Regional anesthesia
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Regional anesthesia · Nov 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison of two application techniques of EMLA and pain assessment in pediatric oncology patients.
The study was designed to compare the analgesic efficacy of the local anesthetic EMLA when applied as a patch and as a cream in combination with a Tegaderm dressing to pediatric oncology patients undergoing repeated lumbar punctures. ⋯ The EMLA patch and the EMLA cream are equally effective in alleviating pain associated with lumbar puncture. The EMLA patch simplifies and speeds up the application of EMLA. It also allows for control of the dose administered per application, thus preventing both over- and underdosing.
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Regional anesthesia · Nov 1996
Randomized Controlled Trial Clinical TrialSubarachnoid neostigmine does not affect blood pressure or heart rate during bupivacaine spinal anesthesia.
Intraspinal administration of neostigmine has been shown to prevent induction of hypotension in rats by bupivacaine spinal block, and thus to provide greater hemodynamic stability. This study was undertaken to determine whether subarachnoid neostigmine would prevent bupivacaine spinal anesthesia from causing hypotension or bradycardia in patients undergoing abdominal hysterectomy. ⋯ A 75-micrograms subarachnoid neostigmine dose does not affect blood pressure or heart rate during bupivacaine spinal anesthesia.
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The use of regional anesthesia in patients receiving anticoagulants is controversial. The purpose of this review is to document the incidence of neurologic complications with insertion and removal of an epidural catheter in patients receiving oral anticoagulants and antiplatelet medication. ⋯ Epidural catheter placement and removal in patients taking oral anticoagulants appears to be safe. Careful monitoring of the patient for evidence of spinal hematoma after epidural catheter removal is recommended.
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Regional anesthesia · Nov 1996
Case ReportsEssential thrombocythemia and epidural analgesia in the parturient. Does thromboelastography help?
It is often considered that essential thrombocythemia contraindicates placement of an epidural catheter because of the danger of epidural hematoma. Thromboelastography offers a possible means of determining the appropriateness of epidural analgesia in a patient with this disorder. ⋯ Thromboelastography may be a useful diagnostic test in determining the suitability of regional techniques for labor analgesia in parturients with essential thrombocythemia. However, success in one patient does not prove the general safety of this approach.
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Regional anesthesia · Nov 1996
Review Comparative StudyCan regional anesthesia worsen outcome? Medicolegal risk.