Regional anesthesia
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Effective management of severe pain in acute pancreatitis is one of the important issues in therapy, as pain reflexes can contribute to the development of life-threatening secondary complications. Although opioid derivatives are still clinically in use, the direct interruption of afferent nociceptive visceral stimulation (e.g., by segmental epidural block) is claimed to be much more effective method of pain relief. However, in a group of the patients with alcohol ingestion as the etiology of pancreatitis and history of drug/opioid addiction in the background, epidural block failed to alleviate the pain. Study aim was to assess the effect of continuous celiac plexus block as an alternative analgesic method in patients with acute pancreatitis by using a retrospective analysis. ⋯ Intermittent or continuous unilateral celiac plexus block offers an effective alternative treatment for pain in acute pancreatitis, especially in patients with alcohol etiology and history of drug/opioid addiction, in whom the conventional methods fail to give proper pain relief.
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Regional anesthesia · Nov 1995
Comment Letter Comparative StudyOutcome of epidural analgesia versus patient-controlled analgesia in cancer patients.
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Regional anesthesia · Nov 1995
Letter Clinical TrialDiaphragmatic motion during continuous interscalene brachial plexus block.
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Regional anesthesia · Nov 1995
Randomized Controlled Trial Comparative Study Clinical TrialA double-blind comparison of the abdominal wall relaxation produced by epidural 0.75% ropivacaine and 0.75% bupivacaine in gynecologic surgery.
Ropivacaine is a long-acting local anesthetic agent with similar potency to that of bupivacaine when administered for epidural anesthesia. Ropivacaine, however, may be less cardiotoxic than bupivacaine. Epidural bupivacaine and ropivacaine have been shown to be equally effective in providing sensory block for lower extremity surgery, but they have not been compared for their ability to produce abdominal wall relaxation. ⋯ Both 0.75% ropivacaine and 0.75% bupivacaine provide adequate surgical anesthesia for lower abdominal surgery when administered epidurally. However, lower extremity motor block with ropivacaine is significantly shorter and of slower onset and sensory block shorter at these concentrations.
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Regional anesthesia · Nov 1995
Randomized Controlled Trial Comparative Study Clinical TrialInfluence of baricity on the outcome of spinal anesthesia with bupivacaine for lumbar spine surgery.
Although the majority of elective lumbar spine surgical procedures are performed under general anesthesia, successful use of spinal and epidural anesthesia has been reported. This study was designed to evaluate the influence of baricity on the performance of spinal anesthesia for lumbar spine surgery. ⋯ Plain bupivacaine is superior to hyperbaric bupivacaine for spinal anesthesia for elective lumbar spine surgery.