Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2005
ReviewContinuous interscalene block using a stimulating catheter: a review of the technique.
The management of postoperative pain after major shoulder surgery can be achieved successfully with a continuous interscalene block. This article reviews the essentials of the stimulating catheter technique for the continuous interscalene block that was described by Boezaart in 1999. The authors also describe their experience and results with the first two hundred catheters they placed.
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Acta Anaesthesiol Belg · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialLaryngeal mask airway insertion with remifentanil.
We conducted a study to find out the best conditions for LMA insertion with two different doses of remifentanil added to propofol and propofol administered alone. ⋯ Propofol given 2.5 mg kg(-1) alone is not a good agent for LMA insertion. Remifentanil used in both doses combined with propofol provides good and excellent conditions for insertion of LMA with minimal hemodynamic disturbances.
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Acta Anaesthesiol Belg · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialA randomized trial comparing low-dose combined spinal-epidural anesthesia and conventional epidural anesthesia for cesarean section in severe preeclampsia.
A prospective, randomized study was designed to compare the maternal and neonatal effects of conventional epidural anesthesia and combined spinal epidural anesthesia (CSE) for Cesarean section in severe preeclamptic patients. Additionally, two strategies in the prophylactic management of hypotension in severe preeclamptic patients were evaluated: fluid preloading or prophylactic ephedrine. ⋯ Our results confirm that combined spinal and epidural anesthesia (CSE) is a safe alternative to conventional epidural anesthesia in severe preeclamptic women and that the prophylactic use of ephedrine is effective and safe to prevent and treat spinal hypotension after combined spinal and epidural anesthesia for Cesarean section in severe preeclamptic women.
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Acta Anaesthesiol Belg · Jan 2005
Randomized Controlled TrialConventional treatment or epidural blood patch for the treatment of different etiologies of post dural puncture headache.
Post dural puncture headache (PDPH) represents a complication of anesthesia (with an increased incidence in obstetric patients) or as the consequence of a diagnostic lumbar puncture. The aim of the present study was to evaluate the efficacy of the epidural blood-patch (EBP) versus the conventional medical treatment of post-anesthetic headaches also including the PDPH following a diagnostic puncture, a category of patients rarely referred to the anesthesia consultation in our hospital because it was believed that they might have equal benefit from conventional measures due to the smaller size of needles used. We studied in a prospective, randomized, double-blinded manner 32 obstetric and non-obstetric patients with PDPH having the onset of the symptoms 24 hours before the inclusion in the study. ⋯ The difference recorded after 24 hours remained statistically significant (p < 0.0001): the VAS scores were 0.7 +/- 0,16 and 7.8 +/- 1.2 respectively. The epidural blood patch represents the first choice treatment of PDPH no matter the etiology, being significantly superior to the conventional treatment which did not affect pain scores. In severe PDPH there is no reason to delay the EBP more than 24 hours after the diagnosis as all except two patients of the conventional treatment group required blood patching following the study period.