Regional anesthesia
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Regional anesthesia · Nov 1993
ReviewPhysiologic mechanisms by which local anesthetics may cause injury to nerve and spinal cord.
Review evidence for possible physiologic mechanisms by which local anesthetics cause nerve injury was reviewed. ⋯ In rare instances, the clinical use of local anesthetics is associated with neurologic morbidity. The physiologic mechanisms of toxicity for which there is the best evidence are inhibition of fast axonal transport, disruption of the axonal cytoskeleton, axonal degeneration, and ischemic nerve injury. The effects of local anesthetics on nerve blood flow may be related to inhibition of endothelium-dependent vasodilation or interruption of the synthesis of vasodilating prostaglandins. Both the prevention and the treatment of nerve injury caused by local anesthetics requires information that is not yet available about the physiologic and molecular mechanisms for direct neural toxicity of local anesthetics.
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Regional anesthesia · Nov 1993
Randomized Controlled Trial Clinical TrialLack of effect of sphenopalatine ganglion block with intranasal lidocaine on submaximal effort tourniquet test pain.
The present study examined whether sphenopalatine ganglion block (SPGB) causes a reduction in the response to acute nociceptive input that may account for the SPGB-induced relief reported by many patients with chronic pain. ⋯ SPGB does not lessen acute extremity pain to a significant degree and is not in and of itself an effective means of analgesia for acute pain. Its potential impact on nociceptive stimuli that elicit a "strong sensation" (i.e., a score of 5-7 in the present study) should be evaluated in hyperpathic pain states and in states with exaggerated aversive responses.
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Regional anesthesia · Nov 1993
Randomized Controlled Trial Comparative Study Clinical TrialThoracic versus lumbar administration of epidural morphine for postoperative analgesia after thoracotomy.
The purpose of this study was to compare the effects of thoracic and lumbar epidural morphine on pulmonary function and analgesia after thoracotomy for pulmonary resection. ⋯ The authors conclude that thoracic epidural morphine administration in patients after thoracotomy results in decreased morphine requirements and the same degree of analgesia as does lumbar administration.
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Regional anesthesia · Nov 1993
Comparative StudyPlasma alcohol concentrations after celiac plexus block in gastric and pancreatic cancer.
The objective of this study was to compare the plasma alcohol concentrations after celiac plexus block in different types of cancer. The authors studied the consecutive changes of plasma alcohol concentrations after celiac plexus block in a gastric cancer group (group 1, n = 6) and a pancreatic cancer group (group 2, n = 5). ⋯ Plasma alcohol concentrations after celiac plexus block showed different patterns according to the site of cancer and the type of operation performed.
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Regional anesthesia · Nov 1993
Comparative StudyComparison of the clinical efficacy of three perivascular techniques for axillary brachial plexus block.
This study compared the efficacy of three perivascular techniques of axillary block. ⋯ There was no significant difference in the number of patients requiring supplementation, with five patients in the back group (25%), three patients in the front group (15%), and one patient in the half and half group (5%) requiring supplementation for the surgical procedure.