Regional anesthesia
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Regional anesthesia · Jul 1997
Distribution of local anesthetic solution in retromediastinal block. Preliminary experimental results.
Interpleural anesthesia blocks pain perception from the thoracoabdominal wall without impairment of leg function. Bilateral interpleural anesthesia is not recommended because of possible bilateral impairment of respiratory function. Infiltration of the retromediastinum with local anesthetic might cause bilateral thoracoabdominal somatic block and block of sympathetic afferents from the abdominal cavity without impairing respiration. ⋯ Block of pain perception from the abdominal wall and cavity is possible by injection of local anesthetic into the retromediastinum via a catheter introduced through the esophageal diaphragm hiatus. The block would not be expected to impair respiratory or leg function. Its efficacy and safety have yet to be established.
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Regional anesthesia · Jul 1997
Randomized Controlled Trial Clinical TrialKetorolac as an adjunct to patient-controlled morphine in postoperative spine surgery patients.
This randomized double-blind study was designed to determine whether administration of ketorolac either on schedule or as a component of patient-controlled analgesia (PCA) to patients who have undergone spinal stabilization would decrease PCA morphine use, decrease side effects, and/or enhance analgesia. ⋯ Ketorolac should be as a component of the PCA morphine in patients undergoing spine stabilization surgery. This results in decreased morphine consumption, decreased somnolence, and enhanced analgesia in comparison with patients who do not receive ketorolac.
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Regional anesthesia · Jul 1997
Local anesthetic infusion through nerve sheath catheters for analgesia following upper extremity amputation. Clinical report.
Reports about the efficacy of local anesthetic perfusion of nerve stumps following lower extremity amputation are conflicting. We report our experience with this technique following amputation of the upper extremity. ⋯ Continuous local anesthetic perfusion of amputated nerves via a catheter placed under direct vision provided excellent postoperative analgesia. The incidence of phantom limb pain for cancer patients did not differ from that previously reported but was easily managed pharmacologically. The technique may also be efficacious for traumatic amputations.