Regional anesthesia
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Regional anesthesia · Jul 1996
Case ReportsPressure sores as a complication of patient-controlled epidural analgesia after cesarean delivery. Case report.
Postoperative epidural analgesia using mixtures of bupivacaine and opioids has become common practice following abdominal surgery. Side effects such as hypotension, motor block, respiratory depression, pruritus, and urinary retention are well known. Pressure sores occurring within the first 24 hours are extremely rare. ⋯ Pressure sores following postoperative epidural analgesia may occur even in young patients. Although bupivacaine may induce a motor block, its combination with other drugs in the analgesic mixture or other contributing factors may explain the occurrence of pressure sores. Prophylaxis and increased alertness should eliminate this complication.
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Regional anesthesia · Jul 1996
An observational study of combined continuous lumbar plexus and single-shot sciatic nerve blocks for post-knee surgery analgesia.
In a study of postoperative analgesia after major knee surgery, an assessment was made of the efficacy of continuous lumbar plexus block combined with a single-shot block of the sciatic nerve. ⋯ Sciatic nerve block is essential for successful analgesia during the immediate postoperative period but is not mandatory for longer-term pain control, which can be achieved by continuous lumbar plexus block.
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Regional anesthesia · Jul 1996
Antinociceptive and motor-blocking efficacy of ropivacaine and bupivacaine after epidural administration in the dog.
This study was initiated to evaluate the antinociceptive and motor blocking capabilities of epidurally administered 0.5% and 0.75% ropivacaine and bupivacaine using a blinded, random crossover design in the dog. Additionally, serum drug concentrations and serum protein binding were determined. ⋯ The 0.5% solutions produced similar sensory block of the vertebral dermatomes. Duration of dermatomal block with 0.75% bupivacaine was longer than with the corresponding ropivacaine concentration. Ropivacaine produced motor block of shorter duration as compared with bupivacaine. Serum concentrations of the two drugs were similar after injection of the same doses. In this animal model, ropivacaine produced shorter durations of sensory and motor block than corresponding concentrations of bupivacaine. These data are consistent with previously published data in animals and humans.
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Regional anesthesia · Jul 1996
Letter Case ReportsStretching of epidural nylon catheters on removal.