Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2001
Randomized Controlled Trial Comparative Study Clinical TrialComparison of technical and block characteristics of different combined spinal and epidural anesthesia techniques.
The combined spinal and epidural (CSE) technique can reduce or eliminate some of the disadvantages of spinal and epidural anesthesia, while still preserving their advantages. CSE anesthesia is now commonly performed with a single-segment needle-through-needle technique; however, this technique involves some controversies about needle handling and the risk of catheter migration. To avoid some of these potential problems, special CSE sets have been produced. In the present study, 2 of these sets were compared with the traditional double-segment technique. ⋯ The use of the CSE sets does not seem to save time compared with the double-segment technique. Technical problems, unsuccessful CSE block, and damaged spinal needle tip were noted relatively often with the interlocking CSE set. Anesthetic characteristics in the successful blocks were similar with the different techniques.
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Reg Anesth Pain Med · Jan 2001
Randomized Controlled Trial Comparative Study Clinical TrialHospital discharge after ambulatory knee arthroscopy: A comparison of epidural 2-chloroprocaine versus lidocaine.
This prospective, randomized, double-blind study compares the efficacy of epidural 2-chloroprocaine and lidocaine for attaining hospital discharge criteria after ambulatory knee arthroscopy. We hypothesized that 2-chloroprocaine would facilitate earlier discharge than lidocaine. ⋯ Epidural 3% 2-chloroprocaine without epinephrine is an advantageous choice for ambulatory knee arthroscopy. It enables readiness for discharge an hour sooner than 1.5% lidocaine, requires fewer reinjection interventions, and may reduce delayed discharge secondary to prolonged time to void. This clinical study shows the superiority of epidural 3% 2-chloroprocaine over 1.5% lidocaine for expediting hospital discharge after ambulatory surgery.
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Reg Anesth Pain Med · Jan 2001
Comparative StudyAn observational study of the frequency and pattern of use of epidural steroid injection in 25,479 patients with spinal and radicular pain.
Frequency of epidural steroid injections (ESI) and characteristics of patients receiving them are unknown or poorly described. Patients believed to respond better to ESI include young or middle-aged individuals, those with recent onset or a radicular pattern of pain, and patients without previous spinal surgery. The aim of this study is to estimate the frequency of ESI, to examine the characteristics of patients who have them recommended, and to determine if clinical practice reflects published data pertaining to indications for ESI. ⋯ ESI are commonly used to treat patients with spinal and radicular pain. There is some consistency between clinical practice and published recommendations for ESI use.
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Reg Anesth Pain Med · Jan 2001
Case ReportsAxillary brachial plexus block with patient controlled analgesia for complex regional pain syndrome type I: a case report.
Brachial plexus block (BPB) has been cited as a treatment modality for complex regional pain syndrome type I (CRPS I) of the upper limb. However, there are no reports using axillary BPB with patient controlled analgesia (PCA) for the treatment of CRPS I. This report is based on the retrospective observations of the outcome and effects of axillary BPB with PCA in a patient with CRPS I. ⋯ Axillary BPB with PCA may provide patients with CRPS I of the upper limb a feasible and effective treatment. .
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Reg Anesth Pain Med · Jan 2001
Case ReportsA case of reversible paraparesis following celiac plexus block.
Permanent and acute reversible paraplegia following celiac plexus block (CPB) have been reported. We report a case of prolonged reversible paraparesis after alcohol celiac plexus block. ⋯ Paraparesis following alcohol celiac plexus block may be reversible over an extended period of time.