Regional anesthesia
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Regional anesthesia · Jan 1995
Clinical Trial Controlled Clinical TrialHemodynamic effects of 0.375% versus 0.25% bupivacaine during cervical epidural anesthesia for hand surgery.
Cervical epidural anesthesia with 0.375% or 0.25% bupivacaine plus fentanyl is a reliable technique for surgical restoration of digital motion-after tourniquet release and rehabilitation. The study was designed to assess the hemodynamic effects of this technique in 11 ASA 1 patients. ⋯ Hemodynamic effects, in ASA 1 patients, are moderate and not dependent on the studied concentration of bupivacaine, indicating that a similar degree of sympathetic block is achieved with 0.375% and 0.25% bupivacaine.
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To acquire an accurate knowledge of the relationship of the sympathetic chain to the vertebral column. ⋯ Although the location of the ganglia is quite variable, the best approach for sympathetic block is to advance the needle paravertebrally through the fascia of the psoas muscle slightly cephalad to the midpoint of the body of L3.