Regional anesthesia
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Regional anesthesia · Jan 1995
Case Reports Clinical TrialRadiofrequency lumbar sympatholysis. The evolution of a technique for managing sympathetically maintained pain.
To develop lumbar radiofrequency sympatholysis for the relief of pain in patients with neuropathic pain who had previously responded to sympathectomy or sympathetic blocks. ⋯ A single technique of radiofrequency sympatholysis does not appear to be applicable to all patients with reflex sympathetic dystrophy or sympathetically maintained pain. Despite early successful sympathetic block with radiofrequency, as confirmed by a warm foot, long lasting pain relief was difficult to obtain. The author concludes that individualized patient management is necessary when considering radiofrequency sympatholysis in the treatment of patients with sympathetically maintained pain.
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Regional anesthesia · Jan 1995
Clinical TrialProlonged PR interval is a risk factor for bradycardia during spinal anesthesia.
Bradycardia occurs during 9%-13% of spinal anesthetics and may lead to cardiac arrest. Several risk factors for the development of bradycardia have been identified, but the risk conferred by presence of abnormalities detected on preoperative electrocardiogram (ECG) has not been examined. The authors undertook the study to correlate abnormal ECG findings with the incidence of bradycardia. ⋯ Risk factors previously identified for the development of bradycardia during spinal anesthesia include: baseline heart rate < 60 bpm, ASA physical status 1 versus 3 or 4, use of beta-blocking drugs, sensory block height > or = T5, and age < 50. The results demonstrate that prolonged PR interval on the preoperative ECG is another significant and independent predictor for bradycardia.
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Regional anesthesia · Jan 1995
Clinical Trial Controlled Clinical TrialHemodynamic effects of 0.375% versus 0.25% bupivacaine during cervical epidural anesthesia for hand surgery.
Cervical epidural anesthesia with 0.375% or 0.25% bupivacaine plus fentanyl is a reliable technique for surgical restoration of digital motion-after tourniquet release and rehabilitation. The study was designed to assess the hemodynamic effects of this technique in 11 ASA 1 patients. ⋯ Hemodynamic effects, in ASA 1 patients, are moderate and not dependent on the studied concentration of bupivacaine, indicating that a similar degree of sympathetic block is achieved with 0.375% and 0.25% bupivacaine.