Regional anesthesia
-
Regional anesthesia · Nov 1996
Randomized Controlled Trial Clinical TrialIncidence of tissue coring with the 25-gauge Quincke and Whitacre spinal needles.
Tissue cores, implanted into the subarachnoid space during subarachnoid injections, can develop into intraspinal lumbar epidermoid tumors. The availability of smaller needles has made spinal anesthesia more popular. Therefore, this prospective, randomized, blinded study was undertaken to determine whether tissue coring occurs with two of the currently used 25-gauge spinal needles. ⋯ The 25-gauge Quincke and 25-gauge Whitacre spinal needles currently used in anesthesia can produce tissue coring.
-
Regional anesthesia · Nov 1996
Randomized Controlled Trial Clinical TrialLidocaine-clonidine retrobulbar block for cataract surgery in the elderly.
Clonidine, an alpha-2-adrenoreceptor agonist, has been shown to decrease intraocular pressure (IOP) and to have some analgesic and sedative effects when it is used in premedication for ophthalmic surgery. This study was designed to investigate the efficacy of lidocaine-clonidine retrobulbar block for cataract surgery with respect to its effect on IOP, analgesic action, and sedative effects. ⋯ Addition of clonidine to lidocaine for retrobulbar block causes a decrease in intraocular pressure, a sedative effect, and an increased duration of analgesia and akinesia, with relatively stable hemodynamic parameters.
-
Regional anesthesia · Nov 1996
ReviewEpidural opioid delivery methods: bolus, continuous infusion, and patient-controlled epidural analgesia.
Multiple methods of delivery of epidural opioids are acceptable, including bolus injection, continuous infusion, and patient-controlled infusion. The incidence of side effects appears to be reduced with the use of continuous infusion techniques, especially with the liquid-soluble opioids, although these appear to be most effective when infused near the center of the dermatomal pain site. with more distant catheters, the water-soluble opioids are more effective, but there use is associated with more frequent side effects. The lowest dose requirement appears to be associated with PCEA, but further study is needed to confirm the theoretical safety and efficacy of this modality, especially if a constant background infusion is used along with the PCEA. At present, significant advantages appear to be obtainable by adding local anesthetic to the opioid infusion, but the ideal drug and dosage are yet to be determined.