Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Case Reports
Complications of peripheral nerve catheter removal at home: case series of five ambulatory interscalene blocks.
The placement of continuous peripheral nerve catheters on an ambulatory basis is increasing and is routine at our institution. There are few reports of complications associated with peripheral nerve catheter removal in the literature. Described herein is a case series of five patients where complications related to catheter withdrawal were observed. ⋯ There can be various causes for difficulty with catheter removal, such as a technical aspect of catheter placement, catheter design, tissue reaction at the catheter site, or a combination thereof. The majority of complications related to outpatient perineural catheters can be handled over the telephone, but our case series may highlight a potential management dilemma in placing continuous stimulating perineural catheters on an ambulatory basis.
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Comparative Study
Systemic dextromethorphan and dextrorphan are less toxic in rats than bupivacaine at equianesthetic doses.
Dextrorphan, a major metabolite of dextromethorphan, produces the duration of spinal and cutaneous anesthesia similar to bupivacaine. The purpose of this study was to test the central nervous system and cardiovascular toxicity of bupivacaine, dextromethorphan, and dextrorphan. ⋯ At equipotent doses for local anesthesia, dextromethorphan and dextrorphan were less likely than bupivacaine to induce central nervous system and cardiovascular toxicity.
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Editorial Comment
Novelty without toxicity: a quest for a safer local anesthetic.