Regional anesthesia
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Regional anesthesia · Sep 1996
Anatomic considerations for sciatic nerve block in the popliteal fossa through the lateral approach.
The disadvantage of the classic posterior approach to block of the sciatic nerve at the knee level (popliteal nerve block [PNB]) is the need to position a patient in the prone position for performance of the block. In this study on cadavers, a lateral approach to the popliteal nerve in the supine position was investigated, and some anatomic considerations of relevance to popliteal nerve block were addressed. ⋯ A lateral approach to the popliteal nerve with insertion of the needle at a 30 degrees angle relative to the horizontal plane results in predictable approximation of the needle tip to the popliteal nerve. The results also suggest the existence of a continuous neural sheath encompassing the popliteal nerve and its main branches. This may have clinical implications similar to those in perivascular neuronal block.
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Regional anesthesia · Jul 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison between hemodynamic changes after single-dose and incremental subarachnoid anesthesia.
The depressant activity on sympathetic tone of subarachnoid anesthetic block is well known. The aim of this study was to compare cardiovascular response to an incremental dose of subarachnoid anesthesia administered through a small-bore microcatheter with the response to single-dose spinal anesthesia. ⋯ In well-hydrated, healthy patients incremental local anesthetics offer adequate subarachnoid anesthesia with minimal hemodynamic effects.
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Regional anesthesia · Jul 1996
Randomized Controlled Trial Clinical TrialFemoral nerve block. Single injection versus continuous infusion for total knee arthroplasty.
This study was conducted to ascertain whether there is any advantage to the continuous-infusion femoral 3-in-1 nerve block over the single-injection femoral nerve block for postoperative analgesia after total knee arthroplasty. ⋯ We were unable to confirm improvements in analgesia provided by continuous-infusion femoral 3-in-1 nerve block for total knee arthroplasty except in the recovery room.
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Regional anesthesia · Jul 1996
Case ReportsPressure sores as a complication of patient-controlled epidural analgesia after cesarean delivery. Case report.
Postoperative epidural analgesia using mixtures of bupivacaine and opioids has become common practice following abdominal surgery. Side effects such as hypotension, motor block, respiratory depression, pruritus, and urinary retention are well known. Pressure sores occurring within the first 24 hours are extremely rare. ⋯ Pressure sores following postoperative epidural analgesia may occur even in young patients. Although bupivacaine may induce a motor block, its combination with other drugs in the analgesic mixture or other contributing factors may explain the occurrence of pressure sores. Prophylaxis and increased alertness should eliminate this complication.