Regional anesthesia
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Regional anesthesia · Nov 1996
Randomized Controlled Trial Clinical TrialIncidence of tissue coring with the 25-gauge Quincke and Whitacre spinal needles.
Tissue cores, implanted into the subarachnoid space during subarachnoid injections, can develop into intraspinal lumbar epidermoid tumors. The availability of smaller needles has made spinal anesthesia more popular. Therefore, this prospective, randomized, blinded study was undertaken to determine whether tissue coring occurs with two of the currently used 25-gauge spinal needles. ⋯ The 25-gauge Quincke and 25-gauge Whitacre spinal needles currently used in anesthesia can produce tissue coring.
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Regional anesthesia · Nov 1996
Hemostasis-altering drugs and central neural block. A survey of anesthetic practice in Scotland and the United Kingdom.
There is debate regarding the use of central neural block in the presence of hemostasis-altering drugs. This study aims to examine current practice. ⋯ There is general agreement regarding contraindication of central neural block in the presence of full anticoagulation with either heparin or warfarin, but there is less consensus about the use of central neural block in the presence of low-dose subcutaneous heparin. There is some confusion about the role of aspirin and its duration of action.
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Regional anesthesia · Nov 1996
Randomized Controlled Trial Comparative Study Clinical TrialEMLA cream effectively reduces the pain of spinal needle insertion.
EMLA cream is an effective topical anesthetic, which is commonly used for analgesia during venous cannulation in the pediatric population. This study was designed to compare the efficacy of EMLA cream with that of infiltration with lidocaine in relieving the pain associated with administration of spinal anesthesia. ⋯ EMLA cream is an effective alternative to lidocaine infiltration for analgesia during the administration of spinal anesthesia when using a 25-gauge spinal needle via a 20-gauge introducer. Application of EMLA cream for at least 30 minutes prior to spinal needle insertion is adequate to provide good analgesia during needle insertion.
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Regional anesthesia · Nov 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison of two application techniques of EMLA and pain assessment in pediatric oncology patients.
The study was designed to compare the analgesic efficacy of the local anesthetic EMLA when applied as a patch and as a cream in combination with a Tegaderm dressing to pediatric oncology patients undergoing repeated lumbar punctures. ⋯ The EMLA patch and the EMLA cream are equally effective in alleviating pain associated with lumbar puncture. The EMLA patch simplifies and speeds up the application of EMLA. It also allows for control of the dose administered per application, thus preventing both over- and underdosing.