RESUMO
EXPAREL® has been used successfully to prolong postoperative pain control when applied as a wound infiltrate. EXPAREL® has not yet been approved for use in regional anesthesia to prolong postoperative pain control. We conducted a clinical case series of 4 patients using EXPAREL® for sciatic blocks via the popliteal fossa approach. Our results suggested that there is a large degree of variability in response to the medication. These inconsistent results and the possibility of bimodal kinetics creating analgesic gaps as seen in two of our patients indicate that more studies with larger sample size are needed to better characterize these phenomena and determine if more consistent results can be obtained in a future clinical trial.
Assuntos
Anestésicos Locais , Bupivacaína , Bloqueio Nervoso/métodos , Redução Aberta/efeitos adversos , Dor Pós-Operatória/prevenção & controle , Traumatismos do Tornozelo/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Redução Aberta/métodos , Manejo da Dor/métodos , Estudos ProspectivosRESUMO
Epidural blood patch is a frequently successful treatment for postdural puncture headache. It is not clear whether a recent epidural blood patch affects subsequent neuraxial analgesia. We describe the case of a patient who received an epidural blood patch for postdural puncture headache and returned 3 days later in active labor, requesting epidural analgesia. The patient successfully received analgesia from a combined spinal epidural without further complications. We discuss the anesthetic considerations for providing neuraxial analgesia after a recent epidural blood patch.