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
Comparative StudyComparative flow rates of saline in commonly used spinal needles including pencil-tip needles.
Certain characteristics of spinal needles that can influence their clinical usefulness were examined, namely, flow rates, internal diameters, and size of orifices of pencil-type needles. ⋯ Needles of the same gauge do not necessarily have the same flow rate. Flow rate correlates well with internal, not external, diameter. By considering < or = 2 seconds to be the desirable time for saline to traverse a spinal needle, all, except two, meet this criterion. The orifice of Whitacre needle has more desirable features than that of Sprottle needle. Anesthesiologists are encouraged to use 27-gauge needles since their flow rate is not slower than that of 26-gauge needles.
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Regional anesthesia · Jan 1994
Case ReportsPostblock epidural hematoma causing paraplegia. Case report.
An elderly man with no obvious preexisting coagulation disorder had paraplegia following epidural block for transurethral prostatectomy that was later found to be due to a large epidural hematoma requiring surgical decompression of the spinal cord. ⋯ The anesthesiologist should be alert to the possibility of epidural hematoma forming in otherwise normal patients to avoid such unfavorable outcomes.
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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.