Regional anesthesia
-
Regional anesthesia · Sep 1992
Continuous pump pressures cannot be used to identify catheter tip migration into the subarachnoid space.
Migration of an epidural catheter into the subarachnoid space is a potentially lethal complication of continuous epidural anesthesia. We evaluated the use of pump pressure measurement during infusion in detecting such an occurrence. ⋯ We conclude that epidural and subarachnoid space resistance is essentially zero and the pump pressure in the system is used to overcome the catheter resistance. Both spaces offer the same total resistance to infusion and, therefore, pump pressure will not change when a catheter migrates into the subarachnoid space.
-
Regional anesthesia · Sep 1992
Brachial plexus block with the nerve stimulator: motor response characteristics at three sites.
Differences in motor response patterns, minimum electrical currents, and success rates using a nerve stimulator for brachial plexus block were determined for the interscalene, supraclavicular, and axillary approaches. ⋯ Localization of the brachial plexus with the nerve stimulator is equally effective at the interscalene, supraclavicular, and axillary sites. Current values in the range reported have no predictive value for success. Advantages of the nerve stimulator for brachial plexus block include an objective endpoint and continuous feedback.
-
Regional anesthesia · Sep 1992
Case ReportsSelective block of nerves in the axillary approach to the brachial plexus.
Optimal surgical conditions for flexor tendon tenolysis in the hand were achieved by ulnar, radial, and musculocutaneous nerve block at the axilla combined with median nerve block at the wrist. ⋯ Palpation of nerves together with a nerve stimulator were used to localize the nerves accurately.
-
Regional anesthesia · Sep 1992
Randomized Controlled Trial Comparative Study Clinical TrialTechnical and light microscopic comparison of four different small-diameter catheters used for continuous spinal anesthesia.
Recently several manufacturers developed ultra-thin catheters for continuous spinal anesthesia. Their use may be associated with technical problems. ⋯ The use of the 32-gauge polyurethane catheter was associated with problems that limit its clinical usefulness. Nylon and polyimide catheters with stainless steel stylets were more resistant to stretching. The nylon catheter was most resistant to adhesion of fibrinous material.
-
Regional anesthesia · Sep 1992
Randomized Controlled Trial Clinical TrialPerioperative analgesia with subarachnoid sufentanil administration.
Thirty-seven ASA Physical Status I parturients undergoing elective cesarean delivery were evaluated to determine the effects of subarachnoid sufentanil administration. ⋯ Duration of complete analgesia and duration of effective analgesia were prolonged significantly in all patient groups receiving sufentanil as compared to control groups receiving no narcotic. Pruritus was significantly increased in patient groups receiving subarachnoid sufentanil. Respiratory depression was not observed in any patient studied. One- and five-minute Apgar scores; umbilical, venous, and arterial blood gas results; and Early Neonatal Neurobehavioral Scale results were all within normal limits and were not significantly different among the groups.