Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2002
Case ReportsVertebral osteomyelitis and psoas abscess occurring after obstetric epidural anesthesia.
Back pain and infectious complications occasionally occur after epidural anesthesia in obstetrics, and accurate diagnosis can be difficult. We report a patient who developed low back pain soon after obstetric epidural anesthesia and was diagnosed 6 months later with lumbar vertebral osteomyelitis, discitis, and a psoas abscess. ⋯ Investigation of severe back pain after epidural anesthesia should include consideration of infectious causes, such as vertebral osteomyelitis and discitis, which may not be causally related to the epidural catheterization itself.
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Reg Anesth Pain Med · Mar 2002
Epidural analgesia and postoperative lipid metabolism: stable isotope studies during a fasted/fed state.
Although previous studies have reported an inhibitory effect of epidural block and glucose feeding on plasma concentrations of glycerol and free fatty acids (FFA), it remains unclear how epidural analgesia modifies the postoperative production and uptake of lipid metabolites. This can be achieved by determining the rate of lipolysis during a feeding state with dextrose. ⋯ The elevated rates of lipolysis associated with surgery cannot be suppressed by either epidural analgesia or dextrose feeding implying that the sustained stress response continues in the postoperative period and is the most important factor responsible for the increased release of glycerol.
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Personal digital assistants (PDAs) are being used more frequently by anesthesiologists. PDAs are pocket-sized electronic devices that, at their most basic level, store information. ⋯ More advanced features are increasingly common and blur the distinction between PDAs and personal computers (PCs). This article reviews the main options for PDAs, purchasing tips, and software applications, especially as they apply to anesthesiologists.
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Reg Anesth Pain Med · Mar 2002
Randomized Controlled Trial Clinical TrialThe effect of single-injection femoral nerve block on rehabilitation and length of hospital stay after total knee replacement.
Continuous-infusion femoral nerve block (FNB) improves analgesia and rehabilitation after total knee replacement. In this study, we investigated the efficacy of single-injection FNB to achieve similar results. ⋯ Single-injection FNB provided effective analgesia, facilitated early ambulation, and reduced the length of acute hospitalization in patients undergoing total knee replacement.