Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2000
Case ReportsComplete brachial plexus palsy after total shoulder arthroplasty done with interscalene block anesthesia.
This report illustrates that brachial plexus palsy can result from either interscalene block or total shoulder arthroplasty. It is often impossible to determine which procedure caused the deficit; therefore, we believe the focus should be placed on treatment of the neurologic deficit. This report provides a suggested algorithm for diagnosis and treatment of postprocedure brachial plexus palsy. ⋯ Proper diagnosis and treatment of postprocedure brachial plexus palsy may improve recovery of function. Several precautions may reduce the likelihood of brachial plexus palsy following interscalene block for total shoulder arthroplasty.
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Reg Anesth Pain Med · May 2000
Case ReportsDetermining epidural catheter location using nerve stimulation with radiological confirmation.
The use of epidural stimulation to confirm epidural catheter placement has been shown. This case report describes the benefits and problems of using the epidural stimulation test to confirm epidural catheter placement and provides supporting evidence for these observations using radiological imaging. ⋯ This report illustrates some of the potential benefits and problems of using the nerve stimulation test to confirm epidural catheter placement, with radiological verification.
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Reg Anesth Pain Med · May 2000
Clinical TrialPlasma lidocaine, monoethylglycinexylidide, and glycinexylidide concentrations after epidural administration in geriatric patients.
The purpose of this study was to evaluate the effect of age on the pharmacokinetics of lidocaine after epidural administration. ⋯ The increase in plasma lidocaine concentration after epidural anesthesia in elderly patients was not as high as anticipated. However, the elderly patients showed longer MRTs, lower clearance, and lower ratios of MEGX/lidocaine than did the adult (middle-age) patients.
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Reg Anesth Pain Med · May 2000
Clinical TrialEffect of high-dose lidocaine treatment on superoxide dismutase and malon dialdehyde levels in seven diabetic patients.
We report on the use of intravenous (IV) high-dose lidocaine to relieve diabetic neuropathic pain, and the technique's effects on clinical measures of lipid peroxidation. ⋯ High-dose lidocaine treatment lessens MDA levels, a marker of free-radical-mediated cell damage. This suggests that one of lidocaine's mechanism of action may be its effect on oxygen free radicals, which in turn impacts lipid peroxidation.