Regional anesthesia
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Regional anesthesia · Sep 1997
Clinical TrialSuperficial and deep cervical plexus block for carotid artery surgery: a prospective study of 1000 blocks.
Cervical plexus blocks are performed for carotid surgery to allow neurological assessment of the awake patient. The aim of this study was to establish the frequency of success, complications, and patient acceptance of the technique. ⋯ We conclude that superficial and deep cervical plexus block has a high success rate, low complication rate, and high patient acceptance rate. Caution should, however, be exercised to ensure a low intravascular injection rate which is of most concern with this technique, because blood was aspirated in 30% of patients during performance of the block.
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Regional anesthesia · Sep 1997
Clinical TrialCulture of bacteria from lumbar and caudal epidural catheters used for postoperative analgesia in children.
Continuous epidural analgesia has been used with increasing frequency to provide postoperative pain relief for children. Epidural space infection is a potential complication of epidural catheter placement. This study investigated the incidence of bacterial colonization on lumbar and caudal epidural catheter tips in postoperative pediatric patients. ⋯ The results of this study suggest that the risk of clinical epidural infection associated with caudal or lumbar postoperative catheters is low. However, the incidence of epidural catheter tip colonization is increased with the caudal route of insertion, and the bacteria differ from those cultured from the lumbar insertion site.
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Regional anesthesia · Sep 1997
Case ReportsContinuous parasacral sciatic nerve block: two case reports.
This study investigated the use of a continuous parasacral sciatic nerve block for anesthesia and postoperative analgesia for lower extremity surgery. ⋯ We conclude that continuous parasacral sciatic nerve block can provide anesthesia and long-term analgesia for operative procedures of the foot and leg.
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Regional anesthesia · Sep 1997
Case ReportsAdrenocorticotropic hormone infusion as a novel treatment for postdural puncture headache.
In two patients, one scheduled for epidural anesthesia and the other for placement of a spinal catheter for operative procedures, severe postdural puncture headache developed and was refractory to conservative therapy. ⋯ A single treatment with ACTH may offer an alternative therapy in the treatment of postdural puncture headache.
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Regional anesthesia · Sep 1997
Case ReportsUnexplained neurologic deficit after uneventful combined spinal and epidural anesthesia for cesarean delivery.
Neurologic deficits after spinal and epidural anesthesia are uncommon and have a variety of pathophysiologic mechanisms. Local anesthetic neurotoxicity may occur, although subarachnoid bupivacaine has an unblemished clinical record. ⋯ Drug-induced neurotoxicity is a possible explanation, although the exact etiology is uncertain.