Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2003
Randomized Controlled Trial Clinical TrialThe effect of intrathecal epinephrine on epidural infused analgesics during labor.
In order to prolong labor analgesia, one may add intrathecal epinephrine to the combination of bupivacaine and fentanyl. In this study, we tested the hypothesis that the addition of intrathecal epinephrine would lessen the requirement for a rescue dose of epidural analgesia during labor. ⋯ The addition of epinephrine to intrathecal bupivacaine-fentanyl lessened the requirement for additional epidural analgesia without increasing hypotension, nausea, or pruritus. However, the incidence of motor block may be increased without labor prolongation.
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Reg Anesth Pain Med · Mar 2003
Randomized Controlled Trial Clinical TrialLidocaine priming reduces tourniquet pain during intravenous regional anesthesia: A preliminary study.
Tourniquet pain often limits the use of intravenous regional anesthesia (IVRA). Intravenous (IV) lidocaine has been shown to be effective in the management of acute and neuropathic pains. We tested the hypothesis that a priming IV injection of lidocaine might have an analgesic effect on tourniquet pain during IVRA. ⋯ Priming IV lidocaine when compared with isotonic saline is effective in reducing tourniquet pain in IVRA.
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Reg Anesth Pain Med · Mar 2003
Randomized Controlled Trial Clinical TrialForearm rescue cuff improves tourniquet tolerance during intravenous regional anesthesia.
Tourniquet pain during intravenous regional anesthesia (IVRA) of the upper limb is common and can limit tourniquet inflation time. We hypothesize that a forearm rescue cuff is better tolerated than the traditional rescue cuff of a double-cuff tourniquet. ⋯ A forearm rescue cuff is better tolerated than an arm cuff double tourniquet during IVRA, allowing for longer tourniquet times. It is also associated with lower pain scores and shorter duration of local anesthetic side effects.
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Reg Anesth Pain Med · Mar 2003
Clinical TrialContinuous peripheral nerve blocks with stimulating catheters.
This study evaluated the efficacy of stimulating catheters used for continuous peripheral nerve blocks as a means of immediate verification and confirmation of correct catheter position. ⋯ The ability to electrostimulate nerves using an in situ catheter increases success rate in catheter placement for continuous peripheral nerve blocks. Further controlled investigations are necessary to compare this technique with more conventional methods in terms of cost and utility for various peripheral nerve blocks.
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Reg Anesth Pain Med · Mar 2003
Case ReportsHypothermia and excessive sweating following intrathecal morphine in a parturient undergoing cesarean delivery.
Intrathecal morphine has been used for the relief of postoperative pain following cesarean delivery. We report a case of postoperative hypothermia down to 33.6 degrees C associated with excessive sweating in patient undergoing elective cesarean delivery under spinal bupivacaine anesthesia who received intrathecal morphine for postoperative pain management. ⋯ Intrathecal morphine may cause disruption of thermoregulation resulting in hypothermia associated with excessive sweating.