Regional anesthesia
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The authors report the use of multiple implanted intraspinal port and catheter systems per test animal to study the in vivo functional characteristics and reliability of a new implantable spinal drug delivery port system. ⋯ The implantable intraspinal port system tested functions reliably under repetitive percutaneous access. However, filtering such ports, though desirable to prevent entry of debris into the spinal canal, did not eliminate pericatheter chronic subarachnoid and epidural reaction. The number of test animals required to test 12 ports chronically was reduced by two-thirds without undue trauma to the individual test subject. Chronic percutaneous injection of an implanted subarachnoid system is feasible but may be associated with behavioral effects similar to that seen with chronic epidural systems. Fibrosis around chronic silicone catheters limited functional utility in one-fourth of the implanted test systems. Further study of the potential reactivity of chronic epidural and subarachnoid catheters is indicated.
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Regional anesthesia · Jul 1993
Case ReportsSupraventricular tachycardia in a parturient under spinal anesthesia.
A 30-year-old woman with a history of palpitations was admitted for a repeat cesarean delivery at 41 weeks' gestation. Spinal anesthesia was administered. ⋯ Phenylephrine may be used successfully for the treatment of SVT that results in hypotension under spinal anesthesia, and it may have advantages over ephedrine.
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Regional anesthesia · Jul 1993
Case Reports Comparative StudyRectus block for postoperative pain relief.
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Regional anesthesia · May 1993
Randomized Controlled Trial Comparative Study Clinical TrialContinuous spinal anesthesia: does low-dose plain or hyperbaric bupivacaine allow the performance of hip surgery in the elderly?
This study was designed to assess the predictability of 5 mg bupivacaine to give a T10 sensory level when injected subarachnoid in elderly patients. ⋯ The authors conclude that 5 mg bupivacaine is too high a dose in the elderly to limit the sensory blockade at T10 and avoid hypotension. In elderly patients, this dose allowed surgery to be performed, provided that the sensory level reached T10. When the initial dose only affects lumbar dermatomes, a caudal direction of the catheter must be evoked, and changing position must be preferred to incremental injections to reach thoracic levels.