Regional anesthesia
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Regional anesthesia · Jul 1993
Multicenter Study Clinical TrialAtraucan: a new needle for spinal anesthesia.
Atraucan 26-gauge spinal needles have a tip designed to make a small linear cut (as opposed to a V-shaped cut) in the dura mater. The cut is shorter than the outside diameter of the needle and is dilated as the needle passes through the dura. The needle is used with a 20-gauge introducer. In vitro, it causes less leakage of cerebrospinal fluid than Quincke 26-gauge or Sprotte 24-gauge needles. This study was designed to test the ease of use and any damage caused to the needle tip during lumbar dural puncture. ⋯ The Atraucan needle is easy to use and has a high success rate in identifying the subarachnoid space. Lumbar dural puncture causes minimal damage to the tip. The incidence of PDPH is low, but a larger comparative study needs to be performed.
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The authors report the use of multiple implanted intraspinal port and catheter systems per test animal to study the in vivo functional characteristics and reliability of a new implantable spinal drug delivery port system. ⋯ The implantable intraspinal port system tested functions reliably under repetitive percutaneous access. However, filtering such ports, though desirable to prevent entry of debris into the spinal canal, did not eliminate pericatheter chronic subarachnoid and epidural reaction. The number of test animals required to test 12 ports chronically was reduced by two-thirds without undue trauma to the individual test subject. Chronic percutaneous injection of an implanted subarachnoid system is feasible but may be associated with behavioral effects similar to that seen with chronic epidural systems. Fibrosis around chronic silicone catheters limited functional utility in one-fourth of the implanted test systems. Further study of the potential reactivity of chronic epidural and subarachnoid catheters is indicated.
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Regional anesthesia · Jul 1993
Case ReportsSupraventricular tachycardia in a parturient under spinal anesthesia.
A 30-year-old woman with a history of palpitations was admitted for a repeat cesarean delivery at 41 weeks' gestation. Spinal anesthesia was administered. ⋯ Phenylephrine may be used successfully for the treatment of SVT that results in hypotension under spinal anesthesia, and it may have advantages over ephedrine.
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Regional anesthesia · Jul 1993
Case Reports Comparative StudyRectus block for postoperative pain relief.