Anesthesia and analgesia
-
Anesthesia and analgesia · Mar 1976
Case ReportsManagement of intractable pain in adiposis dolorosa with intravenous administration of lidocaine.
Intractable pain in a patient with adiposis dolorosa (Dercum's disease) was treated by IV administration of lidocaine (200 to 400 mg). Relief was maximum 20 minutes after the end of drug infusion and persisted for over 10 hours. Toxicity was minimal. Slow EEG waves which appeared during drug administration disappeared within 20 minutes.
-
The incidence of contamination of catheters and syringes used during epidural analgesia for parturients and the effectiveness of bacterial filters were investigated. The effect of bupivacaine on bacterial viability and growth was also studied. Syringes in 5/101 cases were contaminated, while catheter tips located in the epidural space were sterile. ⋯ Bupivacaine (0.25%) was bacteriocidal to S epidermidis and Corynebacterium spp at 37C but not at room temperature. These findings illustrate the efficacy of using bacterial filters during continuous epidural analgesia. New syringes should be used for each epidural injection as insurance against seeding of bacteria in the presence of a defective filter.
-
Anesthesia and analgesia · Mar 1976
The influence of suction catheter tip design on tracheobronchial trauma and fluid aspiration efficiency.
The suctioning efficiency and trauma-producing characteristics of five commercially available tracheobronchial suction catheters (Pharmaseal Tri-Flo, NCC Gentle-Flo, Argyle Aero-Flo, Argyle Dual Side-Hole, and Pharmaseal Whistle-Tip) were experimentally evaluated in anesthetized healthy dogs. The tendency of catheters to invaginate or "grab" tracheobronchial mucosa was observed with a bronchofiberscope during suctioning. Mucosal grabbing was seldom seen even at high (greater than 300 torr) vacuum levels with the cateter tip in the trachea. ⋯ The average tip-suctioning effectiveness for each catheter, determined in vitro by aspirating a thin, uniform layer of simulated mucus, was found to be significantly higher for the Tri-Flo and Whistle-Tip catheters than the others, the Aero-Flo being least effective. Preliminary attempts to demonstrate this difference in suctioning effectiveness by comparing the performance of the catheters which displayed the highest and lowest tip suction effectiveness in a standardized clinical suctioning procedure revealed no significant difference in the percentage of mucus removed by either catheter. Additional studies should clarify this apparent contradiction.