Regional anesthesia
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Regional anesthesia · Jul 1994
Clinical TrialOne needle transcrural celiac plexus block. Single shot or continuous technique, or both.
The purpose of the study was to establish a one needle transcrural technique for the celiac plexus block in the lateral position. Contrary to the conventional prone bilateral approach, the lateral position with a cushion under the flank is better tolerated and makes bony landmarks more accessible. Unilateral needle placement reduces the morbidity of the technique and should also enable one to apply single administration or continuous blocks, or both. ⋯ Clinical results proved that the unilateral, transcrural technique in a lateral position is simple, safe, and gives a reliable celiac plexus block or neurolysis effects under fluoroscopy, or both, comparable to the results where computed tomography was used. The possibility of continuous block makes this technique useful in clinical practice.
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Regional anesthesia · Jul 1994
Comparative StudyProlonged analgesia with liposomal bupivacaine in a mouse model.
Currently available local anesthetics have relatively limited duration of action and some may cause severe systemic toxicity. An ultralong lasting local anesthetic would be useful to produce prolonged intraoperative anesthesia and extended postoperative analgesia. The goal of this study was to synthesize a sustained release local anesthetic formulation that would produce prolonged sensory block and decrease the possibility of systemic toxicity. ⋯ This study shows that liposomal encapsulation of bupivacaine significantly prolongs duration of action and greatly decreases systemic toxicity of the drug. These findings may be promising for the future production of formulations of ultralong lasting local anesthetics with enhanced efficacy and safety.
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Regional anesthesia · Jul 1994
Clinical TrialInfluence of the subarachnoid position of microcatheters on onset of analgesia and dose of plain bupivacaine 0.5% in continuous spinal anesthesia.
Many factors have an impact on the outcome of continuous spinal anesthesia (CSA) with small-bore catheters. Recent publications of neurologic complications after CSA suggest that the local anesthetic as well as the microspinal catheter influence the analgesic effect in CSA. This prospective study was designed to evaluate the influence of the subarachnoid position of 28-gauge spinal catheters on the speed of onset of analgesia and on the dose of plain bupivacaine 0.5% required for a block at the level of T-10 in CSA. ⋯ The subarachnoid position of a 28-gauge microcatheter is an important factor with regard to the effectiveness (e.g., onset time of analgesia and dose requirement) of CSA using plain bupivacaine 0.5%.