Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 1998
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialComparative evaluation of four different infusion rates of ropivacaine (2 mg/mL) for epidural labor analgesia.
Previous studies have reported comparable efficacy for ropivacaine and bupivacaine when used for labor analgesia at concentrations of 2.5 mg/mL. In this multicenter study, we assessed ropivacaine at the commercially available concentration of 2 mg/mL (0.2%) for labor pain management. ⋯ The 2 mg/mL of ropivacaine produces satisfactory labor analgesia at epidural infusion rates of 4, 6, 8, and 10 mL/hour, provided supplemental bolus dosages are available. Clinically, a rate of 6 mL/hour may be the lowest effective rate that provides the best combination of pain relief, motor block, and rebolusing, although rates of 8 and 10 mL/hour produced similar results.
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Reg Anesth Pain Med · Nov 1998
Randomized Controlled Trial Clinical TrialPre-incision infiltration with lidocaine reduces pain and opioid consumption after reduction mammoplasty.
To determine the analgesic efficacy of preoperative tumescent infiltration with lidocaine for reduction mammoplasty. ⋯ Preoperative tumescent infiltration with lidocaine results in reduced pain and lower postoperative opioid requirements in the initial hours after reduction mammoplasty.
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Reg Anesth Pain Med · Nov 1998
Spinal cord neural anatomy in rats examined by in vivo magnetic resonance microscopy.
Magnetic resonance microscopy (MRM) is a technique that is worthwhile for anesthesiologists because it allows spinal cord and plexus anatomy to be visualized three dimensionally and followed over time in the same animal. For example, the long-term effect of indwelling intrathecal or plexus catheters can be studied in situ, and convective and diffusive forces within intrathecal, epidural, or nerve sheath spaces can be investigated. Further, diffusion-weighted MRM, which measures an "apparent diffusion coefficient" (ADC), can be used to track the presence of ischemia, hypoperfusion, or cytotoxic edema. This study investigates problems associated with the use of in vivo MRM for spinal cord and peripheral nerve studies in the rat. ⋯ Three-dimensional diffusion-weighted MRM displays cervical and lumbar spine anatomy accurately in vivo. Apparent diffusion coefficients measurements are feasible in rat cervical spinal cord with intrathecal catheters. Spinal cord ADCs are unaffected by intrathecal catheters, indicating normal spinal cord perfusion.