Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Sep 1998
Randomized Controlled Trial Meta Analysis Comparative Study Clinical TrialRegional anesthesia does not significantly change surgical time versus general anesthesia--a meta-analysis of randomized studies.
The major determinant of variable operating room costs is surgical time. A number of factors contribute to surgical time. This study was designed to determine whether regional anesthesia decreases surgical time when compared with general anesthesia over several surgical procedures. ⋯ Overall, the use of regional anesthesia does not significantly decrease surgical time.
-
Reg Anesth Pain Med · Sep 1998
Randomized Controlled Trial Clinical TrialIntrathecal sufentanil and epidural bupivacaine for labor analgesia: dose-response of individual agents and in combination.
Combinations of local anesthetics and opioids are frequently used during spinal and epidural analgesia for the relief of labor pain. This combination allows for a dose-sparing effect which may reduce potential side effects or toxicity. The precise nature of the interaction between opioids and local anesthetics in the clinical setting, i.e., additivity versus synergism, has not been established. This trial was designed to utilize a validated technique of analysis of drug interactions, isobolography, to investigate this interaction. ⋯ Markedly reduced doses of these drugs in combination can be used to provide adequate analgesia during labor compared with either single drug alone.
-
Reg Anesth Pain Med · Sep 1998
Case ReportsDelayed severe airway obstruction due to hematoma following stellate ganglion block.
Delayed onset of airway obstruction following stellate ganglion block (SGB) may be life threatening. We treated a patient who developed a severe airway obstruction caused by a large hematoma several hours after an SGB. ⋯ We believe that the SGB needle injured the vertebral artery and caused massive hemorrhage anterior to the cervical vertebra, subsequently inducing pharyngolaryngeal edema by obstructing the venous and lymphatic drainage of the cervical region.
-
Reg Anesth Pain Med · Sep 1998
Case ReportsRepeated episodes of transient radiating back and leg pain following spinal anesthesia with 1.5% mepivacaine and 2% lidocaine.
Transient radiating back and leg pain defined as pain or dysesthesias in the buttocks, thighs, or calves within 24 to 48 hours after recovery from spinal anesthesia has been described with the use of 2% and 5% lidocaine. These symptoms have also been associated with other local anesthetics such as bupivacaine and tetracaine, although with a much lower incidence. A recent case report and prospective study have described transient radiating back and leg pain occurring following spinal anesthesia with 4% mepivacaine. ⋯ Transient radiating back and leg pain may occur with lower concentrations (1.5%) of mepivacaine, as it does with lidocaine. The relationship between transient radiating back and leg pain and spinal stenosis is also discussed.