Regional anesthesia
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Regional anesthesia · Mar 1995
Randomized Controlled Trial Clinical TrialAlkalinization of mepivacaine improves the quality of motor block associated with interscalene brachial plexus anesthesia for shoulder surgery.
Interscalene block has produced appropriate anesthesia for shoulder surgery. Success is partly determined by the quality of motor block achieved. This study was designed to evaluate the influence of alkalinization of mepivacaine on the quality of motor block achieved with interscalene brachial plexus anesthesia. ⋯ Alkalinization of mepivacaine improves the quality of motor block after interscalene brachial plexus block for shoulder surgery.
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Regional anesthesia · Mar 1995
Comparative Study Clinical TrialHypnosis as adjunct therapy in conscious sedation for plastic surgery.
Sedation is often requested during local and regional anesthesia. However, some surgical procedures, such as plastic surgery, require conscious sedation, which may be difficult to achieve. Hypnosis, used routinely to provide conscious sedation in the authors' Department of Plastic Surgery, results in high patient and surgeon satisfaction. The authors conducted a retrospective study to investigate the benefits of hypnosis in supplementing local anesthesia. ⋯ Successful hypnosis as an adjunct sedation procedure to conscious intravenous sedation provided better pain and anxiety relief than conventional intravenous sedation and allowed for a significant reduction in midazolam and alfentanil requirements. Patient satisfaction was significantly improved.
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Regional anesthesia · Mar 1995
Clinical TrialCompartment block for foot surgery. A new approach to tibial nerve and common peroneal nerve block.
The concept of single injections of local anesthetics into fascial compartments was pioneered by Winnie in reports on paravascular techniques. Winnie described an axillary approach for brachial plexus block and the inguinal route for lumbar plexus block. The compartmental principle can, with advantage, be extended to more peripheral anesthesia of the tibial and common peroneal nerves by the use of osteofascial compartments in the leg. ⋯ Further studies of compartmental anesthesia for other nerve trunks and plexuses may be of value.
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Regional anesthesia · Mar 1995
Clinical TrialEpidural air injection assessed by transesophageal echocardiography.
The object of this study, using transesophageal echocardiography (TEE) in anesthetized patients, was to investigate the occurrence of venous air embolism (VAE) when air is injected into the epidural space. ⋯ No evidence of clinically significant VAE was seen in any patient. The results suggest that drugs injected into the epidural space may have unexpectedly easy access to the venous circulation with a potential to produce unwanted systemic effects. Clinicians should be alert to the possibility that local anesthetics, or any other drug placed epidurally, may rapidly enter the systemic circulation even without the intravenous placement of an epidural catheter.
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Regional anesthesia · Mar 1995
Case ReportsUnintentional subdural block during labor epidural in a parturient with prior Harrington rod insertion for scoliosis. Case report.
The authors report a case of unintentional subdural block in a parturient with prior Harrington rod insertion. ⋯ Lumbar epidural anesthesia is not always an easily performed technique and is known to be associated with a higher incidence of complications in patients with prior Harrington rod insertion. Prompt recognition and proper management of subdurally placed needle and catheter avoided more serious complications.