Regional anesthesia
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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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Interpleural analgesia is an effective method for pain relief after upper abdominal surgery. To examine whether the analgesic effect is obtained by block of the intercostal nerves, we assessed the analgesic efficacy of the block, the skin sensitivity, and indices of sympathetic outflow over the trunk. ⋯ The incomplete cutaneous sensory and sympathetic block indicates that the analgesic effect of interpleural analgesia cannot be explained by retrograde diffusion of the local anesthetic solution into the intercostal nerves alone.
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Postdural puncture headache can recur following an epidural blood patch but usually does so within the first week. However, a late recurrence was encountered in a 31-year-old woman with probable lupus vasculitis. ⋯ A review of risk factors for postdural puncture headache and the role of an epidural blood patch suggests a possible explanation for the late recurrence in this case.