Regional anesthesia
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Regional anesthesia · May 1997
Randomized Controlled Trial Comparative Study Clinical TrialPain relief after knee arthroscopy: intra-articular morphine, intra-articular bupivacaine, or subcutaneous morphine?
This investigation was undertaken to compare analgesic effects, side effects, and requirements for supplemental analgesic therapy after knee arthroscopy in patients given intra-articular (IA) or subcutaneous (SC) morphine, intra-articular bupivacaine, or placebo. ⋯ A single 10-mg dose of morphine given either IA or SC provides better and longer-lasting postoperative pain relief after knee arthroscopy than 20 mL IA bupivacaine 0.5% with epinephrine.
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Regional anesthesia · May 1997
Clinical TrialSingle-injection lumbar epidural morphine for postoperative analgesia in children: a report of 175 cases.
Since the first report of epidural opioid administration to pediatric patients, several studies have described the quality of analgesia, doses, pharmacokinetics, and side effects of this procedure. A pediatric series using an easy and cheap single-injection technique of epidural morphine administration for postoperative analgesia is presented. ⋯ This technique is easy to perform, even for trainees in anesthesiology. With appropriate patient selection and avoidance of the concomitant use of narcotics and sedatives, epidural morphine provides prompt, effective, safe, and prolonged analgesia in children.
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Regional anesthesia · May 1997
Case ReportsAnesthesia for cesarean delivery in a patient with Ehlers-Danlos syndrome type II.
Ehlers-Danlos syndrome, an inherited connective tissue disease, is rarely seen in pregnancy. Presentation may be mild or severe, depending on which type of the syndrome the patient possesses. ⋯ In patients with Ehlers-Danlos syndrome, it is important to be aware of which type is present and to be knowledgeable about and prepared for any potential complications.
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Regional anesthesia · May 1997
Case ReportsThermal grill illusion and complex regional pain syndrome type I (reflex sympathetic dystrophy).
In normal humans, placing a hand on a thermal grill containing warm elements separated by cool ones produces a burning sensation. In this case report, responses to a thermal grill in a patient with neuropathic pain were examined. ⋯ The thermal grill may be a useful a tool to help understand the pathophysiology of complex regional pain syndrome type I.
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Regional anesthesia · May 1997
Comparative StudyComparison of accuracy and cost of disposable, nonmechanical pumps used for epidural infusions.
Temporary epidural catheter pumps are used to infuse analgesics in patients with chronic intractable pain. Three brands of disposable, nonmechanical pumps adapted for epidural infusion were tested to determine their flow rate efficacy and their cost effectiveness. ⋯ All three units deviated considerably from the claimed flow rate of 2-mL/h, both at the beginning and at the end of the infusion. Presumably, the decreasing flow rates are responsible for the diminishing pain relief often experienced by patients over the course of the infusion. The Homepump unit appeared to be the most cost-effective and the easiest to handle and maintained an acceptable infusion rate for the greatest percentage of the infusion period. The considerable cost benefit of using a nonmechanical disposable pump as opposed to a costly but more reliable computerized pump appears to warrant further product improvement and development.