Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 2003
Clinical TrialContinuous peripheral nerve blocks with stimulating catheters.
This study evaluated the efficacy of stimulating catheters used for continuous peripheral nerve blocks as a means of immediate verification and confirmation of correct catheter position. ⋯ The ability to electrostimulate nerves using an in situ catheter increases success rate in catheter placement for continuous peripheral nerve blocks. Further controlled investigations are necessary to compare this technique with more conventional methods in terms of cost and utility for various peripheral nerve blocks.
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Reg Anesth Pain Med · Mar 2003
Case ReportsCentral nervous system toxicity following the administration of levobupivacaine for lumbar plexus block: A report of two cases.
Central nervous system and cardiac toxicity following the administration of local anesthetics is a recognized complication of regional anesthesia. Levobupivacaine, the pure S(-) enantiomer of bupivacaine, was developed to improve the cardiac safety profile of bupivacaine. We describe 2 cases of grand mal seizures following accidental intravascular injection of levobupivacaine. ⋯ Although levobupivacaine may have a safer cardiac toxicity profile than racemic bupivacaine, if adequate amounts of levobupivacaine reach the circulation, it will result in convulsions. Plasma concentrations sufficient to result in central nervous system toxicity did not produce manifestations of cardiac toxicity in these 2 patients.
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Reg Anesth Pain Med · Mar 2003
Case ReportsHypothermia and excessive sweating following intrathecal morphine in a parturient undergoing cesarean delivery.
Intrathecal morphine has been used for the relief of postoperative pain following cesarean delivery. We report a case of postoperative hypothermia down to 33.6 degrees C associated with excessive sweating in patient undergoing elective cesarean delivery under spinal bupivacaine anesthesia who received intrathecal morphine for postoperative pain management. ⋯ Intrathecal morphine may cause disruption of thermoregulation resulting in hypothermia associated with excessive sweating.