Regional anesthesia
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Regional anesthesia · Mar 1996
Case ReportsHigh spinal anesthesia after epidural test dose administration in five obstetric patients.
A commonly used test dose in parturients receiving continuous lumbar epidural analgesia for labor consists of 3 mL of dextrose-free 1.5% lidocaine with 1:200,000 epinephrine. ⋯ While this test dose appears to be a sensitive indicator of an unexpected subarachnoid catheter, the resulting excessive spinal blocks in these laboring patients raise the question of its safety.
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Epidural air bubbles are known to persist for more than 24 hours after injection. Nitrous oxide may cause expansion of these bubbles. ⋯ Inhalation of nitrous oxide results in expansion of epidural air bubbles. This may cause displacement of epidural local anesthetics it large volumes of air are present in the epidural space.
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Regional anesthesia · Mar 1996
Randomized Controlled Trial Clinical TrialSpinal anesthesia. Volume or concentration--what matters?
An investigation was made of the effects of volume and concentration of a constant dose of subarachnoid lidocaine on the extent and duration of sensory and motor anesthesia produced, as well as of the lidocaine concentration of the cerebrospinal fluid (CSF) as a function of time. ⋯ A constant 70-mg dose of subarachnoid lidocaine produced the same pinprick level of analgesia, degree of motor block, and duration of spinal anesthesia in spite of being injected over an extremely broad range of concentrations and volumes. Despite the fact that all patients received the same dose of lidocaine, the CSF concentrations at 5, 10, and 15 minutes were different and directly related to the concentration of the solution injected. at 20 minutes, the CSF concentrations were similar in all groups. These results indicate a relatively uniform distribution of lidocaine in the CSF for all solutions tested.
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Regional anesthesia · Mar 1996
Randomized Controlled Trial Clinical TrialAnalgesic effect of incisional morphine following inguinal herniotomy under spinal anesthesia.
Opioids have been shown to possess antinociceptive effects after peripheral administration in experimental and clinical studies. The results of clinical studies on intra-articularly administered morphine are, however, conflicting. The objective of this study was to examine a possible analgesic effect of incisionally administered morphine on postoperative pain in patients undergoing inguinal herniotomy. ⋯ A single 5-mg dose of morphine injected in the herniotomy wound did not affect pain scores or supplementary analgesic requirements, which argues against a role of peripheral opioid receptors in mediating analgesia.
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Regional anesthesia · Mar 1996
Comparative StudyAn in vitro comparison of fluid leakage after dural puncture with Atraucan, Sprotte, Whitacre, and Quincke needles.
The study was designed to evaluate the influence of needle size and design on the rate of leakage following dural puncture. ⋯ The comparably low leakage rate produced by the Atraucan, a new needle with a terminal opening, suggests that this needle is worthy of further clinical evaluation.