Regional anesthesia
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An epidural anesthetic was planned for a 24-year-old woman for analgesia during labor and for a 28-year-old woman for an elective cesarean delivery. ⋯ To prevent the knotting of an epidural catheter, it should not be inserted more than 3-4 cm into the epidural space. General anesthesia may be one of the options to remove the catheter.
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Regional anesthesia · Jan 1996
Microscopic analysis of the tips of thin spinal needles after subarachnoid puncture.
Foreign material may pass unrecognized with the spinal needle into the subarachnoid space. Therefore the tips of three clinically used types of spinal needles--Quincke (27-gauge), two-zone bevel (26-gauge), and Sprotte or pencil point (27-gauge)--were prepared for microscopic analysis after subarachnoid puncture in human cadavers. ⋯ Of the three needle types studied, the pencil point type has a tip that best withstands distortion and adherence of foreign material during experimental subarachnoid puncture.
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Transient radicular irritation (TRI) has been described to occur following spinal anesthesia with hyperbaric 5% lidocaine. The authors recently used only isobaric or hyperbaric 0.5% bupivacaine for spinal anesthesia. All patients who had spinal anesthesia for various kinds of surgery were interviewed after the operation to discover the possibility of TRI following bupivacaine spinal anesthesia. ⋯ In spite of one case of TRI, the authors consider bupivacaine to be safe for spinal anesthesia. The association of the sitting and lithotomy positions to the restricted distribution of hyperbaric solution and consequent TRI warrants further studies.