Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 1999
Randomized Controlled Trial Clinical TrialPain relief by wound infiltration with bupivacaine or high-dose ropivacaine after inguinal hernia repair.
Wound infiltration with bupivacaine is often used for pain relief after inguinal hernia surgery. We hypothesized that the lower systemic toxicity of another long-acting local anesthetic of similar potency (ropivacaine) would make it possible to increase the dose to above that recommended for bupivacaine and thereby achieve more effective pain control. ⋯ Wound infiltration with long-acting local anesthetics resulted in low pain scores after hernia surgery. Bupivacaine 100 mg was as effective as ropivacaine 300 mg.
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Reg Anesth Pain Med · Nov 1999
Randomized Controlled Trial Comparative Study Clinical Trial0.75% and 0.5% ropivacaine for axillary brachial plexus block: a clinical comparison with 0.5% bupivacaine.
Although ropivacaine has been extensively studied for epidural anesthesia, very few reports exist on brachial plexus block. We therefore decided to investigate the clinical features of axillary brachial plexus anesthesia with two different concentrations of ropivacaine (0.5% and 0.75%) and to compare the results with those obtained with 0.5% bupivacaine. ⋯ Ropivacaine showed advantages over bupivacaine for axillary brachial plexus block. Because no statistical differences were found between the two ropivacaine groups, we therefore conclude that 0.75% does not add benefit and that 0.5% ropivacaine should be used to perform axillary brachial plexus blocks.
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Reg Anesth Pain Med · Nov 1999
Randomized Controlled Trial Clinical TrialThe addition of epinephrine increases intensity of sensory block during epidural anesthesia with lidocaine.
Little is known about the effect of adding epinephrine to local anesthetic solutions on the intensity of sensory block during epidural anesthesia. This study examined development of sensory block during lumbar epidural anesthesia using a cutaneous current perception threshold (CPT) quantitative sensory testing device. ⋯ These results suggest that lumbar epidural anesthesia using 10 mL 1% lidocaine with epinephrine produces a more intense block of both large and small diameter sensory nerve fibers than that with plain lidocaine. It appears, therefore, that the addition of epinephrine improves the quality of sensory block during epidural anesthesia with lidocaine.
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Reg Anesth Pain Med · Nov 1999
Randomized Controlled Trial Clinical TrialContinuous psoas compartment block for anesthesia and perioperative analgesia in patients with hip fractures.
The perioperative use of continuous psoas compartment block (CPCB) was compared with traditional pain management for patients with fracture of the femur. The anatomy of CPCB was also tested in cadavers. ⋯ The CPCB seems to be an appropriate technique for efficient and safe perioperative pain control. However, in our dissections, the psoas compartment was not well defined in all patients, thus, using this route for anesthesia may result in only partial success.
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Reg Anesth Pain Med · Nov 1999
Randomized Controlled Trial Clinical TrialDouble-injection method using peripheral nerve stimulator is superior to single injection in axillary plexus block.
Axillary block using a single-injection method does not always provide effective analgesia. This study examined whether a double axillary block injection technique is superior to a single injection axillary block. ⋯ A double-injection method in axillary block provides excellent analgesia and motor block compared with a single-injection method. Moreover, the need for supplemental nerve blocks is significantly decreased.