Regional anesthesia
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Regional anesthesia · Jul 1993
Randomized Controlled Trial Comparative Study Clinical TrialPDPH in obstetric anesthesia: comparison of 24-gauge Sprotte and 25-gauge Quincke needles and effect of subarachnoid administration of fentanyl.
Postdural puncture headache (PDPH) is a frequent complication of spinal anesthesia. Some investigators have recommended the use of the Sprotte needle to reduce the incidence of this serious complication. This study prospectively compared the incidence of PDPH with two spinal needles of different size and design: the 24-gauge Sprotte (noncutting point) versus the 25-gauge Quincke (diamond, cutting point). The hypothesis that subarachnoid fentanyl will reduce the incidence of PDPH, as suggested in the literature, was also studied. ⋯ In the current study, the use of the 24-gauge Sprotte spinal needle resulted in a low incidence of severe PDPH, but was not significantly different when compared with the use of a 25-gauge Quincke needle (oriented parallel to the longitudinal dural fibers). The addition of fentanyl to hyperbaric bupivacaine spinal anesthesia did not reduce the risk of PDPH.
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Regional anesthesia · Jul 1993
Randomized Controlled Trial Clinical TrialLack of peripheral analgesic effect of low-dose morphine during intravenous regional anesthesia.
To determine whether 1 mg morphine injected intravenously in conjunction with prilocaine has any effect on postoperative pain and analgesic requirement during intravenous regional anesthesia. ⋯ The authors conclude that 1 mg morphine showed no effect on postoperative pain or analgesic requirements when given in conjunction with prilocaine during intravenous regional anesthesia.
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Regional anesthesia · Jul 1993
Randomized Controlled Trial Clinical TrialEffects of intraarticular morphine on analgesic requirements after anterior cruciate ligament repair.
Intraarticular morphine has been shown to provide postoperative pain relief after knee arthroscopy. The analgesia results from local action within the knee joint. This study was conducted to assess the efficacy of intraarticular morphine as a treatment for postoperative pain after anterior cruciate ligament repair. ⋯ Intraarticular morphine reduces analgesic requirements after anterior cruciate ligament repair and is an effective method of providing postoperative analgesia.
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Regional anesthesia · Jul 1993
Multicenter Study Clinical TrialAtraucan: a new needle for spinal anesthesia.
Atraucan 26-gauge spinal needles have a tip designed to make a small linear cut (as opposed to a V-shaped cut) in the dura mater. The cut is shorter than the outside diameter of the needle and is dilated as the needle passes through the dura. The needle is used with a 20-gauge introducer. In vitro, it causes less leakage of cerebrospinal fluid than Quincke 26-gauge or Sprotte 24-gauge needles. This study was designed to test the ease of use and any damage caused to the needle tip during lumbar dural puncture. ⋯ The Atraucan needle is easy to use and has a high success rate in identifying the subarachnoid space. Lumbar dural puncture causes minimal damage to the tip. The incidence of PDPH is low, but a larger comparative study needs to be performed.