Regional anesthesia
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Regional anesthesia · May 1997
Comparative StudyComparison of accuracy and cost of disposable, nonmechanical pumps used for epidural infusions.
Temporary epidural catheter pumps are used to infuse analgesics in patients with chronic intractable pain. Three brands of disposable, nonmechanical pumps adapted for epidural infusion were tested to determine their flow rate efficacy and their cost effectiveness. ⋯ All three units deviated considerably from the claimed flow rate of 2-mL/h, both at the beginning and at the end of the infusion. Presumably, the decreasing flow rates are responsible for the diminishing pain relief often experienced by patients over the course of the infusion. The Homepump unit appeared to be the most cost-effective and the easiest to handle and maintained an acceptable infusion rate for the greatest percentage of the infusion period. The considerable cost benefit of using a nonmechanical disposable pump as opposed to a costly but more reliable computerized pump appears to warrant further product improvement and development.
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Regional anesthesia · May 1997
Case ReportsSurvey of regional anesthetic practice among French residents at time of certification.
A survey of anesthesia practice was conducted among French residents in anesthesia at the end of their training. This study was performed mainly to evaluate the residents' experience in peripheral nerve blocks. ⋯ French residents in anesthesiology at time of certification are better trained for peripheral nerve blocks of the upper extremity than for those of the lower extremity. Axillary plexus and femoral nerve block are the most widely used blocks, probably reflecting the techniques the most mastered among teachers. Finally, the extensive use of a peripheral nerve stimulator by residents is probably the result of the widespread use of this device by teachers in France.
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Regional anesthesia · May 1997
Effect of subarachnoid gabapentin on tactile-evoked allodynia in a surgically induced neuropathic pain model in the rat.
Spinal gamma-aminobutyric acid (GABA) receptors have been shown to modulate post-nerve injury-induced allodynia. This study sought to examine the antiallodynic effects of a GABA analog gabapentin [1-(aminomethyl)cyclohexaneacetic acid], given by subarachnoid injection in a rat neuropathic pain model. ⋯ Gabapentin shows antiallodynic effect, but its mechanism is not known. The failure to reverse this effect by GABA A or B antagonists at doses that reverse the effects of the respective agonists suggests that gabapentin is involved in the modulation of spinal systems by mechanisms that do not involve either a GABA A or a GABA B site.
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Regional anesthesia · May 1997
Editorial CommentQA in regional anesthesia training: quantity or quality?