Regional anesthesia
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Regional anesthesia · Sep 1996
Randomized Controlled Trial Comparative Study Clinical TrialSpread of local anesthetic into the epidural caudal space for two rates of injection in children.
The optimal rate of injection of local anesthetic in pediatric caudal blocks has not been determined. The purpose of this study was to determine the influence of two rates of injection on the level of analgesia in children. ⋯ Level of analgesia is not affected by the rate injection of 0.25% bupivacaine into the epidural caudal space in children. The time needed to reach the highest level increases as the child ages.
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Regional anesthesia · Sep 1996
Case ReportsPeripheral nerve catheterization in the management of terminal cancer pain.
Peripheral nerve catheterization techniques were used in two patients with severe pain associated with the terminal stages of metastatic cancer. The first patient had severe upper limb pain and lymphedema secondary to breast carcinoma, and the second patient had an acutely ischemic leg secondary to pelvic obstruction from an ovarian tumor. The goal of treatment was to relieve the pain, which was resistant to opioid drugs, and to optimize the quality of life that remained, estimated to be only a few weeks. ⋯ Peripheral nerve catheterization proved beneficial in two patients who presented with difficult pain management problems and should be more widely considered for the relief of severe cancer-related pain in both the upper and lower limbs.
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Regional anesthesia · Sep 1996
Clinical TrialAnalgesic efficacy and side effects of subarachnoid sufentanil-bupivacaine administered to women in advanced labor.
Previous studies of labor analgesia using subarachnoid sufentanil (alone or with adjuvants) have focused on women in the early first stage of labor. This study prospectively evaluated analgesia and side effects of subarachnoid sufentanil (10 micrograms) plus bupivacaine (2.5 mg) in parturients with cervical dilation of 7 cm or more. ⋯ In parturients with cervical dilation of 7 cm or more, subarachnoid sufentanil-bupivacaine produces rapid analgesia with an effective duration of approximately 130 minutes.
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Regional anesthesia · Sep 1996
Case ReportsContinuous spinal anesthesia for cesarean delivery in a patient with arthrogryposis multiplex congenita. A clinical report.
Arthrogryposis multiplex congenita (AMC) is a syndrome, diagnosed at birth, which presents with multiple joint contractures. Because this disease often progresses until there is dysfunction of multiple organ systems, it may have an impact on the anesthetic management. There are few anesthetic reports of this disease in the adult pregnant patient. ⋯ Continuous spinal anesthesia can be safely used for cesarean delivery in patients with AMC in the presence of appropriate monitoring.
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Regional anesthesia · Sep 1996
A multivariate model to predict the distance from the skin to the epidural space in an obstetric population.
Several attempts to relate epidural space depth to individual patient parameters or details of technique have yielded modest correlations. An attempt has been made to construct a multivariate model to predict the depth from the skin of the epidural space with use of several such factors. ⋯ While this model is the best predictor of epidural space depth yet published, it is probably not sufficiently accurate to be clinically useful in confirming proper epidural catheter placement. Further work in this area is probably not justified.