Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2011
Comparative StudyDirect connections between the spinal epidural space and the venous circulation in humans.
Our previous studies in pigs indicate that direct connections exist between the spinal epidural space and the venous circulation. We wondered if similar connections occur in humans and have extended our investigations to human cadavers awaiting autopsy. ⋯ A direct connection between the spinal epidural space and the venous circulation has been demonstrated in human cadavers. The connection is most commonly found in the cervical and upper thoracic spine.
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Reg Anesth Pain Med · Mar 2011
Comparative StudyMinimum effective volume of lidocaine for ultrasound-guided infraclavicular block.
The aim of this study was to determine the minimum effective volume of lidocaine 1.5% with epinephrine 5 μg/mL in 90% of patients (MEV(90)) for single-injection ultrasound-guided infraclavicular block (ICB). ⋯ For single-injection ultrasound-guided ICB, the MEV(90) of lidocaine 1.5% with epinephrine 5 μg/mL is 35 mL. Further dose-finding studies are required for other concentrations of lidocaine, other local anesthetic agents as well as techniques involving multiple injections, a more medial approach to ICB, or precise location of all 3 cords of the brachial plexus.
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Reg Anesth Pain Med · Mar 2011
Case ReportsGranulomatous conduit for intrathecal infusion of morphine and bupivacaine.
Intrathecal drug delivery systems (IT-DDSs) have gained more widespread use in patients with non-cancer-related pain, notably failed back surgery syndrome and spinal arachnoiditis. Secondary to the longer life spans of these patients, more complications have been discovered with IT-DDSs. With an estimated incidence of 1% to 3%, an uncommon but serious complication is that of granuloma formation. ⋯ This case report reinforces the view that the infusate is the causal agent of this lesion.