Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 1998
Randomized Controlled Trial Comparative Study Clinical TrialA clinical comparison between needle-through-needle and double-segment techniques for combined spinal and epidural anesthesia.
The goal of the present investigation was to compare the double-segment and the needle-through-needle techniques for combined spinal and epidural anesthesia (CSE) in a prospective, randomized, blinded study. ⋯ The needle-through-needle technique for CSE requires less time, has no greater failure rate, and results in greater patient satisfaction than the double-segment technique. The use of a spinal needle with an adjustable locking mechanism and protruding up to 15 mm beyond the Tuohy needle improved successful spinal block in the needle-through-needle technique compared with previous reports.
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Reg Anesth Pain Med · Jul 1998
Case ReportsUnusually prolonged duration of spinal anesthesia following 2% mepivacaine.
Spinal mepivacaine has been reported as a reliable anesthetic for ambulatory anesthesia. Its pharmacologic properties are midway between those of bupivacaine and lidocaine, and it can be used in intermediate duration ambulatory surgical procedures. ⋯ Clonidine can increase the duration of spinal anesthetics. Even though this well-known effect has been considered mostly beneficial, it can be an adverse effect when spinal ambulatory anesthesia is given to patients receiving clonidine TTS or clonidine in other forms for long-term treatment of hypertension or other diseases.
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Reg Anesth Pain Med · Jul 1998
Clinical TrialNerve blocks with 5% butamben suspension for the treatment of chronic pain syndromes.
Butamben is a non-water-soluble local anesthetic that can be prepared as an aqueous suspension for nerve blocks. This report describes the use of 5% butamben suspension for the treatment of chronic pain of cancer and noncancer origin. ⋯ When used as described in this report, 5% butamben suspension appears to be effective for treatment of chronic pain of both cancer and noncancer origin and has a low incidence of adverse sequelae.
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Reg Anesth Pain Med · Jul 1998
Editorial CommentProblems with combined spinal and epidural anesthesia.