
Microcatheters have been linked in some cases to the development of cauda equina syndrome, which may be further traced to the maldistribution of the local anesthetic. A long injection time via the microcatheters contributes to the inadequate mixing. With the new Spinocath catheter, considerably shorter injection times can be achieved due to larger internal size. This study examined whether this leads to more homogeneous intrathecal distribution without causing greater trauma to the dura. ⋯ The new Spinocath catheter allows a better mixing of the local anesthetic with the cerebrospinal fluid. Because of significantly shortened injection times, hyperbaric solutions also show a more homogeneous distribution. Although the Spinocath catheter has a larger inner diameter than the other microcatheters, it appeared to cause less trauma to the dura.
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Reg Anesth Pain Med · Sep 1998
Case ReportsContinuous sciatic nerve infusion: expanded case report describing a new approach.
Severe pain following extensive reconstructive foot surgery is difficult to manage effectively. Sciatic nerve block provides excellent analgesia for a limited duration. I wanted to determine an approach to sciatic nerve block enabling an infusion of a local anesthetic for a prolonged period without loss of efficacy due to catheter displacement. ⋯ The described "in line" technique of continuous sciatic nerve infusion of a local anesthetic solution gives prolonged and effective analgesia following foot surgery.