Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2003
Clinical TrialLateral approach to the sciatic nerve block in the popliteal fossa: correlation between evoked motor response and sensory block.
The purpose of this study was to identify which of two motor responses of the foot (plantar flexion versus dorsiflexion) best predicts complete sensory blockade of the sciatic nerve when is used for lateral popliteal sciatic nerve block. ⋯ After stimulation of the sciatic nerve, plantar flexion better predicts complete sensory blockade of the foot than dorsiflexion when using the lateral approach to the popliteal fossa. The findings of the present study apply to a single injection of 30 mL of ropivacaine 0.75%.
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Reg Anesth Pain Med · Sep 2003
Clinical TrialRelationship between evoked motor response and sensory paresthesia in interscalene brachial plexus block.
This study sought to define the relationship between a paresthesia and a motor response (MR) to electrical nerve stimulation using a peripheral nerve stimulator (PNS) during interscalene block. We sought to determine if at a low amperage (< or =1.0 mA) a MR would precede a paresthesia. ⋯ MR preceded paresthesia in every patient. The most likely explanation for this observation is that MR can be achieved at a small distance from the nerve, whereas elicitation of mechanical paresthesia requires either nerve contact or more intimate location of the needle's tip relative to the nerve. Another possible explanation is that motor fibers are located in a more superficial position and are therefore encountered first. Motor and sensory responses are separate and discrete phenomena.
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Reg Anesth Pain Med · Sep 2003
Clinical TrialIs skin disinfection with 10% povidone iodine sufficient to prevent epidural needle and catheter contamination?
Epidural space infection is a potential complication of epidural catheter placement. In this study, we investigated the incidence of epidural needle and catheter contamination after skin surface disinfection with 10% povidone-iodine (PI). ⋯ Our results suggest that despite skin surface disinfection with PI, there is still significant risk for contamination of needles and catheters during epidural catheterization.
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Ambulatory perineural local anesthetic infusion is a relatively new method for providing postoperative analgesia, and many aspects of this technique remain in the domain of conjecture and speculation. This retrospective chart review and survey was undertaken to investigate patients' opinions on various aspects of their ambulatory perineural infusion experience. ⋯ This investigation suggests that perineural local anesthetic infusion is generally well tolerated by ambulatory patients.
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Reg Anesth Pain Med · Sep 2003
Case ReportsTransverse myelitis associated with Acinetobacter baumanii intrathecal pump catheter-related infection.
To describe a late neurologic complication of intrathecal pump implantation and show the methods used for the diagnosis and successful treatment of transverse myelitis in this setting. ⋯ Clinicians should recognize transverse myelitis as a possible late complication of intrathecal pump placement. Early medical intervention and removal of the intrathecal pump may be necessary to prevent irreversible spinal cord damage and may support good recovery.