Regional anesthesia
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Regional anesthesia · Nov 1996
Hemostasis-altering drugs and central neural block. A survey of anesthetic practice in Scotland and the United Kingdom.
There is debate regarding the use of central neural block in the presence of hemostasis-altering drugs. This study aims to examine current practice. ⋯ There is general agreement regarding contraindication of central neural block in the presence of full anticoagulation with either heparin or warfarin, but there is less consensus about the use of central neural block in the presence of low-dose subcutaneous heparin. There is some confusion about the role of aspirin and its duration of action.
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Regional anesthesia · Sep 1996
Case ReportsPeripheral nerve catheterization in the management of terminal cancer pain.
Peripheral nerve catheterization techniques were used in two patients with severe pain associated with the terminal stages of metastatic cancer. The first patient had severe upper limb pain and lymphedema secondary to breast carcinoma, and the second patient had an acutely ischemic leg secondary to pelvic obstruction from an ovarian tumor. The goal of treatment was to relieve the pain, which was resistant to opioid drugs, and to optimize the quality of life that remained, estimated to be only a few weeks. ⋯ Peripheral nerve catheterization proved beneficial in two patients who presented with difficult pain management problems and should be more widely considered for the relief of severe cancer-related pain in both the upper and lower limbs.
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Regional anesthesia · Sep 1996
Clinical TrialAnalgesic efficacy and side effects of subarachnoid sufentanil-bupivacaine administered to women in advanced labor.
Previous studies of labor analgesia using subarachnoid sufentanil (alone or with adjuvants) have focused on women in the early first stage of labor. This study prospectively evaluated analgesia and side effects of subarachnoid sufentanil (10 micrograms) plus bupivacaine (2.5 mg) in parturients with cervical dilation of 7 cm or more. ⋯ In parturients with cervical dilation of 7 cm or more, subarachnoid sufentanil-bupivacaine produces rapid analgesia with an effective duration of approximately 130 minutes.