Regional anesthesia
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Regional anesthesia · Nov 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of postanesthetic sequelae after clinical use of 27-gauge cutting and noncutting spinal needles.
The tips of the bevels of thin spinal needles may be easily damaged by bony contact during puncture attempts. In this respect and also because they are less traumatic by design, noncutting, pencil-point-tip needles may be beneficial. A prospective clinical comparison of postanesthetic effects of the use of 27G Quincke-type and pencil-point spinal needles was therefore performed. ⋯ Postanesthetic sequelae, including postdural puncture headache (overall incidence 2.5%), were not related to the shape of the spinal needles or to the damage of the Quincke-type needles.
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Regional anesthesia · Nov 1997
Case ReportsRemoval of a torn Racz catheter from lumbar epidural space.
Epidural adhesiolysis, described by Racz et al. (1) utilizing a double-contrast injection technique, provides an epidurogram that clearly delineates the area of adhesions and furnishes a means to perform lesion-specific lysis of adhesions utilizing a flexible wire-embedded catheter. ⋯ This case report illustrates a difficult situation with a sheared and retained epidural catheter which could not be removed utilizing the standard techniques but was successfully removed without any residual problems using arthroscopy forceps.
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Regional anesthesia · Nov 1997
Randomized Controlled Trial Clinical TrialA low-dose hypobaric bupivacaine spinal anesthesia for knee arthroscopies.
Ambulatory surgery requires anesthesia methods that allow rapid recovery and safe discharge of the patient. Spinal anesthesia is easy and quick to perform, and the use of noncutting small gauge needles reduces the occurrence of postdural puncture headache. For minimal hemodynamic consequences and faster recovery and discharge it would be optimal to limit the spread of spinal anesthesia only to the area which is necessary for surgery. In this study, the possibility in achieving unilateral spinal anesthesia with 0.18% hypobaric bupivacaine was studied. ⋯ Approximately three and a half milliliters hypobaric 0.18% bupivacaine (6.12 mg) provides a predominantly unilateral spinal block. Thirty minutes spent in the lateral position does not provide benefits over 20 minutes. The main advantages of our method are the hemodynamic stability and the patient satisfaction.
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Regional anesthesia · Nov 1997
Randomized Controlled Trial Comparative Study Clinical TrialIncidence of genitofemoral nerve block during lumbar sympathetic block: comparison of two lumbar injection sites.
Genitofemoral nerve (GFN) block is a known side effect of a lumbar sympathetic block (LSB), although the incidence has not been well documented. Furthermore, genitofemoral neuralgia can occur following neurolytic LSB. Because the level at which the GFN exits the psoas sheath varies, this study was designed to identify differences in the incidence of GFN block following LSB at the level of the second versus the fourth lumbar vertebrae. ⋯ The GFN is less likely to be blocked when the LSB is performed near the second lumbar vertebra as compared with the fourth lumbar vertebra.