Anesthesia and analgesia
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Anesthesia and analgesia · Oct 1996
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative analgesia after peripheral nerve block for podiatric surgery: clinical efficacy and chemical stability of lidocaine alone versus lidocaine plus clonidine.
Postoperative analgesia may be prolonged by the addition of clonidine to local anesthetic solutions used for regional anesthesia. The purpose of this study was to test this hypothesis in a clinical trial of patients undergoing podiatric surgery. The study design was prospective, double-blinded, and randomized. ⋯ Group C20 results suggested no statistically significant improvement over plain lidocaine. One patient in Group C20 experienced significant hypotension postoperatively. pH determinations and chemical analysis by capillary electrophoresis showed no significant change in composition of the solutions when clonidine was mixed with lidocaine and stored at 4 degrees C for 1 wk. Compared to 1.73% lidocaine, combining clonidine (10 micrograms/mL) with lidocaine for local anesthetic block for foot surgery significantly increases the duration and quality of postoperative analgesia.
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Anesthesia and analgesia · Oct 1996
Comparative StudyA comparative study of early postoperative hypoxemia in infants, children, and adults undergoing elective plastic surgery.
To determine the influence of age on postoperative hypoxemia, we studied postoperative hypoxemia in 1152 patients, from infants to adults, ASA physical status I, undergoing elective plastic surgery. Subjects were divided into four groups on the basis of age: Group 1, infants aged 1 yr or less (n = 108); Group 2, children aged 1-3 yr (n = 240); Group 3, children aged 3-14 yr (n = 482); and Group 4, adults aged 14-58 yr (n = 322). Arterial oxygen saturation (Spo2) levels were recorded while patients were breathing room air in the postanesthesia recovery room shortly after arrival (0 min), and 5, 10, 15, 20, 30, 40, 50, 60, 120, and 180 min thereafter. ⋯ Hypoxemia occurred most commonly within 1 h after anesthesia, particularly during the first 40 min in infants and during the first 15 min in older children and adults. A significant correlation was found by linear regression analysis between low Spo2 levels on admission to the recovery room and children's age. Thereafter, Spo2 levels and the incidence of hypoxemia during the early postoperative period were related only to infants' recovery scores.
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Anesthesia and analgesia · Oct 1996
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of the neuromuscular blocking effects of atracurium, mivacurium, and vecuronium on the adductor pollicis and the orbicularis oculi muscle in humans.
Both the orbicularis oculi (OO) and the adductor pollicis (AP) muscles have been used to indirectly quantify the extent of neuromuscular block of the respiratory muscles. To clarify any differences in response of these muscles to neuromuscular blocking drugs, the effects of two different doses of atracurium, mivacurium, and vecuronium on the AP and OO were studied. A new technique was used to measure the evoked mechanical response of the OO with accelerometry. ⋯ TOF 0.7 was shorter with the smaller dose of each drug, but there was no difference with the higher doses. It is concluded that it is possible to record the mechanical response of the OO muscle using a noninvasive method. There are differences between the responses of the OO and the AP to neuromuscular blockers that depend upon both the specific drug itself and the dose used.