Anesthesiology
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Randomized Controlled Trial Clinical Trial
Intravenous remifentanil: placental transfer, maternal and neonatal effects.
Remifentanil has not been studied in obstetric patients. This study evaluates the placental transfer of remifentanil and the neonatal effects when administered as an intravenous infusion. ⋯ Remifentanil crosses the placenta but appears to be rapidly metabolized, redistributed, or both. Maternal sedation and respiratory changes occur, but without adverse neonatal or maternal effects.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of the posterior versus lateral approaches to the block of the sciatic nerve in the popliteal fossa.
The main disadvantage of the posterior approach to the block of the sciatic nerve in the popliteal fossa (popliteal block [PB]) is the need to place the patient in the prone position. In this study, the authors examined the clinical utility of a recently described lateral approach to PB that is performed with the patient in the supine position, and they compared its ability to provide reliable surgical anesthesia with that of the posterior approach. ⋯ Although blockade using the lateral approach took longer to accomplish, both techniques resulted in clinically acceptable anesthesia in the distribution of the sciatic nerve.
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Randomized Controlled Trial Clinical Trial
Effects of oral clonidine on heart rate changes after neostigmine-atropine administration.
Clonidine reduces heart rate (HR) responses to atropine, whereas neostigmine causes bradycardia. This study was designed to determine whether clonidine premedication would reduce tachycardia after neostigmine-atropine administration. ⋯ Premedication with 5 microg/kg oral clonidine attenuates the initial increases in HR without subsequent decreases in HR.
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Randomized Controlled Trial Clinical Trial
Upper airway reflexes during a combination of propofol and fentanyl anesthesia.
The effects of intravenous anesthetics on airway protective reflexes have not been fully explored. The purpose of the present study was to characterize respiratory and laryngeal responses to laryngeal irritation during increasing doses of fentanyl under propofol anesthesia. ⋯ Incremental doses of fentanyl depress airway reflex responses in a dose-related manner, except for apnea with laryngospasm.
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Randomized Controlled Trial Clinical Trial
Treatment of incomplete analgesia after placement of an epidural catheter and administration of local anesthetic for women in labor.
Approximately 15% of women still have pain after placement of an epidural catheter and administration of local anesthetic for labor analgesia. Two techniques frequently used to treat this pain were compared: (1) withdrawal of the catheter 1 cm and repeated dosing with additional local anesthetic, and (2) repeated dosing with additional local anesthetic without any catheter manipulation. ⋯ Administration of additional local anesthetic without first withdrawing the epidural catheter will effectively treat most women for whom analgesia is incomplete after the placement of an epidural catheter during labor.