Regional anesthesia
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Regional anesthesia · Jul 1996
Case ReportsEpidural hematoma after epidural anesthesia in a patient with peripheral vascular disease. Case report.
Epidural hematoma is a severe, uncommon complication associated with epidural anesthesia in patients with peripheral vascular disease who require anticoagulant therapy. ⋯ This case highlights the need for careful individual preoperative analysis and postoperative observation to make anesthetic practice safe in patients receiving perioperative anticoagulant therapy.
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Regional anesthesia · Jul 1996
Case ReportsSuccessful use of epidural blood patch for postdural puncture headache following lumbar sympathetic block.
A 21-year-old man was scheduled for a diagnostic lumbar sympathetic block for reflex sympathetic dystrophy of the right lower extremity. ⋯ Postdural puncture headache resulting from leakage of cerebrospinal fluid through a punctured dural sleeve may be successfully treated with an epidural blood patch should more conservative treatments fail.
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Regional anesthesia · Jul 1996
Case ReportsPressure sores as a complication of patient-controlled epidural analgesia after cesarean delivery. Case report.
Postoperative epidural analgesia using mixtures of bupivacaine and opioids has become common practice following abdominal surgery. Side effects such as hypotension, motor block, respiratory depression, pruritus, and urinary retention are well known. Pressure sores occurring within the first 24 hours are extremely rare. ⋯ Pressure sores following postoperative epidural analgesia may occur even in young patients. Although bupivacaine may induce a motor block, its combination with other drugs in the analgesic mixture or other contributing factors may explain the occurrence of pressure sores. Prophylaxis and increased alertness should eliminate this complication.
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Regional anesthesia · Jul 1996
Editorial Comment Comparative StudyIs an ounce of preoperative local anesthetic better than a pound of postoperative analgesic?