Regional-Anaesthesie
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Regional-Anaesthesie · Apr 1984
Case Reports[Cutaneous cerebrospinal fluid fistula associated with secondary puncture of the dura caused by a peridural catheter].
Prolonged liquor fistula following puncture of the subdural space for diagnostic or anaesthetic purposes has been reported repeatedly. These among other factors are held responsible for headache as well as neurological complications in connection with lumbar puncture. ⋯ Two patients developed a cutaneous liquor fistula after lumbar laminectomy following an inadvertant dural penetration when an epidural steroid injection was performed. The same occurred in a healthy young patient who had undergone several trials to puncture the epidural space for an epidural anaesthesia in a case of emergency cesarean section Our own observation concerns a 62 years old woman who developed a cutaneous cerebrospinal fluid fistula 12 h after the removal of an epidural catheter, which had caused a secondary perforation of the dura.
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Regional-Anaesthesie · Apr 1984
[The popliteo-femoral block, a rarely used form of regional anesthesia. With special reference to the use of peripheral nerve stimulators].
Blockade of the sciatic nerve in the fossa poplitea is a rarely used form of regional anaesthesia. A new method of identification of the tibial and peroneal nerve and their blockade in combination with blockade of the femoral nerve using a peripheral nerve stimulator, is described. Results in 300 patients during a 12 month period are described and discussed.
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Regional-Anaesthesie · Apr 1984
[Identification of the peridural space with the infusion method in relation to the incidence of inadvertent puncture of the dura].
In 868 cases the identification of the epidural space was performed by plugging a running infusion drip. After accurate identification of the epidural space the patient received either 0.5% or 0.75% bupivacaine without adrenalin for operations on the lower extremities, at the perineum and for lower and upper abdominal surgery. Analgesia was adequate. ⋯ Thus the frequency of this complication was below 1%. This is - even according to the latest publications - quite a satisfactory result. An unidentified accidental dural puncture and associated complication did not occur.