Regional anesthesia
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Regional anesthesia · Mar 1995
Randomized Controlled Trial Clinical TrialLateral femoral cutaneous nerve block revisited. A nerve stimulator technique.
Regional block of the lateral femoral cutaneous nerve (LFCN) often has disappointing success rates despite the large volumes of local anesthetic used. This study was undertaken to investigate the utility of using a nerve stimulator (NS) to localize and block the LFCN. ⋯ A NS can be used to localize a purely sensory nerve; such as the LFCN, and improve success rates in regional anesthesia.
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Regional anesthesia · Mar 1995
Comparative Study Clinical TrialHypnosis as adjunct therapy in conscious sedation for plastic surgery.
Sedation is often requested during local and regional anesthesia. However, some surgical procedures, such as plastic surgery, require conscious sedation, which may be difficult to achieve. Hypnosis, used routinely to provide conscious sedation in the authors' Department of Plastic Surgery, results in high patient and surgeon satisfaction. The authors conducted a retrospective study to investigate the benefits of hypnosis in supplementing local anesthesia. ⋯ Successful hypnosis as an adjunct sedation procedure to conscious intravenous sedation provided better pain and anxiety relief than conventional intravenous sedation and allowed for a significant reduction in midazolam and alfentanil requirements. Patient satisfaction was significantly improved.
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Regional anesthesia · Mar 1995
Comparative Study Clinical TrialPostoperative myocardial ischemia: epidural versus intravenous patient-controlled analgesia. A pilot project.
Continuous postoperative epidural analgesia with bupivacaine (BUP) and morphine (MS) may be associated with a decreased incidence of postoperative myocardial ischemia (ISCH) and infarction (MI). This study evaluated the incidence of ISCH and MI in patients with two or more risk factors for coronary artery disease (CAD) who were admitted to the ICU after upper abdominal surgery for cancer. ⋯ These preliminary results suggest that epidural anesthesia and analgesia may decrease the incidence of postoperative tachycardia, ischemia, and possibly infarction in patients undergoing upper abdominal procedures.
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Regional anesthesia · Mar 1995
Clinical TrialEpidural air injection assessed by transesophageal echocardiography.
The object of this study, using transesophageal echocardiography (TEE) in anesthetized patients, was to investigate the occurrence of venous air embolism (VAE) when air is injected into the epidural space. ⋯ No evidence of clinically significant VAE was seen in any patient. The results suggest that drugs injected into the epidural space may have unexpectedly easy access to the venous circulation with a potential to produce unwanted systemic effects. Clinicians should be alert to the possibility that local anesthetics, or any other drug placed epidurally, may rapidly enter the systemic circulation even without the intravenous placement of an epidural catheter.
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Regional anesthesia · Mar 1995
Randomized Controlled Trial Comparative Study Clinical TrialSpinal anesthesia for cesarean delivery. A comparison of two doses of hyperbaric bupivacaine.
Hyperbaric local anesthetic pools in the thoracic spinal curvature in supine patients. The authors hypothesized that patients receiving 12 or 15 mg of hyperbaric bupivacaine would achieve similar levels of sensory block but the spinal anesthetic would be denser and longer lasting in patients receiving the 15 mg dose. ⋯ Parturients receiving 15 mg of hyperbaric bupivacaine developed a higher mean level and longer duration of sensory analgesia than those receiving 12 mg.