Regional anesthesia
-
Regional anesthesia · Jan 1992
Venous levels of lidocaine and bupivacaine after midtarsal ankle block.
No data are available on blood levels of local anesthetics after ankle block. ⋯ The low peak level of local anesthesia and the prolonged analgesia confirmed the safety and efficacy of midtarsal ankle block for forefoot surgery and suggest that bupivacaine may be the local anesthetic agent of choice.
-
Regional anesthesia · Jan 1992
Case ReportsBilateral subdural hematomas after dural puncture: delayed diagnosis after false negative computed tomography scan without contrast.
BACKGROUND. Dural puncture secondary to spinal anesthesia or unintentional dural puncture during attempted epidural anesthesia can lead to headaches complicated by bilateral subdural hematomas. ⋯ CONCLUSION. Computed tomography scans with contrast media or magnetic resonance imaging may be necessary to diagnose bilateral subdural hematomas.
-
Regional anesthesia · Jan 1992
Continuous epidural methadone for the management of postoperative pain after lower abdominal surgery.
The efficacy of methadone administered by continuous epidural infusion for 24 hours for the management of postoperative pain has been reported. The pharmacokinetic characteristics of methadone predict that significant accumulation would occur if infusions were continued for longer than 24 hours and that this accumulation could result in serum concentrations above the threshold associated with systemic analgesia. ⋯ The accumulation of serum concentrations reported here argue that the risks of thoracic epidural placement may outweigh the potential benefits when methadone is administered alone by continuous infusion for longer than 24 hours.