Regional anesthesia and pain medicine
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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
The practice of peripheral nerve blocks in the United States: a national survey [p2e comments].
A nationwide survey was conducted in order to describe practice patterns surrounding the use of peripheral nerve blocks (PNBs). ⋯ Although this survey indicates that regional anesthesia is frequently practiced in the United States, PNBs and particularly PNBs of the lower extremities remain underutilized.
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Reg Anesth Pain Med · May 1998
The rate of successful reactivation of labor epidural catheters for postpartum tubal ligation surgery.
Epidural catheters placed for analgesia during labor and delivery can be reused in the postpartum period for postpartum tubal ligation anesthesia. This study examined the success rate of such reactivation of epidural catheters. ⋯ Epidural catheters can be reactivated reliably for as long as 24 hours after they are placed.