Journal of clinical anesthesia
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To describe the use and adverse effects of chloroprocaine for epidural analgesia in young infants for infusion durations greater than 3.5 hours. ⋯ Epidural 1% chloroprocaine, in doses of 0.4-3 mL/h (1.5-6.1 mg/kg per hour), was well tolerated in both mechanically ventilated and spontaneously breathing infants for up to 96 hours with no identified adverse effects or tachyphylaxis.
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To evaluate changes in cerebral tissue oxygen index (TOI) values under the beach chair position before and during general anesthesia in surgical patients with or without cardiovascular risk factors. ⋯ The beach chair position under general anesthesia did not alter cerebral oxygenation in patients with or without cardiovascular risk factors showing normal preoperative cerebral TOI values when the mean blood pressure was maintained above 60 mm Hg. The careful management using the cerebral oxygenation monitoring appears to maintain cerebral perfusion in the beach chair position during general anesthesia.
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Catastrophic complications have been reported for selective cervical nerve root block (SCNRB) or pulsed radiofrequency (PRF) via an anterolateral transforaminal approach. A posterior approach to these procedures under computed tomography guidance has been reported. Here, we report the clinical outcomes of 42 patients with chronic cervical radicular pain (CCRP) treated with a combination of SCNRB and PRF through a posterior approach under fluoroscopy guidance. ⋯ The posterior approach to combined SCNRB and PRF under fluoroscopy guidance appears to be safe and efficacious in the management of CCRP.
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Case Reports
Persistent cauda equina syndrome after cesarean section under combined spinal-epidural anesthesia: a case report.
A 29-year-old pregnant woman was delivered by cesarean section under a combined spinal-epidural anesthesia. Thirty hours after an uneventful surgery, she complained of weakness in her lower extremities and developed fecal and urinary incontinence. ⋯ Most of the symptoms resolved within a few days, but right side foot drop persisted for 2 years after the procedure. Because there was no other etiologies being noticed, we hypothesized that the hyperbaric bupivacaine neurotoxicity was likely to be the cause for this neurologic deficit.
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Comment Letter
A left bevelled tube is easier inserted from the right side.