Anesthesia and analgesia
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Anesthesia and analgesia · Jun 1997
Randomized Controlled Trial Clinical TrialIntrathecal sufentanil for extracorporeal shock wave lithotripsy provides earlier discharge of the outpatient than intrathecal lidocaine.
Many anesthetic techniques are currently used for extracorporeal shock wave lithotripsy (ESWL). This randomized, prospective, double-blind study was designed to examine postoperative recovery with two anesthetic techniques for unilateral ESWL; i.e., intrathecal sufentanil versus intrathecal 5% lidocaine. The incidence of adverse effects was also assessed. ⋯ There were no differences in PONV between the two groups. Intrathecal sufentanil provided an enhanced recovery profile with significantly earlier home discharge when compared with intrathecal lidocaine. In conclusion, intrathecal sufentanil is a safe and effective method of anesthesia for outpatient unilateral ESWL.
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Anesthesia and analgesia · Jun 1997
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of multiport and uniport epidural catheters in laboring patients.
The relative incidence of technical difficulties associated with multiport (three lateral ports) and uniport (single distal port) epidural catheters remains controversial. As part of a continuing institutional evaluation of epidural catheter insertion, 500 parturients were randomized to have either a multiport or a uniport epidural catheter inserted 6 cm into the epidural space. ⋯ No multiport epidural catheter was associated with multicompartment placement. We conclude that multiport epidural catheters are preferable for use in laboring patients since they reduce the incidence of inadequate epidural analgesia.
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Anesthesia and analgesia · Jun 1997
Randomized Controlled Trial Clinical TrialIntraarticular morphine analgesia in chronic pain patients with osteoarthritis.
Controlled clinical studies have shown that local administration of morphine can significantly relieve acute postoperative pain. This analgesic effect is long-lasting (up to 48 h) and is mediated by peripheral opioid receptors. Experimental evidence shows that analgesic effects of peripheral opioids and the density of opioid receptors on peripheral sensory nerves increase with the duration of painful inflammatory processes. ⋯ The analgesic effect was surprisingly long-lasting and extended into Phase II, a carry-over effect that prevented the analysis of Phase II. No side effects were reported. The treatment of arthritic pain by peripherally acting opioids may be a promising alternative to currently available medications that have serious side effects.
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Anesthesia and analgesia · Jun 1997
Randomized Controlled Trial Comparative Study Clinical TrialTracheal intubation using alfentanil and no muscle relaxant: is the choice of hypnotic important?
Administration of alfentanil followed by propofol intravenously (IV) without neuromuscular blockade for induction of anesthesia provides adequate conditions for tracheal intubation. Other hypnotic drugs have not been thoroughly investigated in this regard. Accordingly, 140 ASA physical status I and II premedicated outpatients were randomly assigned to one of seven groups (n = 20/group). ⋯ Alfentanil/etomidate yielded intubation conditions comparable to those achieved with alfentanil/propofol and d-tubocurarine/thiopental/succinylcholine. Lidocaine appeared to improve intubating conditions, although this improvement did not reach statistical significance. The results suggest that healthy, premedicated patients with favorable airway anatomy who have received alfentanil 40 microg/kg can be reliably tracheally intubated 90 s after administration of propofol 2 mg/kg or etomidate 0.3 mg/kg.