Regional anesthesia
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Regional anesthesia · Jan 1995
Clinical TrialProlonged PR interval is a risk factor for bradycardia during spinal anesthesia.
Bradycardia occurs during 9%-13% of spinal anesthetics and may lead to cardiac arrest. Several risk factors for the development of bradycardia have been identified, but the risk conferred by presence of abnormalities detected on preoperative electrocardiogram (ECG) has not been examined. The authors undertook the study to correlate abnormal ECG findings with the incidence of bradycardia. ⋯ Risk factors previously identified for the development of bradycardia during spinal anesthesia include: baseline heart rate < 60 bpm, ASA physical status 1 versus 3 or 4, use of beta-blocking drugs, sensory block height > or = T5, and age < 50. The results demonstrate that prolonged PR interval on the preoperative ECG is another significant and independent predictor for bradycardia.
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Regional anesthesia · Jan 1995
Case Reports Clinical TrialRadiofrequency lumbar sympatholysis. The evolution of a technique for managing sympathetically maintained pain.
To develop lumbar radiofrequency sympatholysis for the relief of pain in patients with neuropathic pain who had previously responded to sympathectomy or sympathetic blocks. ⋯ A single technique of radiofrequency sympatholysis does not appear to be applicable to all patients with reflex sympathetic dystrophy or sympathetically maintained pain. Despite early successful sympathetic block with radiofrequency, as confirmed by a warm foot, long lasting pain relief was difficult to obtain. The author concludes that individualized patient management is necessary when considering radiofrequency sympatholysis in the treatment of patients with sympathetically maintained pain.
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Regional anesthesia · Jan 1995
Randomized Controlled Trial Clinical TrialContinuous high thoracic epidural administration of morphine with bupivacaine after thoracotomy.
The purpose of the study is to determine the ideal concentration of morphine when given with bupivacaine as a continuous high thoracic epidural infusion for postthoracotomy pain. ⋯ Continuous high thoracic epidural administration 0.2 mg/mL morphine in bupivacaine 0.75% at an infusion rate of 0.8 mL/hr with a loading dose of 1 mg morphine is an effective dose for postthoracotomy pain relief in rest, and more important, during exercise.
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Regional anesthesia · Jan 1995
Comparative Study Clinical TrialA retrospective comparison of interscalene block and general anesthesia for ambulatory surgery shoulder arthroscopy.
An increasing percentage of all surgery is performed in an ambulatory surgery setting. Concurrently, arthroscopy of the shoulder joint has allowed definitive repair of shoulder pathology to occur in this environment. This study was designed to ascertain whether interscalene block is reliable and efficient for use in same-day surgery compared with general anesthesia for shoulder arthroscopy. ⋯ Interscalene block should be considered as a viable alternative to general anesthesia for shoulder arthroscopy in ambulatory surgery patients.