Regional anesthesia
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Regional anesthesia · Sep 1997
Case Reports Clinical TrialDoes combined spinal-epidural analgesia with subarachnoid sufentanil increase the incidence of emergency cesarean delivery?
The purpose of this review was to determine if patients who receive combined spinal-epidural (CSE) analgesia with subarachnoid sufentanil have an increased incidence of emergency cesarean delivery for fetal distress when compared with patients who receive systemic or no medication (S/NM) for labor analgesia. ⋯ This experience indicates that patients who receive CSE analgesia do not have a higher incidence of emergency cesarean delivery than patients who have S/NM for labor analgesia. Emergency cesarean section for fetal distress within 90 minutes of the administration of intrathecal sufentanil only occurred in association with obstetric factors. However, caution should be exercised in extrapolating these results to other practice settings, particularly high-risk referral centers.
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Regional anesthesia · Sep 1997
Case ReportsTrigger point injections for myofascial pain during epidural analgesia for labor.
Myofascial pain is the leading cause of chronic low back pain and in most cases can be successfully resolved with trigger point injections of local anesthetics. This type of pain can exist during pregnancy and exceed the analgesia provided by an epidural for labor. ⋯ Myofascial pain can be an etiology of back pain in the parturient. Trigger point injections, even when used concomitantly with a functioning epidural infusion, can be a valuable aid for the provision of complete analgesia.
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Regional anesthesia · Sep 1997
Case ReportsContinuous parasacral sciatic nerve block: two case reports.
This study investigated the use of a continuous parasacral sciatic nerve block for anesthesia and postoperative analgesia for lower extremity surgery. ⋯ We conclude that continuous parasacral sciatic nerve block can provide anesthesia and long-term analgesia for operative procedures of the foot and leg.
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Regional anesthesia · Sep 1997
Case ReportsAdrenocorticotropic hormone infusion as a novel treatment for postdural puncture headache.
In two patients, one scheduled for epidural anesthesia and the other for placement of a spinal catheter for operative procedures, severe postdural puncture headache developed and was refractory to conservative therapy. ⋯ A single treatment with ACTH may offer an alternative therapy in the treatment of postdural puncture headache.
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Regional anesthesia · Sep 1997
Case ReportsTwo cases of cauda equina syndrome following spinal-epidural anesthesia.
Cauda equina syndrome (CES) is a well-known complication of spinal and epidural anesthesia. Previous reports have implicated lidocaine, chloroprocaine, and procaine in its etiology, but not bupivacaine. ⋯ This case report describes two cases of CES following the use of bupivacaine. The first patient had spinal stenosis which could explain this complication; however the explanation for CES in the second patient is uncertain and consequently speculative. We have discussed the possible contributing factors but believe that the etiology of CES in the second patient remains unknown.