Regional anesthesia
-
Regional anesthesia · May 1993
Randomized Controlled Trial Comparative Study Clinical TrialPostdural puncture headache: comparison of 25-gauge Whitacre and Quincke needles.
To evaluate the influence of the shape of the needle tip on postdural puncture headache (PDPH) independent of the needle diameter, a 25-gauge Whitacre and a 25-gauge Quincke needle were compared. ⋯ The use of a conical tipped Whitacre needle results in significantly less PDPH compared to a standard Quincke spinal needle of the same size.
-
Regional anesthesia · May 1993
Randomized Controlled Trial Comparative Study Clinical TrialEpidural clonidine decreases postoperative requirements for epidural fentanyl.
This study assesses the possibility that clonidine may decrease analgesic opioid demand in postoperative patients. ⋯ The combination of clonidine to epidural fentanyl allows a decrease in opioid requirements without impairing analgesia. Reduction of opioids administration may have beneficial effects on respiratory function in postoperative patients.
-
To determine the length of needle that should be advanced beyond the distance to the lateral pterygoid plate to reach the mandibular nerve. ⋯ There is no osteologic basis to advance the needle beyond the distance to the lateral pterygoid plate to reach mandibular nerve. However, because the needle may contact the nerve at variable points rather than the shortest distance to the nerve, the needle may be advanced by 0.07 cm on the right and 0.11 cm on the left side in patients. This increase is much less than that indicated in the standard textbooks. Therefore, while performing mandibular nerve block, we suggest caution in advancing the needle beyond the distance to lateral pterygoid plate.
-
Regional anesthesia · May 1993
Case ReportsSuccessful spinal anesthesia after inadequate epidural block in a parturient with prior surgical correction of scoliosis.
Lumbar epidural anesthesia is safe in patients with previous spinal surgery, but it is not always successful or easily performed. ⋯ After letting the epidural block recede below the lumbar level, a successful spinal anesthetic was administered producing a sensory level to T4.
-
Regional anesthesia · May 1993
Case ReportsPneumocephalus after accidental dural puncture during epidural anesthesia.
BACKGROUND. Pneumocephalus developed in a 45-year-old woman after epidural anesthesia was performed to treat her low back pain. The cause was thought to be the loss of resistance to air technique. ⋯ These symptoms disappeared during the first 24 hours with no neurologic sequelae. CONCLUSION. This case suggests that using the loss of resistance technique with saline versus air should prevent this complication, especially after unintentional dural puncture or when, in difficult placements, the technique is repeated frequently in the same patient.