Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2003
Randomized Controlled Trial Comparative Study Clinical TrialComparison of continuous 3-in-1 and fascia Iliaca compartment blocks for postoperative analgesia: feasibility, catheter migration, distribution of sensory block, and analgesic efficacy.
Efficacy and technical aspects of continuous 3-in-1 and fascia iliaca compartment blocks were compared. ⋯ The authors conclude that a catheter for continuous lumbar plexus block can be placed more quickly and at lesser cost using the fascia iliaca technique than the perivascular technique with equivalent postoperative analgesic efficacy.
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Military anesthesiologists must master the complexities of modern anesthesia at home, like their civilian counterparts, and also be prepared to provide effective, safe anesthesia in the chaotic and austere environment of the modern battlefield. This article describes the Army Regional Anesthesia Initiative and Operational Anesthesia Rotation programs designed to facilitate this difficult goal.
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In this study, we have performed hypogastric plexus block using a posterior transdiscal approach in 20 patients diagnosed with pelvic pain because of cancer. ⋯ Transdiscal approach to the hypogastric plexus appears to be a safe and effective procedure. However, prospective randomized controlled studies comparing different approaches are needed to increase our knowledge of hypogastric plexus block.
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Reg Anesth Pain Med · Jul 2003
Case ReportsEpidural clonidine relieves intractable neuropathic itch associated with herpes zoster-related pain.
We present a case of intense herpes zoster-related pain and itching in the ophthalmic division of the trigeminal nerve (V1). Successful pain and itch management was achieved after insertion of a high thoracic epidural catheter with a continuous infusion of bupivacaine and clonidine. ⋯ High thoracic epidural infusion of bupivacaine and clonidine was beneficial in relieving neuropathic itch in a patient with acute herpes zoster-related pain in the distribution of the trigeminal nerve.
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Reg Anesth Pain Med · Jul 2003
Comparative StudyLevobupivacaine versus ropivacaine for sciatic nerve block in the rat.
Ropivacaine and levobupivacaine, both single S- enantiomers, are being promoted as safer alternatives to racemic bupivacaine. To determine whether levobupivacaine produces a more potent and longer lasting peripheral nerve block than ropivacaine, we compared functional blockade of sciatic nerve in the rat at several doses with these 2 agents. ⋯ At the lowest concentration (0.0625%), levobupivacaine produces a greater degree of motor impairment and a longer duration of proprioceptive impairment relative to ropivacaine. At the middle concentration (0.125%), there no differences between the 2 drugs. At the higher concentration (0.25%), which is within the range used clinically for peripheral nerve block (0.25%-0.5%), levobupivacaine produces approximately a 30% longer duration of complete block in each modality compared with that by ropivacaine.