Regional Anesthesia Compared to GA..Part1

The evidence regarding regional techniques compared with general anesthesia has been reviewed with respect to several outcomes.

Ten studies of neuraxial blockade showed no decrease in postanesthesia care unit (PACU) time, or in the rate of PACU bypass, probably related to the persistent immobility associated with neuraxial anesthesia in the early recovery phase. In contrast, peripheral nerve blockade allowed for earlier discharge from phase 1 PACU, as well as a higher percentage of eligibility to bypass phase 1 at the end of surgery.

Both neuraxial blockade and peripheral nerve block were associated with significantly lower visual analog scale (VAS) scores in the PACU, as well as a significantly reduced requirement for postoperative analgesics in the PACU. Despite better pain relief, as noted previously there was no difference in the PACU time with neuraxial blockade.

With neuraxial blockade, there was a 40% reduction in nausea associated with neuraxial blockade, but this was not statistically different from the general anesthesia group. Peripheral nerve blockade did provide a significant fivefold decrease in nausea.

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power injectable peripherally inserted central catheters

Clinical experience with power injectable peripherally inserted central catheters in intensive care patients Introduction In intensive care units (ICU), peripherally inserted central catheters (PICC) may be an alternative option to standard central venous catheters, particularly in patients with coagulation disorders or at high risk for infection. Some limits of PICCs (such as low flow rates) may be overcome by the use of power-injectable catheters . Method We have retrospectively reviewed all the power injectable PICCs inserted in adult and pediatric patients in the ICU during a 12-month period, focusing on the rate of complications at insertion and during maintenance. Results We have collected 89 power injectable PICCs (in adults and in children), both multiple and single lumen. All insertions were successful. There were no major complications at insertion and no episodes of catheter-related blood stream infection. Non-infective complications ...

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