Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2000
Randomized Controlled Trial Clinical TrialEfficacy of oral mexiletine for neuropathic pain with allodynia: a double-blind, placebo-controlled, crossover study.
Mexiletine is an oral sodium channel antagonist that has been reported to be effective in a variety of neuropathic pain syndromes. However, recent reports question the efficacy of oral mexiletine in neuropathic pain. The objectives of this study were to examine the effect of oral mexiletine on pain, neurosensation, allodynia, and quality of life. ⋯ At doses of up to 900 mg/d, mexiletine has minimal effects on pain and allodynia of neuropathic pain. However, side effects may preclude higher doses.
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Reg Anesth Pain Med · Sep 2000
ReviewMaternal fever, neonatal sepsis evaluation, and epidural labor analgesia.
Numerous studies have found an association between epidural analgesia for labor and maternal fever (temperature > or =38 degrees C). Maternal fever often results in treatment with maternal or neonatal antibiotics, neonatal sepsis evaluation, and increased costs. ⋯ Maternal epidural labor analgesia is associated with maternal fever and possibly increased neonatal sepsis evaluation. There is no proof the relationship is causal.
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Reg Anesth Pain Med · Sep 2000
Randomized Controlled Trial Clinical TrialAlkalinized lidocaine and bupivacaine with hyaluronidase for sub-tenon's ophthalmic block.
Alkalinization of local anesthetics has been shown to decrease the onset and prolong the duration of block for extraconal and intraconal application in ocular surgery. The objective of this study is to determine if alkalinization is also effective in sub-Tenon's block when hyaluronidase is added to the drug mixture. ⋯ pH adjustment of the local anesthetic mixture of lidocaine, bupivacaine, and hyaluronidase offered no additional benefit in sub-Tenon's technique in ocular procedures.
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Reg Anesth Pain Med · Sep 2000
Technical aspects and postoperative sequelae of spinal and epidural anesthesia: a prospective study of 3,230 orthopedic patients.
Major complications after spinal or epidural anesthesia are extremely rare. The occurrence of less serious and transient sequelae and complaints may be underestimated if there is no established organization for the systematic and continuous surveillance of patients after anesthesia. This study was designed to evaluate the possible relationship between various block-related occurrences and the intra- and postoperative side effects and complaints. ⋯ Although sensory changes were quite frequent, they were mild and transient. Rather than having been caused by the anesthetic technique, per se, a "nonanesthetic" reason (position, tourniquet, immobilization) should also be considered as their origin. Sensory disturbances, as well as strong pain for at least a week, were reported by several patients, and to become aware of these problems and improve the quality of treatment, a universal regional anesthesia follow-up system is recommended.
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Reg Anesth Pain Med · Sep 2000
Effect of clonidine on upper extremity tourniquet pain in healthy volunteers.
Tourniquet pain is often a limiting factor during intravenous regional anesthesia (IVRA). The purpose of this study was to evaluate the efficacy of 1 microg/kg of clonidine added to IVRA-lidocaine in decreasing the onset of severe tourniquet pain. ⋯ This study shows that the addition of 1 microg/kg of clonidine to 40 mL of 0.5% IVRA-L delays the onset time of tourniquet pain in healthy, unsedated volunteers.