Regional anesthesia
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Regional anesthesia · Sep 1992
Case ReportsHeadache from intracranial air after a lumbar epidural injection: subarachnoid or subdural?
There is a growing awareness of the possibility of headache resulting from intracranial air secondary to identification of the epidural space by loss of resistance using air (LOR-A). Most reported cases have been attributed to subarachnoid air passage. A case is described of sudden headache following LOR-A. ⋯ Recovery was uneventful.
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Regional anesthesia · Sep 1992
Randomized Controlled Trial Comparative Study Clinical TrialTechnical and light microscopic comparison of four different small-diameter catheters used for continuous spinal anesthesia.
Recently several manufacturers developed ultra-thin catheters for continuous spinal anesthesia. Their use may be associated with technical problems. ⋯ The use of the 32-gauge polyurethane catheter was associated with problems that limit its clinical usefulness. Nylon and polyimide catheters with stainless steel stylets were more resistant to stretching. The nylon catheter was most resistant to adhesion of fibrinous material.
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Regional anesthesia · Sep 1992
Brachial plexus block with the nerve stimulator: motor response characteristics at three sites.
Differences in motor response patterns, minimum electrical currents, and success rates using a nerve stimulator for brachial plexus block were determined for the interscalene, supraclavicular, and axillary approaches. ⋯ Localization of the brachial plexus with the nerve stimulator is equally effective at the interscalene, supraclavicular, and axillary sites. Current values in the range reported have no predictive value for success. Advantages of the nerve stimulator for brachial plexus block include an objective endpoint and continuous feedback.
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Regional anesthesia · Sep 1992
Continuous pump pressures cannot be used to identify catheter tip migration into the subarachnoid space.
Migration of an epidural catheter into the subarachnoid space is a potentially lethal complication of continuous epidural anesthesia. We evaluated the use of pump pressure measurement during infusion in detecting such an occurrence. ⋯ We conclude that epidural and subarachnoid space resistance is essentially zero and the pump pressure in the system is used to overcome the catheter resistance. Both spaces offer the same total resistance to infusion and, therefore, pump pressure will not change when a catheter migrates into the subarachnoid space.