Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2005
Plasma concentrations and analgesic effects of ropivacaine 3.75 mg/ml during long-term extrapleural analgesia after thoracotomy.
Fourteen patients received long-term extrapleural analgesia with ropivacaine for postoperative pain relief after posterolateral thoracotomy. We determined plasma concentrations of ropivacaine as well as pain scores and opioid consumption to assess the analgesic effect. ⋯ A dose of 0.375 mg/kg/h of ropivacaine can safely be administered for long-term extrapleural analgesia after thoracotomy.
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Reg Anesth Pain Med · Jul 2005
Differential block of N-propyl derivatives of amitriptyline and doxepin for sciatic nerve block in rats.
The propyl group of ropivacaine ( N -propyl-2',6'-pipecoloxylidide hydrochloride) could be responsible for conferring some sensory selectivity to this drug. Thus, adding a propyl group to experimental local anesthetics (LAs) (e.g., the tricyclic antidepressants amitriptyline and doxepin) to increase sensory selectivity may be useful. We, therefore, synthesized N -propyl amitriptyline and N -propyl doxepin and investigated a potential predominance of sensory/nociceptive block over motor block (differential block) in a rat sciatic nerve block model. In addition, tetrodotoxin (TTX), a naturally occuring Na + channel blocker, was coinjected to investigate whether it increased block duration. ⋯ Detailed histopathologic nerve toxicity evaluations are justified to determine whether N -propyl amitriptyline has potential as a more sensory-selective local anesthetic at lower concentrations or as a predominantly sensory-selective neurolytic agent at higher concentrations.
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Reg Anesth Pain Med · Jul 2005
Ultrasound-guided periradicular injections in the middle to lower cervical spine: an imaging study of a new approach.
The objective of this study was to show the efficacy of ultrasound in facilitating the performance of a simulated cervical periradicular injection in cadavers. ⋯ This preclinical study suggests that ultrasound is a useful guiding tool for periradicular injections in the cervical spine.
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Reg Anesth Pain Med · Jul 2005
Case ReportsUse of stellate ganglion block to salvage an ischemic hand caused by the extravasation of vasopressors.
This case report describes the successful use of early stellate ganglion block to salvage an acutely ischemic hand caused by the extravasation of vasopressors. ⋯ Stellate ganglion block may prove to be an early measure in the treatment of upper-extremity ischemia caused by vasopressor extravasation.
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Reg Anesth Pain Med · Jul 2005
The musculocutaneous nerve: ultrasound appearance for peripheral nerve block.
To gain complete anesthesia of the forearm, block of the musculocutaneous nerve is necessary. Variations in its course and position make localization of the musculocutaneous nerve problematic. The aim of the study is to describe the ultrasound appearance of the musculocutaneous nerve in the axilla and to suggest potential areas to target neural block. ⋯ Knowledge of its ultrasound appearance facilitates localization and successful block of the musculocutaneous nerve. Because the distance between the musculocutaneous nerve and brachial plexus varies, different locations of musculocutaneous nerve puncture during ultrasound-guided regional anesthesia can be chosen.