Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2010
Prospective survey of patient-controlled epidural analgesia with bupivacaine and hydromorphone in 3736 postoperative orthopedic patients.
Patient-controlled epidural analgesia(PCEA) has been shown to be superior to intravenous patient-controlled analgesics (PCA) for postoperative analgesia after thoracic, abdominal, pelvic, and lower extremity surgery. However, it is unclear which opioid is optimal for PCEA. Hydromorphone has potential advantages, yet there are no data to establish its efficacy and safety. Thus, we prospectively monitored our patients receiving PCEA with bupivacaine combined with hydromorphone after orthopedic surgery. ⋯ Patient-controlled epidural analgesia with bupivacaine and hydromorphone provides effective and safe postoperative analgesia for orthopedic surgery.
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Reg Anesth Pain Med · Jul 2010
Case ReportsNerve injury complicating ultrasound/electrostimulation-guided supraclavicular brachial plexus block.
Neurologic complications after peripheral nerve blocks (PNBs) are relatively uncommon. It has been postulated that real-time, needle-nerve visualization during ultrasound guided PNBs might further reduce the risk of neurologic or vascular complications. ⋯ Ultrasound guidance should not preclude development of additional monitoring and protocols to decrease the risk of complications with PNBs.
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Reg Anesth Pain Med · Jul 2010
Randomized Controlled Trial Comparative StudyIntravenous lidocaine is as effective as epidural bupivacaine in reducing ileus duration, hospital stay, and pain after open colon resection: a randomized clinical trial.
Both postoperative epidural analgesia and intravenous (IV) infusion of local anesthetic have been shown to shorten ileus duration and hospital stay after colon surgery when compared with the use of systemic narcotics alone. However, they have not been compared directly with each other. ⋯ No differences were observed between groups in terms of return of bowel function, duration of hospital stay, and postoperative pain control, suggesting that IV infusion of local anesthetic may be an effective alternative to epidural therapy in patients in whom epidural anesthesia is contraindicated or not desired.