Regional anesthesia and pain medicine
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Epidural catheters are seldom difficult to remove from patients. In fact, a review of the literature demonstrates only a few cases pertaining to epidurals and the unusual complication of catheter entrapment. ⋯ This case report involves an uncomplicated obstetric patient who had an epidural placed for labor and in whom multiple attempts were needed to remove the catheter.
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Reg Anesth Pain Med · Nov 1998
Spinal cord neural anatomy in rats examined by in vivo magnetic resonance microscopy.
Magnetic resonance microscopy (MRM) is a technique that is worthwhile for anesthesiologists because it allows spinal cord and plexus anatomy to be visualized three dimensionally and followed over time in the same animal. For example, the long-term effect of indwelling intrathecal or plexus catheters can be studied in situ, and convective and diffusive forces within intrathecal, epidural, or nerve sheath spaces can be investigated. Further, diffusion-weighted MRM, which measures an "apparent diffusion coefficient" (ADC), can be used to track the presence of ischemia, hypoperfusion, or cytotoxic edema. This study investigates problems associated with the use of in vivo MRM for spinal cord and peripheral nerve studies in the rat. ⋯ Three-dimensional diffusion-weighted MRM displays cervical and lumbar spine anatomy accurately in vivo. Apparent diffusion coefficients measurements are feasible in rat cervical spinal cord with intrathecal catheters. Spinal cord ADCs are unaffected by intrathecal catheters, indicating normal spinal cord perfusion.
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Reg Anesth Pain Med · Nov 1998
Letter Case Reports Randomized Controlled Trial Clinical TrialIntrathecal ropivacaine in cancer pain.
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Reg Anesth Pain Med · Nov 1998
Randomized Controlled Trial Comparative Study Clinical TrialClonidine added to bupivacaine-epinephrine-sufentanil improves epidural analgesia during childbirth.
A double-blind study was conducted to assess the efficacy and the side effects of a low dose of clonidine added to an epidural injection of bupivacaine and epinephrine, with or without sufentanil. ⋯ The addition of a low dose of clonidine to an epidural injection of bupivacaine with epinephrine and sufentanil provides better analgesia during labor, while keeping the side effects minimal and of minor clinical importance.
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Reg Anesth Pain Med · Nov 1998
Randomized Controlled Trial Comparative Study Clinical TrialUltrasonographic guidance reduces the amount of local anesthetic for 3-in-1 blocks.
Recently it has been demonstrated that the use of ultrasound (US) improves the onset time and the quality of sensory block for 3-in-1 blocks compared with conventional nerve stimulator (NS) techniques. The present study was designed to evaluate if US guidance for 3-in-1 blocks reduces the amount of local anesthetic compared to NS guidance. ⋯ The amount of local anesthetic for 3-in-1 blocks can be reduced by using US guidance compared with the conventional NS-guided technique.