Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 1999
Randomized Controlled Trial Clinical TrialThe association between injected volume of local anesthetic and spread of epidural anesthesia: a hypothesis.
Clinically, an increase of the injected volume of local anesthetic does not result in a linear increase in the spread of epidural anesthesia. This study was designed to evaluate this observation. ⋯ The present study demonstrates lack of a linear relationship between injected volume of local anesthetic and spread of epidural anesthesia. Whether the cubic equation developed is clinically useful remains unclear because of the variability of the data.
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Reg Anesth Pain Med · Mar 1999
Randomized Controlled Trial Comparative Study Clinical TrialContinuous spinal anesthesia: a comparative study of standard microcatheter and Spinocath.
This prospective, randomized study evaluated the advantages and disadvantages of a new subarachnoid catheter. ⋯ Spinocath insertion required 6.3 +/- 3.2 minutes in group 1 versus 3.9 +/- 1.2 minutes in group 2 (P < .01) with similar difficulties with catheter introduction. Perception of dural puncture was better in group 1 (P < .05). There were significant intergroup differences in time to free flow of CSF through the catheter. In group 2, correct catheter positioning had to be confirmed by aspiration in 80% of cases (P < .05). At the end of surgery, the catheters were removed, and there were no significant differences between groups. The anesthetic blocks were similar with both systems. Patient opinion of the technique did not differ between groups, and regression analysis did not show any differences between groups or correlation to any incident during performance of the technique. Globally, the anesthesiologists participating in the study considered both systems to be easy to use and adequate for continuous spinal anesthesia. With respect to the advantage afforded by a directional needle in orientating the catheter within the spinal canal, the Spinocath system-with a longer technique performance time than the standard approach-involves a success rate and incidence of technical problems similar to that of the conventional technique.
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Reg Anesth Pain Med · Jan 1999
Randomized Controlled Trial Clinical TrialThe effects of arm position on central spread of local anesthetics and on quality of the block with axillary brachial plexus block.
Spread of local anesthetic solution in axillary brachial plexus block is thought to be influenced by the position of the arm and the use of compression maneuvers. We investigated how these two factors affected central local anesthetic spread and block quality. ⋯ The central spread of local anesthetics is facilitated by injection without abduction of the arm but not by the use of compression at the injection site. This, however, did not alter the quality of the block.
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Reg Anesth Pain Med · Jan 1999
Randomized Controlled Trial Clinical TrialIntravenous administration of caffeine sodium benzoate for postdural puncture headache.
In this study, we evaluated the efficacy and safety of prophylactic administration of intravenous caffeine sodium benzoate for postdural puncture headaches (PDPH) on patients administered spinal anesthesia. ⋯ Intravenous caffeine sodium benzoate administration during spinal anesthesia is a simple and safe way to minimize PDPH.
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Reg Anesth Pain Med · Nov 1998
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialComparative evaluation of four different infusion rates of ropivacaine (2 mg/mL) for epidural labor analgesia.
Previous studies have reported comparable efficacy for ropivacaine and bupivacaine when used for labor analgesia at concentrations of 2.5 mg/mL. In this multicenter study, we assessed ropivacaine at the commercially available concentration of 2 mg/mL (0.2%) for labor pain management. ⋯ The 2 mg/mL of ropivacaine produces satisfactory labor analgesia at epidural infusion rates of 4, 6, 8, and 10 mL/hour, provided supplemental bolus dosages are available. Clinically, a rate of 6 mL/hour may be the lowest effective rate that provides the best combination of pain relief, motor block, and rebolusing, although rates of 8 and 10 mL/hour produced similar results.