Anesthesia and analgesia
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Anesthesia and analgesia · Dec 1989
Clinical Trial Controlled Clinical TrialMotor and sensory blockade after epidural injection of mepivacaine, bupivacaine, and etidocaine--a double-blind study.
In a double-blind study of epidural anesthesia, 30 young volunteers were given either 2% mepivacaine (400 mg), 0.5% bupivacaine (100 mg), or 1.5% etidocaine (300 mg), all solutions containing epinephrine (1:200,000). The spread of analgesia was equal in the groups, whereas the longest duration was noted in the etidocaine and bupivacaine groups. With use of a method for determining muscle force, motor blockade during anesthesia was recorded quantitatively for hip flexion, knee extension, and plantar flexion of the big toe. ⋯ With etidocaine, the motor blockade outlasted the sensory blockade by 150 min. The Bromage scale corresponded to the motor blockade only during the first half of the regression phase. Not until 1-3 h after attainment of Bromage grade 0 was the muscle force of all movements restored (90% of control values).
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Anesthesia and analgesia · Dec 1989
Comparative StudyComparative systemic toxicity of convulsant and supraconvulsant doses of intravenous ropivacaine, bupivacaine, and lidocaine in the conscious dog.
This study evaluated the systemic toxicity, arrhythmogenicity, and mode of death of convulsant and supraconvulsant doses of lidocaine, bupivacaine, and ropivacaine. Experiments in awake dogs were designed to mimic the clinical situation of an accidental intravenous (IV) injection of local anesthetics. On the first experimental day, lidocaine (8 mg.kg-1.min-1), bupivacaine (2 mg.kg-1.min-1), and ropivacaine (2 mg.kg-1.min-1) were infused intravenously until seizures occurred (n = 6 for each group). ⋯ In the ropivacaine group one animal died because of hypotension, respiratory arrest, and cardiovascular collapse (Cmax = 72.4 micrograms/mL). A surviving dog had transient premature ventricular contractions. Twenty-four hours later three times the convulsive dose was administered to the survivors.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Dec 1989
Comparison of the fascia iliaca compartment block with the 3-in-1 block in children.
A new single injection procedure, the fascia iliaca compartment block, is described for blocking the femoral, lateral cutaneous, and obturator nerves. The technique consists of injecting a local anesthetic immediately behind the fascia iliaca at the union of the lateral with the two medial thirds of the inguinal ligament, and forcing it upward by finger compression. This block was prospectively evaluated in 60 pediatric patients aged 0.7 to 17 years undergoing surgery of the lower limb, and then compared with a similar group of 60 children given a 3-in-1 block. ⋯ In the authors' opinion, a multieffective block can only develop when the local anesthetic is introduced behind the fascia iliaca, which circumscribes a potential space where the femoral, lateral cutaneous, and obturator nerves run for a considerable part of their course. This report shows that deliberately injecting this space almost always results in an easy and effective block of these three nerves. The fascia iliaca compartment block can be recommended for use in children.
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Anesthesia and analgesia · Dec 1989
What is the safest endotracheal tube for Nd-YAG laser surgery? A comparative study.
To determine whether a safe endotracheal tube for Nd-YAG surgery could be found, an Nd-YAG laser operating at 50 W was directed at six different endotracheal tubes that had 5 L/min of oxygen flowing through them. A plain Rusch red rubber endotracheal tube, a Bivona Fome-cuff laser endotracheal tube, a stainless steel Mallinckrodt Laser-Flex endotracheal tube, and a Xomed Laser-shield endotracheal tube were all ignited and perforated by the laser within 12 s. ⋯ Red rubber endotracheal tubes wrapped with 3M No. 425 or Venture copper foil tape were unaffected by 1 min of exposure to the laser beam. They are recommended for clinical use.
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Anesthesia and analgesia · Dec 1989
Delayed side effects of droperidol after ambulatory general anesthesia.
The incidence of postoperative effects of droperidol, in the hospital and at home the following night, after general anesthesia for minor outpatient procedures was evaluated in two groups of 50 patients each. Anesthetic techniques were identical except for the presence or absence of 1.25 mg of IV droperidol. ⋯ No patient not receiving droperidol had these reactions. It is suggested that the routine use of droperidol in all outpatients receiving general anesthesia may not be appropriate.