Regional anesthesia
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Four local or regional anesthesia techniques for the insertion of cardiac pacemaker were studied prospectively in 40 patients. The four techniques studied were: local anesthesia, field block of the supraclavicular nerves, interscalene block at C4, and interscalene block at C6. The three goals of the study were to find the technique that gave the best quality of analgesia, the incidence of complications related to each technique, and the area of sensory innervation of C4. ⋯ Interscalene blocks at C4 and C6 were associated with complications and side effects more often than the two other techniques. The authors also suggest that the dermatome of C4 is not under the clavicle but above the clavicle. It was concluded that local anesthesia infiltration at the site of cardiac pacemaker insertion or field block of the supraclavicular nerves are the best techniques for cardiac pacemaker insertion.
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Regional anesthesia · Mar 1989
A retrospective analysis of neurolytic celiac plexus block for nonpancreatic intra-abdominal cancer pain.
Neurolytic celiac plexus block (NCPB) has been reported to be an effective method for pain relief for a variety of intra-abdominal malignancies, especially pancreatic. In spite of this, few data exist concerning efficacy of the block for pain related to other intraabdominal tumors. ⋯ The incidence of neurologic injury (footdrop) was less than 0.5%. This therapy deserves more widespread use in patients with abdominal pain secondary to a variety of other malignancies, in addition to that of the pancreas.
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Regional anesthesia · Mar 1989
Comparative StudyA comparison of cardiovascular responses of normotensive and hypertensive elderly patients following bupivacaine spinal anesthesia.
The hypotensive effects of spinal anesthesia were investigated in 60 patients aged 75 years or older and divided into two groups: 30 normotensive patients (group 1) and 30 treated hypertensive patients (group 2). In both groups, spinal anesthesia was performed in lateral decubitus position with 3 ml 0.5% isobaric bupivacaine. Hemodynamic measurements were performed before the establishment of spinal blockade and repeated during the 60 minutes following intrathecal injection. ⋯ Five patients in group 2 (but none in group 1) had a SBP decrease of 40% from baseline or more. The decreases in MBP and DBP were persistent after 60 minutes. These results suggest that pre-existing hypertension can be recognized as an important factor to explain blood pressures changes during isobaric bupivacaine spinal anesthesia in elderly patients.
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Regional anesthesia · Jan 1989
Randomized Controlled Trial Comparative Study Clinical TrialTreatment of shivering after epidural lidocaine.
The effectiveness of intravenous meperidine and warm local anesthetic for prevention of postanesthetic shivering was evaluated in urology patients undergoing epidural blockade for extracorporeal shockwave lithotripsy. When administered before the blockade, meperidine, 12.5 mg or 25 mg, was not significantly better than saline placebo for preventing postepidural shivering. ⋯ The authors concluded that neither meperidine, in doses employed, nor body-temperature lidocaine prevents shivering after epidural blockade. This shivering appears to be different from that observed during emergence from general anesthesia.