Regional anesthesia
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Regional anesthesia · Nov 1997
Clinical TrialFailed axillary brachial plexus block techniques result in high plasma concentrations of mepivacaine.
Unintentional extrasheath injection causes failed axillary brachial plexus block. We wanted to find out if extrasheath injections produce higher plasma concentrations of local anesthetics compared to intrasheath injections. We also studied the incidence of extrasheath injection with radiographs. ⋯ Failed extrasheath injection of 50 mL 1.5% plain mepivacaine produces higher arterial plasma concentration in axillary brachial plexus block.
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Regional anesthesia · Nov 1997
Case ReportsRemoval of a torn Racz catheter from lumbar epidural space.
Epidural adhesiolysis, described by Racz et al. (1) utilizing a double-contrast injection technique, provides an epidurogram that clearly delineates the area of adhesions and furnishes a means to perform lesion-specific lysis of adhesions utilizing a flexible wire-embedded catheter. ⋯ This case report illustrates a difficult situation with a sheared and retained epidural catheter which could not be removed utilizing the standard techniques but was successfully removed without any residual problems using arthroscopy forceps.
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Regional anesthesia · Nov 1997
Randomized Controlled Trial Clinical TrialA low-dose hypobaric bupivacaine spinal anesthesia for knee arthroscopies.
Ambulatory surgery requires anesthesia methods that allow rapid recovery and safe discharge of the patient. Spinal anesthesia is easy and quick to perform, and the use of noncutting small gauge needles reduces the occurrence of postdural puncture headache. For minimal hemodynamic consequences and faster recovery and discharge it would be optimal to limit the spread of spinal anesthesia only to the area which is necessary for surgery. In this study, the possibility in achieving unilateral spinal anesthesia with 0.18% hypobaric bupivacaine was studied. ⋯ Approximately three and a half milliliters hypobaric 0.18% bupivacaine (6.12 mg) provides a predominantly unilateral spinal block. Thirty minutes spent in the lateral position does not provide benefits over 20 minutes. The main advantages of our method are the hemodynamic stability and the patient satisfaction.