Anesthesia and analgesia
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Anesthesia and analgesia · Oct 1991
Randomized Controlled Trial Comparative Study Clinical TrialIntradermal anesthesia and comparison of intravenous catheter gauge.
A double-blinded randomized prospective study was performed to determine whether alkalinization of lidocaine decreases the pain of intradermal injection and if a larger intravenous catheter (16 gauge) causes more discomfort on insertion than a smaller (20 gauge) catheter when intradermal anesthesia has been used. In a random manner, 100 patients received skin wheals with commercially prepared lidocaine or lidocaine with the addition of sodium bicarbonate before the insertion of a 16- or 20-gauge intravenous catheter. Visual analogue pain scores were obtained after the skin wheal was placed and after the intravenous catheter was inserted. ⋯ However, the catheter insertions pain scores were slightly, but statistically significantly larger in the 16-gauge group regardless of local anesthetic solution used. The addition of sodium bicarbonate to commercially prepared lidocaine does not decrease the pain associated with an intradermal skin wheal. There is a slight increase in patient discomfort upon insertion of a large-bore intravenous catheter, even with the prior use of local anesthetic.
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Anesthesia and analgesia · Oct 1991
Randomized Controlled Trial Clinical TrialOnset of epidural blockade after plain or alkalinized 0.5% bupivacaine.
This double-blind study investigated the effect of adding 1.4% bicarbonate to 0.5% bupivacaine on onset time of sensory and motor blockade after epidural administration. Forty patients were randomly divided into one of two groups. Group 1 received 20 mL of 0.5% bupivacaine (pH, 5.58 +/- 0.12) and group 2 received 20 mL of 0.5% bupivacaine + 0.6 mL of 1.4% bicarbonate (pH, 6.53 +/- 0.06). ⋯ Maximum motor blockade was reached after 30 min in group 1 and after 36 min in group 2. No difference in motor blockade or upward spread of anesthesia was noted between the two groups. The authors conclude that alkalinization of 0.5% bupivacaine offers no improvement in the onset of epidural blockade.
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Anesthesia and analgesia · Oct 1991
Adverse interaction between bupivacaine and halothane on ventricular contractile force and intraventricular conduction in the dog.
Regional anesthesia with bupivacaine in pediatric patients is often accompanied by light levels of halothane general anesthesia. To determine the potential cardiotoxicity of these two drugs when used together, we defined the interaction between moderate plasma bupivacaine concentrations (1270-1760 ng/mL) and halothane (end-tidal concentrations, 0.5%-1.0%) on ventricular contractility and conduction in 22 closed-chest dogs anesthetized with chloralose. ⋯ In other dogs given halothane but in which bupivacaine levels were held constant (1400 ng/mL), VCT remained constant and VERP lengthened slightly, whereas dP/dtmax decreased. We conclude that the combination of bupivacaine and halothane can cause adverse effects on ventricular contractility and intraventricular conduction.