Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 1998
Clinical Trial Controlled Clinical TrialPostoperative epidural injection of saline can shorten postanesthesia care unit time for knee arthroscopy patients.
The goal of this prospective, double-blind study was to ascertain if the postanesthesia care unit (PACU) stay of outpatients receiving epidural anesthesia for knee arthroscopy is decreased by injection of epidural saline at the end of the case. ⋯ Patients receiving epidural anesthesia for knee arthroscopy had a shorter PACU stay if they received an injection of saline into the epidural space at the end of surgery.
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Reg Anesth Pain Med · May 1998
Comparative Study Clinical Trial Controlled Clinical TrialComparison of double-hole and single-hole pencil-point needles for spinal anesthesia with hyperbaric bupivacaine.
The use of thin single-hole pencil-point (SHPP) spinal needles may be a reason for subarachnoid maldistribution of local anesthetic. A new double-hole pencil-point (DHPP) needle may be preferable because of a theoretic more uniform initial distribution of local anesthetic. ⋯ There was no difference between the spread of analgesia using either SHPP or DHPP spinal needles. The DHPP needles appear to be vulnerable to tip damage from mechanical contact.
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Reg Anesth Pain Med · May 1998
Case ReportsPatient-controlled analgesia using ropivacaine via an intrathecal catheter.
A 38-year-old woman presented with severe intractable pain in the sacral and perirectal areas secondary to metastatic stage I.B. squamous cell carcinoma of the cervix. ⋯ The use of ropivacaine in combination with other analgesics, via an intrathecal catheter for patient-controlled analgesia, was an effective treatment for this patient. In the future, ropivacaine administered epidurally or intrathecally alone, or in combination with other analgesics, may become the local anesthetic of choice due to its preservation of motor function. Certainly, further scientific studies are indicated in the cancer patient population.
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Reg Anesth Pain Med · May 1998
Computed tomographic study of lumbar (L3-4) epidural depth and its relationship to physical measurements in young adult men.
This study was performed to devise a method for predicting epidural depth more accurately with a variety of physical measurements not previously studied. ⋯ Addition of the physical parameters such as waist circumference/neck circumference ratio or BMI results in a higher predictive value for epidural depth than use of more traditional physical parameters such as weight/height ratio and/or weight only. The value of Sl-Ep is independent of any physical parameters. Thus, the significant correlation between the physical measurements and the epidural depth seems to be due only to obesity-related factors.
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Reg Anesth Pain Med · May 1998
Paravertebral somatic nerve block for outpatient inguinal herniorrhaphy: an expanded case report of 22 patients.
Inguinal herniorrhaphy is a common outpatient surgical procedure. However, anesthetic techniques for inguinal herniorrhaphy are still associated with numerous side effects. Paravertebral somatic nerve block (PSNB) has the potential advantage to offer unilateral abdominal wall anesthesia and long-lasting pain relief with minimal side effects. We report our initial trial of PSNB for outpatient inguinal herniorrhaphy. ⋯ The results of our initial experience suggest that PSNB is a potentially safe and effective technique. In general, the block provided long-lasting pain relief in most patients with few side effects. A randomized study comparing paravertebral blocks with conventional anesthesia choices is suggested given the findings in this initial series of patients.