Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2001
Randomized Controlled Trial Clinical TrialSpinal anesthesia with hypobaric bupivacaine for knee arthroscopies: effect of posture on motor block.
The clinical impact of patient positioning on motor block during unilateral spinal anesthesia was the focus of our study. It was assumed that a 45 degrees rotation toward the prone position would minimize blocking the ventral motor roots compared with using the conventional lateral decubitus position. ⋯ The position of the patient affects the spread of the spinal anesthesia when clearly hypobaric agents are used. However, this small modification in positioning of the patient did not lead to a clinically meaningful difference in the spread of the motor block.
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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 Clinical TrialIntrathecal low-dose bupivacaine versus lidocaine for in vitro fertilization procedures.
Recent controversy with the use of intrathecal lidocaine has prompted the search for suitable ambulatory surgery alternatives. The purpose of our study was to evaluate the clinical utility of intrathecal low-dose bupivacaine for outpatient transvaginal oocyte retrieval. ⋯ Although prolongation to voiding and discharge was observed, intrathecal hyperbaric bupivacaine 3.75 mg with fentanyl 25 microg is a viable anesthetic for oocyte retrieval.
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Reg Anesth Pain Med · Jan 2001
Randomized Controlled Trial Comparative Study Clinical TrialFemoral nerve block with 0.25% or 0.5% bupivacaine improves postoperative analgesia following outpatient arthroscopic anterior cruciate ligament repair.
Femoral nerve block is effective in reducing postoperative pain after inpatient knee surgery. We studied its efficacy compared with standard analgesia following outpatient anterior cruciate ligament repair, including the duration of analgesia and the effect of different concentrations of bupivacaine. ⋯ Femoral nerve block with 0.25% bupivacaine contributes significantly to multimodal postoperative analgesia in the immediate postoperative period following outpatient anterior cruciate ligament repair. Both doses of bupivacaine studied provided analgesia for the first night after surgery.
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Reg Anesth Pain Med · Jan 2001
Randomized Controlled Trial Clinical TrialUltrasound imaging facilitates localization of the epidural space during combined spinal and epidural anesthesia.