Regional anesthesia
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Regional anesthesia · May 1997
Letter Historical ArticleThe evolution of combined spinal-epidural anesthesia needles.
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Regional anesthesia · May 1997
Clinical TrialSingle-injection lumbar epidural morphine for postoperative analgesia in children: a report of 175 cases.
Since the first report of epidural opioid administration to pediatric patients, several studies have described the quality of analgesia, doses, pharmacokinetics, and side effects of this procedure. A pediatric series using an easy and cheap single-injection technique of epidural morphine administration for postoperative analgesia is presented. ⋯ This technique is easy to perform, even for trainees in anesthesiology. With appropriate patient selection and avoidance of the concomitant use of narcotics and sedatives, epidural morphine provides prompt, effective, safe, and prolonged analgesia in children.
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Regional anesthesia · May 1997
Case ReportsThermal grill illusion and complex regional pain syndrome type I (reflex sympathetic dystrophy).
In normal humans, placing a hand on a thermal grill containing warm elements separated by cool ones produces a burning sensation. In this case report, responses to a thermal grill in a patient with neuropathic pain were examined. ⋯ The thermal grill may be a useful a tool to help understand the pathophysiology of complex regional pain syndrome type I.
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The clinical utility of a new parasacral approach for conduction block of the sciatic nerve was investigated, with critical examination of onset, extent, and success rates when this block was used for surgical procedures below the knee. ⋯ The parasacral approach to the sciatic nerve exhibits a high success rate, resulting in anesthesia of the entire sacral plexus and generally in motor block of the obturator nerve was an interesting observation.
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Regional anesthesia · May 1997
Case ReportsPhantom pain with probable reflex sympathetic dystrophy: efficacy of fentanyl infiltration of the stellate ganglion.
The stellate ganglion can alleviate phantom pain of the upper extremity, possibly because of the presence in it of enkephalin receptors, as has been suggested by experimental and clinical reports. A case is reported in which fentanyl, instead of local anesthetic, was used for stellate ganglion block. ⋯ Fentanyl infiltration of the stellate ganglion proved to be successful in the management of the pain and temperature sensation changes in the stump and phantom upper extremity.