Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Jan 2004
Clinical TrialLower lobe collapse during continuous interscalene brachial plexus local anesthesia at home.
We report a case of pulmonary left lower lobe collapse following an interscalene local anesthetic infusion administered at home. This case highlights the need for patient education and postoperative communication. ⋯ Good communication must be maintained with the patient at all times. Doctors from other specialties may be unaware of the potential complications of an interscalene block.
-
Reg Anesth Pain Med · Jan 2004
Case ReportsMisplacement of a psoas compartment catheter in the subarachnoid space.
This case report describes an unusual cause of misplacement of an indwelling catheter in the subarachnoid space after primary psoas compartment block in a patient undergoing total knee arthroplasty. ⋯ An additional test dose via the catheter is recommended if the indwelling catheter is inserted after injection of the local anesthetics through the puncture needle. If epidural anesthesia occurs, an x-ray of the catheter is advisable because negative aspiration via catheter does not rule out subarachnoid catheter location.
-
Reg Anesth Pain Med · Jan 2004
Case ReportsAccidental subdural injection during attempted lumbar epidural block may present as a failed or inadequate block: radiographic evidence.
Until now, case reports after accidental subdural injection during attempted epidural block have usually described extensive neuraxial blocks with a delayed onset, after low doses of local anesthetic, with a characteristic radiographic appearance on contrast injection. Our radiographic investigation of atypical "epidural" blocks has revealed that subdural injection may go unrecognized clinically and may be a cause of inadequate blocks. The mechanism is explored. ⋯ Accidental subdural injection may now be added to the list of causes of failed or inadequate "epidural" block. Clinicians should be aware of the diagnosis of a possible subdural injection, if a poor quality block with restricted spread and slow onset is associated with pain on postoperative reinjection of the catheter.