Regional anesthesia
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Regional anesthesia · Nov 1997
ReviewProgress in the development of ultra-long-acting local anesthetics.
Local anesthetic agents with a duration of action longer than the currently available local anesthetics could have widespread clinical application for the treatment of both chronic and acute pain. Over the last several decades, several different approaches have been used in the development of ultra-long-acting agents. There are currently promising preparations in development which may prove clinically useful in the near future. ⋯ Although encouraging results have been reported in the literature, there is currently no agent or delivery system that has shown reliable and practical prolongation of local anesthetic effect in humans. There have been several encouraging reports in animals that have shown local anesthetic effects lasting up to several days, but these results must be validated and then performed in human studies before a clinically useful agent is found. Further research is warranted.
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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.
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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
Randomized Controlled Trial Clinical TrialPostoperative analgesia and antiemetic efficacy after intrathecal neostigmine in patients undergoing abdominal hysterectomy during spinal anesthesia.
Postoperative analgesia and antiemetic efficacy after intrathecal neostigmine were investigated in a randomized, double-blind, placebo-controlled trial of 100 patients undergoing abdominal hysterectomy. ⋯ Intrathecal neostigmine (100 microg) was ineffective for postoperative analgesia after abdominal hysterectomy due to side effects of nausea and vomiting.