Regional anesthesia
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Regional anesthesia · Jan 1994
Randomized Controlled Trial Comparative Study Clinical TrialSciatic nerve block. A comparison of single versus double injection technique.
Two techniques, single versus double injection, for blocking the sciatic nerve via the classical (Labat) approach were prospectively evaluated for onset and efficacy of block in 50 adult patients undergoing lower extremity surgery. The tibial, common peroneal, and posterior femoral cutaneous nerves were evaluated at 5, 10, 15, 20, 30, and 45 minutes after the initial injection of local anesthetic. Motor function was used to assess the block of the tibial and common peroneal nerves while pinprick response was used to assess block of the posterior femoral cutaneous nerve. ⋯ The double injection technique for sciatic nerve block via the classical approach results in a more rapid onset and increased efficacy of block than that of the single injection technique.
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Regional anesthesia · Jan 1994
Randomized Controlled Trial Clinical TrialSensory, motor, and sympathetic block during epidural analgesia with 0.5% and 0.75% ropivacaine with and without epinephrine.
Ropivacaine is a new long-acting local anesthetic, with vasoconstrictive properties. The purpose of this randomized, double-blind study was to evaluate sensory, motor, and sympathetic block following epidural anesthesia, and the influence of the addition of epinephrine. ⋯ Ropivacaine given epidurally provided adequate sensory anesthesia and motor block for transurethral surgery. Addition of epinephrine did not provide any significant prolongation of the sensory or motor block, nor any influence upon the sympathetic block.
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Regional anesthesia · Jan 1994
Randomized Controlled Trial Comparative Study Clinical TrialBrachial plexus block. A comparison of the supraclavicular lateral paravascular and axillary approaches.
Anesthesia of the brachial plexus has been associated with injuries to adjacent structures (e.g., pneumothorax, vascular penetration). It is not uncommon to have only partial block of the upper extremity, hindering completion of the surgical procedure. The supraclavicular lateral paravascular approach to brachial plexus anesthesia has been proposed as an effective, safe alternative to the traditional approaches to brachial plexus anesthesia. ⋯ The supraclavicular lateral paravascular approach is as effective as the axillary approach.
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Regional anesthesia · Jan 1994
Randomized Controlled Trial Comparative Study Clinical TrialSubarachnoid morphine and fentanyl for labor analgesia. Efficacy and adverse effects.
The study was designed to compare analgesic efficacy and associated adverse effects between a group of parturients receiving subarachnoid opioids via the combined spinal-epidural (CSE) technique with a group receiving epidural analgesia alone for labor. ⋯ The combination of subarachnoid morphine 0.25 mg and fentanyl 25 micrograms, when used for labor analgesia as part of the CSE technique, was associated with a higher incidence of clinically significant nausea and vomiting and pruritus, compared to conventional epidural anesthesia. Furthermore, the combination of subarachnoid morphine and fentanyl proved ineffective in providing adequate pain relief for the duration of labor and delivery for the majority of patients. The authors recommend that subarachnoid morphine and fentanyl serve a limited role in the treatment of labor pain.
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Regional anesthesia · Jan 1994
Randomized Controlled Trial Clinical TrialDiluting lidocaine and mepivacaine in balanced salt solution reduces the pain of intradermal injection.
Intradermal injection of local anesthetics prior to percutaneous needle insertion is often painful. This study evaluated the effect of diluting lidocaine and mepivacaine with balanced salt solution on perception of pain on intradermal injection. ⋯ The dilution of lidocaine and mepivacaine with balanced salt solution produces a solution that is both painless on injection and of moderate duration.