Journal of clinical anesthesia
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Case Reports
Pediatric thoracic paravertebral block: roentgenologic evidence for extensive dermatomal coverage.
A case of a 10 year old boy who underwent a T10 continuous thoracic paravertebral block (TPVB) using a standard technique for postoperative pain management is reported. In the postoperative recovery area, 10 mL of Omnipaque contrast dye was injected through the catheter and an anteroposterior chest radiograph was performed. The radiograph showed longitudinal spread of contrast parallel to the spine from the T(4)-T(5) intervertebral disc to the T(10)-T(11) intervertebral disc with clear lateral extension of contrast along the fifth through the tenth intercostal nerves.
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A 2 month old, 51 kg female infant underwent neuraxial anesthesia for repair of a right inguinal hernia. After two unsuccessful attempts at obtaining free-flowing cerebrospinal fluid (CSF) in the L(3)-L(4) lumbar interspace with a 25-gauge (G) neonatal spinal needle, clear CSF was obtained using a Quincke 22-G needle. After easy aspiration, a total of 0.7 mL of 0.75% hyperbaric bupivicaine was injected intrathecally. ⋯ The bulge resolved over the next 48 hours. In the majority of neonates, CSF leaks into the epidural space after lumbar puncture. In our case, the patient showed CSF accumulation at the site of puncture.
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Editorial Comment
Bilateral total knee arthroplasties: a call for practice guidelines.
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To determine whether financial incentives given to faculty members for favorable teaching scores improve the quality of clinical education. ⋯ A productivity-based faculty compensation system did not appear to influence faculty OR teaching scores.