Regional anesthesia
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Regional anesthesia · Sep 1994
Randomized Controlled Trial Comparative Study Clinical TrialDifferential epidural block. Does the choice of local anesthetic matter?
It is well established that spinal anesthesia results in a differential block to the sensations of pinprick and cold temperature discrimination. However, the existence of differential block during epidural anesthesia has not always been accepted. Recently, it has been shown that lumbar epidural anesthesia with chloroprocaine and lidocaine produces a differential block to pinprick and cold sensation. The purpose of this study was to determine if the choice of local anesthetic used for epidural anesthesia has any influence on the relative levels of anesthesia, analgesia, and cold sensation. ⋯ This study reaffirms the existence of differential sensory block during epidural anesthesia and establishes that the observed differential block appears to be independent of the local anesthetic used.
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Regional anesthesia · Sep 1994
Clinical TrialInterscalene brachial plexus block for shoulder surgery.
To evaluate the efficacy of interscalene brachial plexus block as the primary anesthetic for shoulder surgery, the influence on blood loss, and the rate of complication. ⋯ Interscalene anesthesia is an effective anesthetic for elective shoulder surgery that may decrease intraoperative blood loss with a low complication rate.
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Regional anesthesia · Sep 1994
Case ReportsSubdural anesthesia as a complication of an interscalene brachial plexus block. Case report.
Interscalene brachial plexus block is performed in the groove between the anterior and middle scalene muscles at the level of C6, just over the transverse process. Injection occurs within 1-2 cm of the dural sleeve and could be misdirected into the epidural, subdural, or subarachnoid spaces. ⋯ The case represents a partial injection of local anesthetic intended for the interscalene brachial plexus into the subdural space. The diagnosis is based on the normal evolution of the block into full motor and sensory anesthesia of the ipsilateral brachial plexus that evolved into a patchy, sensory, and motor block involving many dermatomes outside the brachial plexus, with minimal sympathetic block, and evidence of a normal interscalene block on emergence from general anesthesia. Subdural injection must be considered when unusual motor and sensory block occurs after interscalene block, especially after a time interval too long for epidural or subarachnoid injection, or with minimal evidence of sympathetic block, after suspected high central block injection.
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Regional anesthesia · Sep 1994
Comment Letter Case ReportsCombined spinal-epidural anesthesia in parturient with Harrington rods.
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Regional anesthesia · Sep 1994
Letter Historical ArticleInventors of the pencil-point spinal needle.