Articles: postoperative-pain.
-
Intrathecal morphine in an average dose of 0.01 mg/kg was given to 33 patients between ages 11 and 16 years who had spinal arthrodesis for idiopathic scoliosis. The morphine was administered intrathecally as a 10 cc bolus at the conclusion of the arthrodesis, but before closure. The goal was to study safety in terms of respiratory depression and pain relief. ⋯ It may be that the 10 cc bolus injected intrathecally circulates to the brain and ventricles faster than desired, or that factors relating to type of anesthesia or dose need to be considered. Low-dose intrathecal morphine does provide noticeable pain relief in younger patients undergoing spinal fusion. The side effects of nausea and respiratory depression can be managed safely with medication.
-
Regional-Anaesthesie · Aug 1991
Case Reports[Paraplegia following removal of an epidural catheter].
Acute paraplegia caused by an epidural hematoma developed in a patient following the removal of an epidural catheter. This catheter had been used for 3 days for postoperative pain relief with no apparent complications. Heparin (10,000 units/day) had been infused for thrombosis prophylaxis and was associated with a normal activated partial thromboplastin time (aPTT) for the first two postoperative days. ⋯ An epidural hematoma extending from T12 to L4 was evacuated during emergency laminectomy and neurologic deficits resolved completely over the next days. Thus, the removal of an epidural catheter has the potential for inducing formation of an epidural hematoma. Accordingly, it may be safest to leave epidural catheters in place if test results demonstrate a bleeding diathesis or if a potential for bleeding is suspected on clinical grounds.
-
Surg Gynecol Obstet · Aug 1991
Continuous intercostal nerve block for postoperative analgesia after surgical treatment of the upper part of the abdomen.
Continuous intercostal nerve block can be used effectively for pain relief after abdominal operations. We have developed a greatly simplified technique instituted by the surgeon at operation using bupivacaine hydrochloride (Marcain, ASTRA). ⋯ In addition, no postoperative pulmonary complications or adverse reactions to bupivacaine hydrochloride or the procedure were encountered. This method proved to be a success in postoperative pain relief and we highly recommend that it be used routinely.