Regional anesthesia
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Regional anesthesia · Nov 1994
Case ReportsDelayed respiratory arrest in combined spinal-epidural anesthesia. Case report.
A case of delayed respiratory arrest in the combined spinal-epidural anesthesia (CSEA) is described. This event was likely due to morphine injected through the epidural catheter, unintentionally entering into the subarachnoid space through the hole in the dura that was made previously by the spinal needle in the needle-through-needle technique. ⋯ Careful attention to technique is necessary with utilization of CSEA.
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Regional anesthesia · Nov 1994
Letter Clinical Trial Controlled Clinical TrialPrevention of epidural morphine pruritus by intramuscular promethazine in parturients.
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Regional anesthesia · Nov 1994
Randomized Controlled Trial Clinical TrialEpidural catheters for obstetrics. Terminal hole or lateral eyes?
Controversy exists over the choice of the ideal epidural catheter for obstetric use, particularly whether the catheter should have a single terminal hole or three lateral eyes. ⋯ The use of terminal eye epidural catheters in our obstetric patients has led to an unacceptably high incidence of both unsatisfactory blocks and catheter replacement. Lateral eye catheters produced better results in our circumstances.
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Regional anesthesia · Sep 1994
Case ReportsSubdural anesthesia as a complication of an interscalene brachial plexus block. Case report.
Interscalene brachial plexus block is performed in the groove between the anterior and middle scalene muscles at the level of C6, just over the transverse process. Injection occurs within 1-2 cm of the dural sleeve and could be misdirected into the epidural, subdural, or subarachnoid spaces. ⋯ The case represents a partial injection of local anesthetic intended for the interscalene brachial plexus into the subdural space. The diagnosis is based on the normal evolution of the block into full motor and sensory anesthesia of the ipsilateral brachial plexus that evolved into a patchy, sensory, and motor block involving many dermatomes outside the brachial plexus, with minimal sympathetic block, and evidence of a normal interscalene block on emergence from general anesthesia. Subdural injection must be considered when unusual motor and sensory block occurs after interscalene block, especially after a time interval too long for epidural or subarachnoid injection, or with minimal evidence of sympathetic block, after suspected high central block injection.
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Regional anesthesia · Sep 1994
Comment Letter Case ReportsCombined spinal-epidural anesthesia in parturient with Harrington rods.