The Components of an Effective Test Dose Prior to Epidural Block

Section: Methodsmentioning

confidence: 99%

Fluoroscopically Guided Epidural Block in the Thoracic and Lumbar Regions

Nagaro

Yorozuya

Kamei

et al. 2006

“…To these ends, various intravascular identification methods have been proposed since the description of the epinephrine test dose by Moore and Batra in 1981. 26 Literature review Copyright @ American Society of Regional Anesthesia and Pain Medicine. Unauthorized reproduction of this article is prohibited.…”

Section: Preventionmentioning

confidence: 99%

ASRA Practice Advisory on Local Anesthetic Systemic Toxicity

Neal¹,

Bernards²,

Butterworth³

et al. 2010

568

365

The American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Local Anesthetic Systemic Toxicity assimilates and summarizes current knowledge regarding the prevention, diagnosis, and treatment of this potentially fatal complication. It offers evidence-based and/or expert opinion-based recommendations for all physicians and advanced practitioners who routinely administer local anesthetics in potentially toxic doses. The advisory does not address issues related to local anesthetic-related neurotoxicity, allergy, or methemoglobinemia. Recommendations are based primarily on animal and human experimental trials, case series, and case reports. When objective evidence is lacking or incomplete, recommendations are supplemented by expert opinion from the Practice Advisory Panel plus input from other experts, medical specialty groups, and open forum. Specific recommendations are offered for the prevention, diagnosis, and treatment of local anesthetic systemic toxicity.

“…When the question of cardiotoxicity of these drugs arose, he was the first to describe the appropriate use of ''test doses'' to detect intravascular injection. 28 His laboratory team, led by the Englishman Dr. Goeffrey Tucker, was instrumental in investigating many realms of clinical significance, including the blood levels of the local anesthetics, the effect of compounding drugs, 29 and the data regarding maximum safe doses of aminoamide local anesthetics.…”

Section: Development Of New Local Anestheticsmentioning

confidence: 99%

Daniel C. Moore, MD, and the Renaissance of Regional Anesthesia in North America

Mulroy

2011

While much attention is paid to the early days of organized regional anesthesia in North America under the leadership of Gaston Labat in New York, there was a period of decline in energy and activity in those techniques after the demise of his original American Society of Regional Anesthesia in 1940. In the years after World War II, questions were raised about the safety and utility of regional blockade. Dr. Daniel C. Moore emerged as a colorful and enthusiastic advocate of regional techniques, effectively leading a renaissance of regional anesthesia interest through his textbook, teaching, and research in Seattle, Washington. His protégés were instrumental in the rebirth of American Society of Regional Anesthesia and the extensive spread of regional anesthesia today.