Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 1998
Clinical Trial Controlled Clinical TrialPostoperative epidural injection of saline can shorten postanesthesia care unit time for knee arthroscopy patients.
The goal of this prospective, double-blind study was to ascertain if the postanesthesia care unit (PACU) stay of outpatients receiving epidural anesthesia for knee arthroscopy is decreased by injection of epidural saline at the end of the case. ⋯ Patients receiving epidural anesthesia for knee arthroscopy had a shorter PACU stay if they received an injection of saline into the epidural space at the end of surgery.
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The role of sympathetic blocks in pain therapy is examined in the light of changing concepts of pain pathophysiology. A critical review of the literature also sought to develop an evidence-based analysis of outcome studies to provide recommendations for appropriate applications of sympathetic blocks, together with ideas for further clinically based research. ⋯ Changes in the understanding of CRPS disorders and the role of the sympathetic nervous system in neuropathic pain has changed both the diagnostic and management strategies for these pain states. The sensitivity and specificity of response to sympathetic blocks in establishing their value at diagnostic aids will not be fully established without further clinical study. Further use of intravenous regional blocks or diagnostic intravenous infusions remains questionable. Preventive and therapeutic use of sympathetic blocks in herpes zoster pain remains open to well-controlled study.
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Reg Anesth Pain Med · May 1998
Comparative Study Clinical Trial Controlled Clinical TrialComparison of double-hole and single-hole pencil-point needles for spinal anesthesia with hyperbaric bupivacaine.
The use of thin single-hole pencil-point (SHPP) spinal needles may be a reason for subarachnoid maldistribution of local anesthetic. A new double-hole pencil-point (DHPP) needle may be preferable because of a theoretic more uniform initial distribution of local anesthetic. ⋯ There was no difference between the spread of analgesia using either SHPP or DHPP spinal needles. The DHPP needles appear to be vulnerable to tip damage from mechanical contact.