Regional anesthesia
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Regional anesthesia · Jan 1994
Randomized Controlled Trial Clinical TrialDiluting lidocaine and mepivacaine in balanced salt solution reduces the pain of intradermal injection.
Intradermal injection of local anesthetics prior to percutaneous needle insertion is often painful. This study evaluated the effect of diluting lidocaine and mepivacaine with balanced salt solution on perception of pain on intradermal injection. ⋯ The dilution of lidocaine and mepivacaine with balanced salt solution produces a solution that is both painless on injection and of moderate duration.
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Regional anesthesia · Jan 1994
Comparative StudyComparative flow rates of saline in commonly used spinal needles including pencil-tip needles.
Certain characteristics of spinal needles that can influence their clinical usefulness were examined, namely, flow rates, internal diameters, and size of orifices of pencil-type needles. ⋯ Needles of the same gauge do not necessarily have the same flow rate. Flow rate correlates well with internal, not external, diameter. By considering < or = 2 seconds to be the desirable time for saline to traverse a spinal needle, all, except two, meet this criterion. The orifice of Whitacre needle has more desirable features than that of Sprottle needle. Anesthesiologists are encouraged to use 27-gauge needles since their flow rate is not slower than that of 26-gauge needles.
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Regional anesthesia · Jan 1994
Case ReportsCombined spinal and epidural anesthesia for abdominal hysterectomy in a patient with myotonic dystrophy. Case report.
The authors report a case of myotonic dystrophy in a 34-year-old woman who presented for total abdominal hysterectomy. The goal of anesthetic management is to prevent the known triggers of myotonic crisis, such as hypothermia, shivering, and hyperkalemia; and to avoid depolarizing muscle relaxants and anticholinesterase agents. ⋯ After the postoperation, optimal analgesia was obtained by infusing local anesthetic (0.125% bupivacaine) via the epidural catheter. No obvious side effects occurred. The authors believe combined spinal and epidural block provides a safe alternative, to other techniques, and minimizes the potential hazards of myotonic dystrophy, while offering effective intraoperative anesthesia and postoperative analgesia.