Epidural catheter placement in morbidly obese parturients with the use of an epidural depth equation prior to ultrasound visualization.

Background: Previously, Balki determined the Pearson correlation coefficient with the use of ultrasound (US) was 0.85 in morbidly obese parturients. We aimed to determine if the use of the epidural depth equation (EDE) in conjunction with US can provide better clinical correlation in estimating the distance from the skin to the epidural space in morbidly obese parturients.

Perioperative dental injury at a tertiary care health system: An eight-year audit of 816,690 anesthetics.

Among all complications of airway management, dental injury is the most common cause of patient complaints with medicolegal consequences. Over an 8-year period, data on dental injury were collected within a large university hospital system that included community, tertiary, and quaternary care centers. Patient characteristics were compared among all patients receiving anesthesia care using billing data collected from the same period.

Aprepitant plus ondansetron compared with ondansetron alone in reducing postoperative nausea and vomiting in ambulatory patients undergoing plastic surgery.

Background: Postoperative nausea and vomiting is a major challenge in the perioperative setting. The incidence can be as high as 80 percent, and the majority of the symptoms among outpatients occur after discharge. This study evaluated the efficacy of a neurokinin-1 receptor antagonist (aprepitant) in reducing postoperative symptoms for up to 48 hours in patients undergoing outpatient plastic surgery.

Transdermal scopolamine patch in addition to ondansetron for postoperative nausea and vomiting prophylaxis in patients undergoing ambulatory cosmetic surgery.

Study Objective: To determine the efficacy of transdermal scopolamine in addition to ondansetron in decreasing the incidence of postoperative nausea and vomiting (PONV).

Design: Randomized controlled trial.

Setting: Academic hospital.

Epidural labor analgesia: continuous infusion versus patient-controlled epidural analgesia with background infusion versus without a background infusion.

Unlabelled: The purpose of this study was to compare the total epidural dose of 3 commonly used labor epidural modalities. After local institutional review board approval, 195 laboring parturients received an epidural catheter for labor analgesia. All patients received an initial bolus of 0.

Efficacy of ropivacaine, bupivacaine, and levobupivacaine for labor epidural analgesia.

Study Objective: To compare analgesic efficacy and intensity of motor block with continuous infusions of ropivacaine, bupivacaine, and levobupivacaine in combination with fentanyl for labor epidural analgesia.

Design: Prospective, randomized, double-blinded study.

Setting: Labor and delivery suite at Magee Womens Hospital, Pittsburgh, PA.

Desflurane versus sevoflurane for laparoscopic gastroplasty in morbidly obese patients.

Study Objective: To determine if desflurane results in a faster emergence as measured by time to eye opening compared to sevoflurane in morbidly obese patients undergoing laparoscopic gastroplasty.

Study Design: Prospective, randomized, double-blinded study.

Setting: Tertiary care hospital.

Preemptive analgesia with bupivacaine for segmental mastectomy.

Background And Objectives: Preemptive analgesia is the concept of providing analgesia before surgical incision, resulting in less postoperative pain. The purpose of this study is to determine if preemptive and/or postoperative local anesthetic infiltration of bupivacaine in patients undergoing segmental mastectomy results in less postoperative pain compared with patients receiving placebo.

Methods: In this prospective, double-blinded study, 120 patients were randomized into 4 groups: group 1, preincisional (10 mL) and postoperative (10 mL) wound infiltration of 0.

Bupivacaine versus L-bupivacaine for labor analgesia via combined spinal-epidural: a randomized, double-blinded study.

Study Objective: To compare the intensity and duration of motor block and the duration of sensory block with racemic bupivacaine and l-bupivacaine for combined spinal-epidural analgesia, as previous studies have shown contradictory results.

Design: A prospective, randomized, double-blinded study.

Setting: Birth Center at Magee-Womens Hospital, Pittsburgh, Pa.

Piriformis syndrome in a patient after cesarean section under spinal anesthesia.

Objectives: The diagnosis, pathogenesis, and treatment of piriformis syndrome as a cause of persistent buttock and hip pain after spinal anesthesia are presented in this case report.

Case Report: A 29-year-old woman presented 5 days after cesarean delivery with sudden onset of pain in the left buttock and left hip radiating to the posterior knee with fever. She was subsequently diagnosed with piriformis syndrome.