Regional anesthesia
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Regional anesthesia · Jul 1996
Case ReportsEpidural hematoma after epidural anesthesia in a patient with peripheral vascular disease. Case report.
Epidural hematoma is a severe, uncommon complication associated with epidural anesthesia in patients with peripheral vascular disease who require anticoagulant therapy. ⋯ This case highlights the need for careful individual preoperative analysis and postoperative observation to make anesthetic practice safe in patients receiving perioperative anticoagulant therapy.
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Regional anesthesia · Jul 1996
Case ReportsSuccessful use of epidural blood patch for postdural puncture headache following lumbar sympathetic block.
A 21-year-old man was scheduled for a diagnostic lumbar sympathetic block for reflex sympathetic dystrophy of the right lower extremity. ⋯ Postdural puncture headache resulting from leakage of cerebrospinal fluid through a punctured dural sleeve may be successfully treated with an epidural blood patch should more conservative treatments fail.
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Regional anesthesia · Jul 1996
Antinociceptive and motor-blocking efficacy of ropivacaine and bupivacaine after epidural administration in the dog.
This study was initiated to evaluate the antinociceptive and motor blocking capabilities of epidurally administered 0.5% and 0.75% ropivacaine and bupivacaine using a blinded, random crossover design in the dog. Additionally, serum drug concentrations and serum protein binding were determined. ⋯ The 0.5% solutions produced similar sensory block of the vertebral dermatomes. Duration of dermatomal block with 0.75% bupivacaine was longer than with the corresponding ropivacaine concentration. Ropivacaine produced motor block of shorter duration as compared with bupivacaine. Serum concentrations of the two drugs were similar after injection of the same doses. In this animal model, ropivacaine produced shorter durations of sensory and motor block than corresponding concentrations of bupivacaine. These data are consistent with previously published data in animals and humans.
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Regional anesthesia · Jul 1996
An observational study of combined continuous lumbar plexus and single-shot sciatic nerve blocks for post-knee surgery analgesia.
In a study of postoperative analgesia after major knee surgery, an assessment was made of the efficacy of continuous lumbar plexus block combined with a single-shot block of the sciatic nerve. ⋯ Sciatic nerve block is essential for successful analgesia during the immediate postoperative period but is not mandatory for longer-term pain control, which can be achieved by continuous lumbar plexus block.