Regional anesthesia
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Regional anesthesia · Nov 1993
Case Reports Randomized Controlled Trial Clinical TrialDirection of catheter insertion and incidence of paresthesias and failure rate in continuous epidural anesthesia: a comparison of cephalad and caudad catheter insertion.
Paresthesias and unblocked segments during continuous epidural anesthesia--sometimes leading to higher doses of local anesthetics--can increase the risk of this technique. A cephalad insertion of the epidural catheter might decrease the incidence of these problems, but this has not been evaluated before in a controlled study. ⋯ Our results support the contention that the catheter should be directed cephalad during insertion for continuous epidural anesthesia.
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Regional anesthesia · Nov 1993
Randomized Controlled Trial Comparative Study Clinical TrialThoracic versus lumbar administration of epidural morphine for postoperative analgesia after thoracotomy.
The purpose of this study was to compare the effects of thoracic and lumbar epidural morphine on pulmonary function and analgesia after thoracotomy for pulmonary resection. ⋯ The authors conclude that thoracic epidural morphine administration in patients after thoracotomy results in decreased morphine requirements and the same degree of analgesia as does lumbar administration.
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Regional anesthesia · Nov 1993
Medial branch blocks are specific for the diagnosis of cervical zygapophyseal joint pain.
To determine the specificity of cervical medial branch blocks for the diagnosis of cervical zygapophyseal joint pain by ascertaining the disposition of the local anesthetic after injection of the medial branches of the cervical dorsal rami. ⋯ Local anesthetic blocks of the cervical medial branches are a specific test for the diagnosis of cervical zygapophyseal joint pain. The local anesthetic always reaches the target nerve and does not affect any other diagnostically important structures.
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Regional anesthesia · Nov 1993
Continuous spinal anesthesia: mechanical and technical problems of catheter placement.
Although continuous spinal anesthesia with microcatheters has a number of advantages, there are also some drawbacks: technical problems in advancing the catheter, the possibility of traumatizing neural structures, the development of cauda equina syndrome, and maldistribution of the local anesthetic. ⋯ To take advantage of continuous spinal anesthesia, a meticulous technique is required.
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Regional anesthesia · Nov 1993
Historical ArticleContinuous spinal anesthesia: a historical perspective.