Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 1999
Biography Historical ArticleLincoln Fleetwood Sise: regional anesthesia's forgotten man?
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Reg Anesth Pain Med · Jul 1999
Comparative StudyThe endoneurial response to neurolytic agents is highly dependent on the mode of application.
The variability and predictability of neurolytic neural blocks were studied using an experimental rat sciatic nerve model. The goal of the study was to compare endoneurial and clinical responses to commonly used neurolytic agents. ⋯ There were no differences in the effects of clinically used neurolytic agents after intraneural injections. Although the perineurally applied 7% phenol-aqua induced marked endoneural damage, the destructive effect of glycerol and phenol-glycerol injections seemed to be prevented by the perineurium; phenol-glycerol and glycerol treatments induced subperineural damage only after perineural injections. The ability to penetrate the perineurium favors the use of 7% phenol-aqua in peripheral perineural blocks when complete neurolysis is the goal.
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Reg Anesth Pain Med · Jul 1999
Randomized Controlled Trial Clinical TrialRetrobulbar/peribulbar block with 0.2% ropivacaine or 1% lidocaine for transscleral cyclophotocoagulation or retinal panphotocoagulation.
Brief analgesia is needed to complete krypton laser cyclophotocoagulation for glaucoma patients and is advantageous in argon laser panphotocoagulation for diabetic retinopathy. We studied whether 0.2% ropivacaine, known for analgesia with minimal motor block or 1% lidocaine, with rapid onset and short duration of action, both supplemented with hyaluronidase, are suitable local anesthetics for retrobulbar/peribulbar block for these procedures. ⋯ According to our preliminary data, neither 0.2% ropivacaine nor 1% lidocaine reached acceptable frequencies of adequate analgesia during transscleral cyclophotocoagulation, while all retinal panphotocoagulations could be completed under the initial block.
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Reg Anesth Pain Med · Jul 1999
Randomized Controlled Trial Comparative Study Clinical TrialRopivacaine for peribulbar anesthesia.
We compared the efficacy of a mixture of ropivacaine and lidocaine with a mixture of bupivacaine and lidocaine for providing peribulbar anesthesia for cataract surgery. We used the time to adequate block for surgery and ocular and eyelid movement scores as clinical end points. ⋯ Ropivacaine 1% is an effective alternative to 0.75% bupivacaine for peribulbar anesthesia, when combined with lidocaine and hyaluronidase.
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Reg Anesth Pain Med · Jul 1999
Randomized Controlled Trial Comparative Study Clinical TrialComparative therapeutic evaluation of intrathecal versus epidural methylprednisolone for long-term analgesia in patients with intractable postherpetic neuralgia.
BACKGROUND AND OBJECTIVES The goal of this study was to evaluate the analgesic effects of intrathecal versus epidural methylprednisolone acetate (MPA) in patients with intractable postherpetic neuralgia (PHN). ⋯ Our results suggest the effectiveness of intrathecal as compared to epidural MPA for relieving the pain and allodynia associated with PHN. Also, our findings, together with the decrease in IL-8, may indicate that intrathecal MPA improves analgesia by decreasing an ongoing inflammatory reaction in the CSF.