Search results for "regional anesthesia"
showing 10 items of 25 documents
Plasmakonzentrationen von Bupivacain bei kontinuierlicher Periduralanästhesie im Kindesalter
1998
Zur postoperativen Schmerztherapie bei Kindern mit Operationen an der unteren Korperhalfte bietet sich eine Periduralanasthesie an. Bisher wurde die initiale Pharmakokinetik bei Kindern untersucht, nicht hingegen der langfristige Verlauf. Ziel dieser Untersuchung war die Erhebung von Daten zum zeitlichen Verlauf des Plasma-Bupivacainspiegels, der sauren α1-Glycoprotein- und Albuminkonzentrationen bei Kindern mit kontinuierlicher Periduralanasthesie in der postoperativen Phase. Methodik:Uber eine 19G Tuohy-Kanule legten wir einen Katheter mit 0,63 mm Ausendurchmesser in den Periduralraum ein. Wahrend der kontinuierlichen periduralen Bupivacaininfusion durfte eine Dosis von 0,4 mg/kgKG/h Bupi…
Regional anesthesia and chronification of acute postoperative pain
2014
Chronification of acute postoperative pain is the consequence of a number of factors; the article mentions different preemptive strategies that may put a limit to its development. Certain anesthetic and analgesic techniques have been assessed over the last years, and most articles highlight the usefulness of carrying out regional anesthesia techniques from the intraoperative period through several days into the postoperative period. Preventing the patients from suffering acute postoperative pain is one of the most appropriate tools for stopping the activation of the mechanisms involved in pain chronification. None of the regional techniques are equally valid and applicable to all surgical p…
Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe
2017
Background Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. Methods The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurenc…
Quantitative Analysis of Real-Time Infrared Thermography for the Assessment of Lumbar Sympathetic Blocks: A Preliminary Study
2021
Lumbar sympathetic blocks (LSBs) are commonly performed to treat pain ailments in the lower limbs. LSBs involve injecting local anesthetic around the nerves. The injection is guided by fluoroscopy which is sometimes considered to be insufficiently accurate. The main aim was to analyze the plantar foot skin temperature data acquired while performing LSBs in patients with complex regional pain syndrome (CRPS) affecting the lower limbs. Forty-four LSBs for treating lower limb CRPS in 13 patients were assessed. Pain medicine physicians visualized the infrared thermography (IRT) video in real time and classified the performance depending on the observed thermal changes within the first 4 min. Th…
Influence of a Brief Episode of Anesthesia during the Induction of Experimental Brain Trauma on Secondary Brain Damage and Inflammation
2011
It is unclear whether a single, brief, 15-minute episode of background anesthesia already modulates delayed secondary processes after experimental brain injury. Therefore, this study was designed to characterize three anesthesia protocols for their effect on molecular and histological study endpoints. Mice were randomly separated into groups that received sevoflurane (sevo), isoflurane (iso) or an intraperitoneal anesthetic combination (midazolam, fentanyl and medetomidine; comb) prior to traumatic brain injury (controlled cortical impact, CCI; 8 m/s, 1 mm impact depth, 3 mm diameter). Twenty-four hours after insult, histological brain damage, neurological function (via neurological severit…
Tibial Nerve Block: Supramalleolar or Retromalleolar Approach? A Randomized Trial in 110 Participants.
2020
Of the five nerves that innervate the foot, the one in which anesthetic blocking presents the greatest difficulty is the tibial nerve. The aim of this clinical trial was to establish a protocol for two tibial nerve block anesthetic techniques to later compare the anesthetic efficiency of retromalleolar blocking and supramalleolar blocking in order to ascertain whether the supramalleolar approach achieved a higher effective blocking rate. A total of 110 tibial nerve blocks were performed. Location of the injection site was based on a prior ultrasound assessment of the tibial nerve. The block administered was 3 mL of 2% mepivacaine. The two anesthetic techniques under study provided very simi…
Postoperative Schmerztherapie Teil II
1996
Die postoperative Schmerztherapie ist ein relativ neues Feld der operativen Medizin. Fur definierte Patientengruppen und Operationen stehen spezielle Therapieformen zur Verfugung. Starke Schmerzen nach einer Operation unterhalten und verstarken die Stresantwort des Korpers. Sie aktivieren das sympathische Nervensystem und konnen dadurch zu kardiozirkulatorischen Belastungen fuhren. Schmerzen behindern das Durchatmen und Abhusten und konnen dadurch pulmonale Storungen verursachen. Ein Patient mit Schmerzen ist schwieriger zu mobilisieren, die Rehabilitation ist verzogert. Der Einflus der verschiedenen Analgesieverfahren auf den Heilungsprozes wird kontrovers beurteilt. Zumindest bei Patiente…
Long-term placement of continuous popliteal nerve block catheter for management of a wounded patient in a combat field environment: a case report
2019
Costantino Fontana,1 Monica Rocco,2 Luigi Vetrugno,3 Elena Bignami41Anesthesia and Intensive Care Unit, Sapienza University of Rome, Rome, Italy; 2Intensive Care Unit and Anesthesia, Ospedale S. Andrea Rome, Rome, Italy; 3Anesthesia and Intensive Care Clinic, University-Hospital of Udine, Udine, Italy; 4Intensive Care Unit and Anestehsia, Università degli Studi di Parma, Parma, ItalyCorrespondence: Costantino FontanaAnesthesia and Intensive Care Unit, Sapienza University of Rome, Policlinico Militare di Roma, Piazza Celimontana n. 50, Roma 00184, ItalyEmail cosfontana@gmail.comAbstract: Continuous peripheral nerve block is a relevant part of multimodal treatment of postoperative …
Intravenous Regional Anesthesia
1988
Intravenous regional anesthesia was first described by Bier in 1908. The technique fell into disuse until 1963, when Holmes revived the technique by substituting lidocaine for procaine (see Sect. V. D, “Choice and Dosage of Agents”).
Totale Spinalanästhesie im Notarztdienst
2002
Die vorliegende Kasuistik beschreibt den auserst seltenen Fall einer auserklinisch aufgetretenen totalen Spinalanasthesie. Neben dem initialen Management werden die weiteren moglichen Komplikationen von paravertebralen Injektionen fur die differenzialdiagnostische Uberlegung erlautert. Das Erkennen der Symptomatik kann neben der lebensrettenden Therapie im weiteren Verlauf bei gesichertem kausalen Zusammenhang eine kostenintensive Ausweitung der Diagnostik und Therapie verhindern. In der Regel behalten die Patienten bei adaquater Notfalltherapie keine bleibenden Schaden zuruck. Fur die Anwender von paravertebralen Injektionstechniken ergibt sich, dass adaquate personelle und apparative Vora…