Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Nov 1999
The incidence of tissue coring during the performance of caudal injection in children.
The performance of caudal injection (CI) has become a routine part of pediatric anesthesia. The intraoperative and immediate postoperative complications of CIs have been reported extensively. Although the long-term consequences of CI are unknown, they may include the development of epidermoid tumors in the spinal canal. Such tumors have been attributed to tissue coring (the process by which pieces of tissue are removed by a needle as it passes through the tissue) and the subdural deposition of such tissue. ⋯ These findings suggest that technical modifications may improve patient safety. The results also have implications for long-term follow-up of caudal anesthetics. Techniques for reducing the incidence of tissue coring during the performance of CI are discussed.
-
Reg Anesth Pain Med · Nov 1999
Randomized Controlled Trial Clinical TrialIntravenous lidocaine, amantadine, and placebo in the treatment of sciatica: a double-blind, randomized, controlled study.
Sciatica is a neuropathic pain syndrome caused by compression and/or inflammation of spinal nerve roots by herniated disc material, and its treatment is therefore usually aimed at reducing compression and inflammation. Studies have shown that both systemic local anesthetics and N-methyl-D-aspartate (NMDA) receptor antagonists may produce analgesia in a variety of neuropathic pain syndromes. The present study evaluated the analgesic efficacy of i.v. infusions of the local anesthetic lidocaine, the NMDA receptor antagonist amantadine, and a placebo in sciatica. ⋯ Intravenous lidocaine, rather than amantadine, reduces both spontaneous and evoked sciatic pain.