Regional anesthesia
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Regional anesthesia · May 1993
Randomized Controlled Trial Comparative Study Clinical TrialContinuous spinal anesthesia: does low-dose plain or hyperbaric bupivacaine allow the performance of hip surgery in the elderly?
This study was designed to assess the predictability of 5 mg bupivacaine to give a T10 sensory level when injected subarachnoid in elderly patients. ⋯ The authors conclude that 5 mg bupivacaine is too high a dose in the elderly to limit the sensory blockade at T10 and avoid hypotension. In elderly patients, this dose allowed surgery to be performed, provided that the sensory level reached T10. When the initial dose only affects lumbar dermatomes, a caudal direction of the catheter must be evoked, and changing position must be preferred to incremental injections to reach thoracic levels.
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Regional anesthesia · May 1993
Randomized Controlled Trial Comparative Study Clinical TrialPostdural puncture headache: comparison of 25-gauge Whitacre and Quincke needles.
To evaluate the influence of the shape of the needle tip on postdural puncture headache (PDPH) independent of the needle diameter, a 25-gauge Whitacre and a 25-gauge Quincke needle were compared. ⋯ The use of a conical tipped Whitacre needle results in significantly less PDPH compared to a standard Quincke spinal needle of the same size.
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Regional anesthesia · May 1993
Randomized Controlled Trial Comparative Study Clinical TrialEpidural clonidine decreases postoperative requirements for epidural fentanyl.
This study assesses the possibility that clonidine may decrease analgesic opioid demand in postoperative patients. ⋯ The combination of clonidine to epidural fentanyl allows a decrease in opioid requirements without impairing analgesia. Reduction of opioids administration may have beneficial effects on respiratory function in postoperative patients.
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To determine the length of needle that should be advanced beyond the distance to the lateral pterygoid plate to reach the mandibular nerve. ⋯ There is no osteologic basis to advance the needle beyond the distance to the lateral pterygoid plate to reach mandibular nerve. However, because the needle may contact the nerve at variable points rather than the shortest distance to the nerve, the needle may be advanced by 0.07 cm on the right and 0.11 cm on the left side in patients. This increase is much less than that indicated in the standard textbooks. Therefore, while performing mandibular nerve block, we suggest caution in advancing the needle beyond the distance to lateral pterygoid plate.
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Regional anesthesia · May 1993
Case ReportsSuccessful spinal anesthesia after inadequate epidural block in a parturient with prior surgical correction of scoliosis.
Lumbar epidural anesthesia is safe in patients with previous spinal surgery, but it is not always successful or easily performed. ⋯ After letting the epidural block recede below the lumbar level, a successful spinal anesthetic was administered producing a sensory level to T4.