Regional anesthesia
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Regional anesthesia · Sep 1996
Case ReportsContinuous spinal anesthesia for cesarean delivery in a patient with arthrogryposis multiplex congenita. A clinical report.
Arthrogryposis multiplex congenita (AMC) is a syndrome, diagnosed at birth, which presents with multiple joint contractures. Because this disease often progresses until there is dysfunction of multiple organ systems, it may have an impact on the anesthetic management. There are few anesthetic reports of this disease in the adult pregnant patient. ⋯ Continuous spinal anesthesia can be safely used for cesarean delivery in patients with AMC in the presence of appropriate monitoring.
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Regional anesthesia · Sep 1996
Clinical TrialSpinal clonidine fails to provide surgical anesthesia for transurethral resection of prostate. A dose-finding pilot study.
This study was designed to determine whether subarachnoid clonidine administration alone results in surgical anesthesia for transurethral resection of the prostate. ⋯ Subarachnoid clonidine cannot be reliably used as the sole agent for spinal anesthesia, since general anesthesia is often required or deep sedation occurs. Increasing doses of clonidine do not prolong postoperative analgesia. Thus, clonidine could be used as a spinal analgesic but not as a spinal anesthetic.
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Regional anesthesia · Sep 1996
A multivariate model to predict the distance from the skin to the epidural space in an obstetric population.
Several attempts to relate epidural space depth to individual patient parameters or details of technique have yielded modest correlations. An attempt has been made to construct a multivariate model to predict the depth from the skin of the epidural space with use of several such factors. ⋯ While this model is the best predictor of epidural space depth yet published, it is probably not sufficiently accurate to be clinically useful in confirming proper epidural catheter placement. Further work in this area is probably not justified.
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The object of this study was to measure the clinically relevant depth of the posterior epidural space (ES) while placing subarachnoid catheters. ⋯ The posterior ES has been found to be somewhat larger and more variable than previously described. The findings provide clinical confirmation of recent radiologic and cadaveric studies, which portray a posterior ES of variable size and complex shape. These findings have implications for cannulation and use of epidural therapy as well as for the combined catheter epidural and single-dose spinal technique.
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Regional anesthesia · Sep 1996
Epidural anatomy examined by cryomicrotome section. Influence of age, vertebral level, and disease.
Cryomicrotome section is a means of anatomic examination with minimal artifact ideally suited to delineating details of tissue relationships in the epidural space. In the past, healthy adult lumbar levels have been studied by this method. This report extends observations to other regions of the vertebral column, other age groups, and some abnormal conditions. ⋯ Variations in epidural anatomy due to vertebral level, age, and disease may alter the ease of epidural entry and passage of catheters and injected solution.