Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Jul 2001
Confirmation of location of epidural catheters by epidural pressure waveform and computed tomography cathetergram.
Epidural pressure has remained a relatively unused test of physiological monitoring for the past 3 decades. It is our hypothesis that epidural pressure waveforms (EPWFs) obtained by transducing an epidural catheter (EC) can be used as a surrogate for the accurate location of the EC. The goal of this study was to validate this new method by comparing it with a more objective radiographic technique such as computed tomography cathetergram (CTC). ⋯ The strong relationship between EPWF and CTC suggests that EPWF can be used reliably to confirm the correct placement of the EC in a selected group of patients.
-
Reg Anesth Pain Med · Jul 2001
Randomized Controlled Trial Clinical TrialDoes alkalinization of 0.75% ropivacaine promote a lumbar peridural block of higher quality?
We did not find clinical studies of the alkalization of ropivacaine in the literature. The objectives of this study were: (1) to determine the quantity of sodium bicarbonate (NaHCO(3)), which alkalinizes 0.75% ropivacaine (with and without adrenaline); (2) to verify the physico-chemical alterations arising from this alkalization; and (3) to determine whether alkalinized ropivacaine produces a higher-quality epidural block measured via sensory-motor onset, block spread and anesthesia duration. ⋯ This study indicates that the quantity of NaHCO(3) needed to alkalize 10 mL of 0.75% ropivacaine at room temperature is 0.012 mEq. When the solution contains adrenaline 1:200,000 (mg.mL(-1)), up to 0.015 mEq of NaHCO(3) may be added. The alkalization of the 0.75% ropivacaine solution did not cause a reduction of sensory-motor onset, but did provide a significant increase in the duration of the epidural block with no significant differences between the solutions with and without adrenaline.
-
Reg Anesth Pain Med · Jul 2001
The injection of intrathecal normal saline reduces the severity of postdural puncture headache.
We investigated whether the injection of 10 mL of normal saline into the subarachnoid space following accidental dural puncture reduced the incidence of postdural puncture headache (PDPH) and the need for epidural blood patch (EBP). ⋯ The immediate injection of 10 mL intrathecal normal saline after a wet tap significantly reduced the incidence of PDPH and the need for EBP. When an intrathecal catheter had been placed following a wet tap, injection of 10 mL of normal saline before its removal effectively prevented PDPH.
-
Reg Anesth Pain Med · Jul 2001
Editorial CommentMultimodal therapy for post-cesarean delivery pain.