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1. Intrathecal Morphine for Postpartum Tubal Ligation Postoperative Analgesia

Author

Celina M. Riben, Ray W. Yip, David Campbell, Michael E. Rooney, and Lesley-Ann L. Crone

Subjects
medicine.medical_specialty, Tubal ligation, Lidocaine, Visual analogue scale, business.industry, medicine.medical_treatment, Surgery, Fentanyl, Anesthesiology and Pain Medicine, Anesthesia, medicine, Morphine, Adverse effect, business, Saline, Postpartum period, medicine.drug
Abstract

UNLABELLED: Intrathecal morphine (ITM) provides effective postoperative cesarean delivery analgesia but has not been reported for postoperative postpartum tubal ligation (PPTL) analgesia. We designed this prospective, randomized, double-blinded study to determine the efficacy of 100 microg ITM for postoperative PPTL analgesia. Sixty-six women received spinal anesthesia with 60 mg (1.2 mL) of 5% hyperbaric lidocaine, 10 microg (0.2 mL) of fentanyl, and either 0.2 mL of 0.9% saline (normal saline; NS) or 100 microg (0.2 mL) of morphine (morphine sulfate, MS). Postoperative analgesia was limited to patient-controlled IV analgesia morphine. Six women (three NS and three MS) were excluded because of major protocol violations. Twenty-four-hour patient-controlled IV analgesia morphine use was (mean +/- SD) 39.6 +/- 19.6 mg in the NS group and 1.1 +/- 2.5 mg in the MS group (P < 0.0000001). Visual analog scale scores for crampy and incisional pain (rest and movement) were significantly higher in the NS group compared with the MS group at 4, 8, 12, and 24 h (P < 0.001). The adverse effect profile was similar between groups. Visual analog scale satisfaction scores (mean +/- SD) were 96.6 +/- 16.0 in the MS group and 84.2 +/- 23.6 in NS group (P < 0.05). The results of this study indicate that women experience significant postoperative pain after PPTL surgery, and this pain is effectively obviated by 100 microg ITM. IMPLICATIONS: This investigation documents the extent of the significant postoperative pain experienced by women after routine postpartum tubal ligation surgery and demonstrates the efficacy of a small dose (100 microg) of intrathecal morphine to obviate this pain with minimal adverse effects.

Published
2001
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2. Ambulatory Labor Epidural Analgesia: Bupivacaine Versus Ropivacaine

Author

Lesley-Ann L. Crone, Ray W. Yip, David Campbell, and Rhonda M. Zwack

Subjects
Bupivacaine, Anesthesiology and Pain Medicine, Ropivacaine, business.industry, Anesthesia, Ambulatory, medicine, Motor blockade, business, medicine.drug, Fentanyl, Balance (ability)
Abstract

Dilute concentrations of bupivacaine combined with fentanyl have recently been used to initiate labor epidural analgesia in an attempt to balance adequate analgesia and minimal maternal motor blockade. Similar concentrations of ropivacaine have not been evaluated. This prospective, randomized, doubl

Published
2000
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3. Abstracts

Author

Cristina Hurtado, John Bradley, Andrew R. Burns, Keyvan Karkouti, Rob Anderson, Simon D. Abrahamson, C. David Mazer, O. R. Hung, L. Comeau, Joseph A. Fisher, Janet Tessler, Joshua Rucker, Alix Mathicu, Sara Murray-Foster, Chou Tz-Chong, Li Chi-Yuan, Takako Tsuda, Akihiko Tabuchi, Hiroshi Sasano, Masanobu Kiriyama, Akinori Okada, Junichiro Hayano, Akinori Takeuchi, Hirotada Katsuya, Claude P. Tousignant, Elizabeth Ling, Ramiro Arellano, N. Dowd, J. Karski, D. Cheng, J. Carroll-Munro, D. K. Rose, C. O. Mazer, M. M. Cohen, D. Wigglesworth, William P. S. McKay, Robert J. Teskey, Julio Militzer, Guy Kember, Travis Blanchet, Peter H. Gregson, Steven R. Howells, James A. Robblee, Terrance W. Breen, Laura Dierenfield, Tacie McNeil, Donna J. Nicholson, Stephen E. Kowalski, G. Andrew Hamilton, Michael P. Meyers, Carl Serrette, Peter C. Duke, Ingrid Custeau, Rend Martin, Sonia Larabée, Martine Pirlet, Madeleine Pilote, Jean-Pierre Tetrault, Ban C. H. Tsui, Sunil Gupta, Brendan Finucane, Mitchell J. Weisbrod, Vincent W. S. Chan, Z. Kaszas, C. Dragomir, M. R. Cohen, M. Gandhi, A. S. Clanachan, B. A. Finegan, Lisa Isaac, William M. Splinter, L. A. Hall, H. M. Gould, E. J. Rhine, Lyne Bergeron, Michel Girard, Pierre Drolet, Hong Hanh Le Truong, Carl Boucher, Daniel Vézina, Martin R. Lessard, Marie Gourdeau, Claude A. Trépanier, Theresa Yang, Alison Macarthur, P. Chouinard, F. Fugère, M. Ruel, Pekka Tarkkila, Marja Silvasti, Marjatta Tuominen, Nils Svartling, Per H. Rosenberg, David M. Bond, John F. Rudan, Michael A. Adams, Brian K. Tsang, Wanda Keahey, Lucia Gagliese, Marla Jackson, Paul Ritvo, Adarose Wowk, Alan N. Sandler, Joel Katz, J. G. Laffey, J. F. Boylan, Neal H. Badner, Wendy E. Komar, R. A. Cherry, S. M. Spadafora, R. J. Butler, Fiona McHardy, Joanne Fortier, Frances Chung, Scott Marshall, Ananthan Krishnathas, Jean Wong, Ewan Ritchie, Andrew Meikle, Nicole Avery, Janet van Vlymen, Joel L. Parlow, David Sinclair, Gabor Mezei, Fengling Jin, Andrew Norris, Tharini Ganeshram, Bernard A. MacLeod, Aliréza Azmudéh, Luigi G. Franciosi, Craig R. Ries, Stephan K. W. Schwarz, William PS McKay, Benjamin W. S. McKay, Pascal Meuret, Vincent Bonhomme, Gilles Plourde, Pierre Fiset, Stevens B. Backman, Alex Vesely, Leeor Sommer, Joel Greenwald, Elana Lavine, Steve Iscoe, George Volgyesi, Ludwik Fedorko, Joseph Fisher, Emilio B. Lobato, Cheri A. Sulek, Laurie K. Davies, Peter F. Gearen, François Bellemare, François Donati, Jacques Couture, Hwan S. Joo, Sunil Kapoor, Shahriar Shayan, Kenneth M. LeDez, Jim Au, John H. Tucker, Edwin B. Redmond, V. Gadag, Catherine Penney, Gregory M. T. Hare, Timothy D. G. Lee, Gregory M. Hirsch, Fan Yang, Eric Troncy, Gilbert Blaise, Yoshiyuki Naito, Shoji Arisawa, Masahiro Ide, Susumu Nakano, Kazuo Yamazaki, Takae Kawamura, Noriko Nara, Reiji Wakusawa, Katsuya Inada, Robert J. Hudson, Karanbir Singh, Gary A. Harding, Blair T. Henderson, Ian R. Thomson, Christopher G. Wherrett, Donald R. Miller, Alan A. Giachino, Michelle A. Turek, Kelly Rody, H. Vaghadia, V. Chan, S. Ganapathy, A. Lui, J. McKenna, K. Zimmer, William D. Regan, Ross G. Davidson, Krista Nevin, Sergio Escobedo, E. Mitmaker, M. J. Tessler, K. Kardash, S. J. Kleiman, M. Rossignol, L. Kahn, F. Baxter, A. Dauphin, C. Goldsmith, P. Jackson, J. McChesney, J. Miller, L. Takeuchi, E. Young, Kristine Klubien, Edith Bandi, Franco Carli, Kathleen Dattilo, Doris Tong, Mohit Bhandari, Louise Mazza, Linda Wykes, L. Z. Sommer, J. Rucker, A. Veseley, E. Levene, Y. Greenwald, G. Volgyesi, L. Fedorko, S. Iscoe, J. A. Fisher, Guo-Feng Tian, Andrew J. Baker, F. X. Reinders, A. J. Baker, R. J. Moulton, J. I. M. Brown, L. Schlichter, Laurence Van Tulder, Stéphane Carignan, Julie Prénovault, Jean-Paul Collet, Stan Shapiro, Jean-Gilles Guimond, Louis Blait, Thierry Ducruet, Martin Francœur, Marc Charbonneau, Guy Cousineau, Daniel R. Wong, Michele McCall, Fergus Walsh, Regina Kurian, Mary Keith, Michael J. Sole, Kursheed N. Jeejeebhoy, E. Whitten, P. H. Norman, J. A. Aucar, L. A. Coveler, Rodney M. Solgonick, Y. Bastien, Bruce Mazer, Koji Lihara, Beverley A. Orser, Michael Tymianski, Brendan T. Finucane, Nuzhat Zaman, Ibrahim Kashkari, Soheir Tawfik, Yun K. Tarn, Peter D. Slinger, Karen McRae, Timothy Winton, Alan N. Sandier, J. E. Zamora, Mary Jane Salpeter, Donglin Bai, John F. MacDonald, Kelly Mayson, Ed Gofton, Keith Chambers, Susan E. Belo, J. Colin Kay, Sean R. R. Hall, Louie Wang, Brian Milne, Chris Loomis, Zhi He, Wichai Wougchanapai, Ing K. Ho, John H. Eichhorn, Tangeng Ma, Wichai Wongchanapai, John H. Eicnhorn, Damian B. Murphy, M. B. Murphy, Steven B. Backman, Reuben D. Stein, Brian Collier, Canio Polosa, Chi-Yuan Li, Tz-Chong Chou, Jia-Yi Wang, John Fuller, Ronald Butler, Salvatore Spadafora, Neil Donen, Laurence Brownell, Sandy Shysh, Keith Carter, Chris Eagle, Isabella Devito, Stephen Halpern, J. Hugh Devitt, Doreen A. Yee, John L. deLacy, Donald C. Oxorn, Gary F. Morris, Raymond W. Yip, M. G. Gregoret-Quinn, R. F. Seal, LJ. Smith, A. B. Jones, C. Tang, B. J. Gallant, L. A. Nadwidny, Gerald V. Goresky, Tara Cowtan, Hilary S. Bridge, Carolyne J. Montgomery, Ross A. Kennedy, Pamela M. Merrick, M. Yamashita, K. Wada, Sylvie LeMay, Jean-François Hardy, Pamela Morgan, Steven Halpern, Jana Evers, P. Ronaldson, F. Dexter, Desmond Writer, Holly Muir, Romesh Shukla, Rob Nunn, John Scovil, Jeremy Pridham, Ola Rosaeg, Allan Sandier, Patricia Morley-Foster, Simon Lucy, Lesley-Ann Crone, Karen Zimmer, Deborah J. Wilson, Robert Heid, M. Joanne Douglas, Dan W. Rurak, Anna Fabrizi, Chantal T. Crochetière, Louise Roy, Edith Villeneuve, Louise Lortie, Sandra Katsiris, Barbara Leighton, Donna Wilson, Jean Kronberg, Leszek Swica, Janet Midgley, Robert Nunn, Bruce Smith, Michael E. Rooney, David C. Campbell, Celina M. Riben, Ray W. Yip, Jo MacDonell, and Tracey Levine

Subjects
Sevoflurane, Anesthesiology and Pain Medicine, Morphine, Total Knee Arthroplasty, Pulmonary Capillary Wedge Pressure, Ropivacaine, General Medicine, Article
Published
1998

4. Addition of Epinephrine to Intrathecal Bupivacaine and Sufentanil for Ambulatory Labor Analgesia

Author

Lesley-Ann L. Crone, Robert Banner, Ray W. Yip, David Campbell, and Wendy Gore-Hickman

Subjects
Adult, medicine.medical_specialty, Epinephrine, Sufentanil, medicine.drug_class, Intrathecal, Double-Blind Method, Pregnancy, Ambulatory Care, Humans, Medicine, Labor analgesia, Prospective Studies, Anesthetics, Local, Injections, Spinal, Bupivacaine, Labor, Obstetric, business.industry, Local anesthetic, Drug Synergism, Surgery, Anesthesiology and Pain Medicine, Regional anesthesia, Anesthesia, Ambulatory, Analgesia, Obstetrical, Drug Therapy, Combination, Female, business, Anesthetics, Intravenous, medicine.drug
Abstract

Background The intrathecal combination of sufentanil and bupivacaine provides rapid, effective analgesia for labor with a limited duration. Many anesthesiologists have concerns that the use of intrathecal local anesthetics precludes maternal ambulation. This prospective, randomized, double-blind study was designed to determine whether the addition of epinephrine to the combination of sufentanil and bupivacaine would prolong intrathecal analgesia for labor. Patients' ability to ambulate was also assessed. Methods Thirty-nine patients received either an intrathecal control dose of 10 micrograms sufentanil plus 2.5 mg bupivacaine plus 0.2 ml normal saline (control group); or 10 micrograms sufentanil plus 2.5 mg bupivacaine plus 0.2 ml (0.2 mg) of epinephrine (EPI group). Results Seven patients (3 control, 4 EPI) delivered vaginally and two (1 control, 1 EPI) required cesarean delivery before requesting epidural analgesia. The duration (mean +/- SD) of intrathecal labor analgesia was prolonged significantly by the addition of epinephrine: control (n = 15): 145 +/- 23 min; EPI (n = 15): 188 +/- 25 min (P < 0.0001). Maternal ambulation was demonstrated in 100% (19 of 19) of the control group and in 80% (16 of 20) of the EPI group (P = NS). Conclusions The addition of 0.2 mg epinephrine to the intrathecal combination of sufentanil and bupivacaine significantly prolonged labor analgesia without causing adverse effects to the mother or fetus. The intrathecal combination of sufentanil and bupivacaine, with or without epinephrine, provided rapid, profound labor analgesia and allowed most patients to ambulate.

Published
1997
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5. Abstract

Author

Mike van der Wal, Scott A. Lang, Ray W. Yip, Frances L. Chow, Peter G. Duncan, Robert A. Perverseff, Lesley-Ann L. Crone, Robert A. Verity, Jim Flath, David L. Twist, William E. Code, Jim Thornhill, Louie Wang, Murray Hong, Brian Milne, Khem Jhamandas, Janet L. Shannon, Martin Gerard, Larry Takeuchi, Stephen A. Puchalski, Robin Roberts, Victor Law, Roger Bell, Geoffrey L. Dunn, Robert P. Eger, B. A. McLeod, Francisco Asenjo, Gilbert Blaise, Denise Normandin, Mohamed Naguib, Mohamed Abdulatif, Orlando R. Hung, Michael Mezei, John R. Varvel, Sara C. Whynot, Wileena McKenzie, Colin Bands, Steven L. Shafer, Michael W. Neumeister, Richard I. Hall, Gefeng Li, Gwen Dawe, Noel O’Regan, Richard Hall, Martin Gardner, H. El-Beheiry, E. S. Shelley, Sharpe Frcpc, D. J. Freeman, A. W. Gelb, Beverley A. Orser, Lu-Yang Wang, John F. MacDonald, Jeanette Derdemezi, Beverley A. Britt, Malignant Hyperthermia, D. John Doyle, Thomas C. Y. Chau, Joanne Guay, Chantal Crochètiere, Pierre Gaudreault, Louise Lortie, France Varin, David R. Bevan, R. Gilles Plourde, Francoise Zaharia, J. W. Donald Knox, Susan Belo, C. Brian Warriner, John E. Cannon, John B. Watson, R. J. Byrick, J. B. M. Mullen, D. F. Wigglesworth, J. R. Klinck, F. Ortiz, J. Pedersen, M. F. Smith, G. A. Hayman, C. Buckingham, Stephan P. Nebbia, Victor Un, Frances F. Chung, Christina Theodorou-Michaloliakou, Godofredo J. Baylon, Jose G. Chua, Sharad Sharma, Charles Cruise, Glenn McGuire, Vincent W. S. Chan, Nilesh Patel, Alfred C. Pinchak, Charles E. Smith, Donald E. Hancock, Michael J. Tessler, Bobby H. Grillas, Sonia Gioseffini, B. Grillas, J. F. Desparmet, C. MacArthur, A. MacArthur, Robert D. Carpenter, Bruno Bissonnette, David W. Fear, J. Lerman, I. A. Spahr-Schopfer, N. Sikich, Joan F. Hagen, John G. Fuller, Michael Taylor, John Fisgus, Colleen Petz, Joan Hagen, J. B. Forrest, D. N. Buckley, W. S. Beattie, A. E. Beattie, M. Clairoux, J. Katz, B. Kavanagh, S. Roger, H. Nierenberg, A. Sandler, Alan D. Baxter, Benolt Samson, Sylvie Laganière, John Stewart, Kathryn A. Hull, Lynne Goernart, Mitchel B. Sosis, Berton Braverman, Anthony Toppses, Eugene Lipov, Anthony D. Ivankovich, D. Keith Rose, Marsha M. Cohen, Davy C. H. Cheng, Buvanendran Asokumar, Antonio C. Caballero, David Wong, J. Roger Maltby, Chris J. Eagle, Hermann G. Müller, Sallie J. Teasdale, Jacek M. Karski, Jo A. Carroll, Sue Van Luven, Vytas J. Zulys, Ann Davies, Peter N. Norman, Pamela Cuddihy, Brian Kavanagh, Antonio Caballero, Alan Sandier, Charlie Peniston, Alan N. Sandler, John F. Boylan, Christopher M. Feindel, Alan N. Sandier, Patricia Boylen, Craig R. Ries, Ernie Puil, Donald R. Hickey, Andrew Scott, Dennis D. Doblar, Luc Frenette, Gwendolyn Boyo, Steven Poplawski, Dinesh Ranjan, Mark B. Godley, Sam Saprunoff, D. Vincent, Doreen Yee, Deborah Goodall, John Zawacki, Davinia E. Withington, Michael Davis, Peter Vallinis, Joan C. Bevan, A. Sapin-Leduc, G. Plourde, N. Fosset, J. F. Symes, J. E. Morin, B. De Varennes, D. Latter, Gareth S. Kantor, Robert J. Smyth, Michael Glynn, Richard F. McLean, Andrew A. Phillips, Stephen E. Fremes, Peter Bunting, Lance Joy, Carol Hamilton, Norman R. Searle, Micheline Roy, Jean Perrault, Jeanne Roof, Cory C. Hermanns, Micheline Courtemanche, Christine Demers, Raymond Cartier, Daniel Boudreault, Pierre Couture, Quy To, Martin Parent, Neal H. Badner, Wendy E. Komar, J. M. Murkin, J. B. Martzke, A. M. Buchan, C. Bentley, C. David Mazer, Robert J. Byrick, Jeff Tong, Karl Van Kessel, Michael F. Glynn, René Martin, S. Jourdain, J. P. Tétrault, Keith B. Javery, George W. Colclough, John Sutterlin, William O. Witt, Steve Rolbin, Carey Levinton, Yousuf G. Sayeed, Marlene E. Ward, David Campbell, M. Joanne Douglas, Pamela Merrick, Alan Baxter, Benoit Samson, Joel Katz, Mark Friedlander, Maria Donnelly, Derrick S. Pagenkopf, Bonnie L. Bagdan, Jan M. Davies, Louise M. Parsons, Leah Roth, R. Lawre Garnett, Annette MacIntyre, M. Patrice Lindsay, Suntheralingham Yogendran, D’Arcy Little, Joseph Lena, Stephen H. Halpern, Susan Lin, Dean D. Bell, Patricia Ostryzniuk, Edward Roberts, Dan Roberts, Jean E. Gauthier, C. Perreault, Grace Tomasa, Nitchel B. Sosis, Basil F. Matta, Calvin C. Eng, Teresa S. Mayberg, Arthur M. Lam, Terri L. Mathisen, John Kitts, Raymond Martineau, Donald Miller, Patrice Lindsay, Michael Curran, Jeffrey G. Betcher, Haresh Kirpalani, Shari Gray, Kevin E. Lung, Joseph Multari, Ronald D. Stewart, S. Paula Forward, Patrick J. McGrath, G. Allen Finley, Gillian McNeill, Nancy L. Biddle, Adrian W. Gelb, John T. Hamilton, M. D. Sharpe, T. Vanelli, R. A. Craen, I. Brodkin, D. Le, P. Lok, D. K. Rose, D. A. Yee, A. Joseph Layon, Sno E. White, Gordon L. Gibby, Paul D. Greig, Hilary Nierenberg, Patricia A. Sheiner, S. Levytam, R. Arellano, Michael F. X. Glynn, Jonathan P. Purday, Clayton C. Reichert, Eleanor J. Reimer, Carolyne J. Montgomery, Derek Blackstock, Clayton Reichert, G. F. Byers, J. G. Muir, M. F. Levine, S. Kleinman, J. Sarner, P. Davis, E. Motoyaraa, D. R. Cook, Daniel I. Sessler, J. M. T. Foster, F. A. Burrows, Margaret Haig, Benoit Poitras, Craig W. Reid, Peter Slinger, Serge Lenis, P. Wilkes, S. M. Henderson, C. Zhang, Vytas Zulys, John Bradwell, Norifumi Mabuchi, Jo Carroll, Pat Harley, Dennis Doblar, Gwen Boyd, Dan Singer, Simon Gelman, J. Hugh Devitt, R. Wenstone, Alva G. Noel, Michael P. O’Donnell, Saul Pytka, Michael F. Murphy, Gordon O. Launcelott, Ian R. Morris, Sarah C. Stevens, Richard M. Cooper, John C. Irish, Dale H. Brown, Neil Donen, Ian W. C. White, Lisa Snidal, Claudia Sanmartin, Margot G. Knox, Fiona Roper, Wayne Gornall, John D. Fisk, Paul Ritvo, and W. Stanish

Subjects
Anesthesiology and Pain Medicine, General Medicine
Published
1993
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6. Psychiatric side effects of indomethacin in parturients

Author

Michelle Clunie, Lesley-Ann L. Crone, Linda Klassen, and Ray W. Yip

Subjects
Adult, medicine.medical_specialty, Analgesic, Population, Indomethacin, Psychoses, Substance-Induced, Psychiatric history, Pregnancy, Anesthesiology, Medicine, Humans, Prospective Studies, Adverse effect, Psychiatry, education, education.field_of_study, business.industry, Anti-Inflammatory Agents, Non-Steroidal, Brain, General Medicine, Puerperal Disorders, medicine.disease, Anesthesiology and Pain Medicine, Anesthesia, Anxiety, Female, medicine.symptom, Complication, business
Abstract

To examine the central nervous system side effects of the non-steroidal anti-inflammatory drug (NSAID) indomethacin in a case-series of obstetric patients. The hospital records of patients experiencing any post-partum complication between 1994 and 1999 were reviewed for adverse drug reactions (ADR) attributed to indomethacin. Additional cases of indomethacin-induced adverse effects were identified through reports to the nursing administration and the Saskatchewan ADR reporting program. The Naranjo ADR probability scale was applied to all cases. Thirty-two patients experienced a psychiatric reaction after receiving indomethacin for postpartum pain. The symptoms were often severe and included dizziness, anxiety, fear, agitation, affective lability, depersonalization, paranoia, and hallucinations. There was no past psychiatric history documented in any of the cases. This study identifies a possible ADR to indomethacin occurring in postpartum patients. Whether the vulnerability to these neuropsychiatric reactions is randomly distributed or if parturients are at increased risk is yet to be determined. Proposed mechanisms of these side effects include a postpartum dopamine supersensitivity exacerbated by prostaglandin inhibition as well as a structural similarity between serotonin and indomethacin. The severity of the reactions to indomethacin in parturients and the potential for these disturbing psychiatric side effects to compromise the safety of both mother and infant have led to the use of alternative analgesics including different classes of NSAIDs for this population at our institution.

Published
2003

8. Saphenous nerve anaesthesia--a nerve stimulator technique

Author

Scott A. Lang, Ray W. Yip, and V. Kim Comfort

Subjects
Adult, Aged, 80 and over, Male, medicine.medical_specialty, Leg, Adolescent, business.industry, Nerve Block, General Medicine, Middle Aged, Lower limb, Surgery, Electrical isolation, Saphenous nerve, Anesthesiology and Pain Medicine, Regional anesthesia, Anesthesia, medicine, Humans, Female, Prospective Studies, business, Nerve stimulator, Aged
Abstract

This two part study was undertaken to assess both the feasibility of identifying the saphenous nerve with a nerve stimulator and to assess the efficacy of saphenous nerve anaesthesia with electrical isolation of the nerve.(Part I): In Part I we studied 25 volunteers. Each had saphenous nerve blocks performed using a nerve stimulator (NS) and loss of resistance (LOR) technique. We recorded 10 cm linear visual analogue pain scores on completion of the blocks, time to completion of the blocks, onset time, and success of the blocks. (Part II): Clinical utility of the NS technique of saphenous nerve block was investigated. We evaluated the NS technique in 21 consecutive patients having surgery below the knee.(Part I): The LOR technique successfully produced saphenous nerve anaesthesia in 18/25 (72%) volunteers and the NS technique was successful in all volunteers (25/25-P0.05). The nerve stimulator approach required more time to complete (NS 13 +/- 7 min vs LOR 8 +/- 2 min; P0.05). Visual analogue pain scores differed (P0.05) with a median of 1.0 cm for the LOR technique and a median of 2 cm for the NS technique. (Part II): The saphenous nerve block was successful in 20/21 (95%) of the patients.(Part I): The first part of the study established the feasibility of electrical identification of the saphenous nerve and demonstrated that the NS technique could be utilized to provide superior anaesthesia of the saphenous nerve when compared with a previously validated LOR technique. (Part II): The clinical utility of the NS technique of saphenous nerve block was successfully demonstrated.

Published
1996

10. AMBULATORY LABOR EPIDURAL ANALGESIA

Author

Rhonda M. Zwack, Lesley-Ann L. Crone, Ray W. Yip, Karen Sawatzky, and David Campbell

Subjects
Bupivacaine, Anesthesiology and Pain Medicine, business.industry, Ropivacaine, Anesthesia, Ambulatory, Medicine, business, medicine.drug
Published
1999
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