Anesthesia and analgesia
-
Anesthesia and analgesia · Apr 1982
Hemodynamic and catecholamine changes after administration of naloxone.
The hemodynamic and catecholamine response to intravenously administered naloxone, 0.2 mg and 0.4 mg, were determined in one group of surgical patients and one group of volunteers. Naloxone, 0.2 mg, was administered 30 minutes before the 0.4-mg dose. Group I consisted of six normotensive (IA) (aged 18 to 64, mean 35.7 years) and six hypertensive surgical patients (IB) (aged 35 to 67, mean 49.1 years) who were receiving a nitrous oxide, oxygen, and halothane anesthetic. ⋯ Mean arterial pressure, heart rate, plasma norepinephrine, epinephrine, and dopamine levels were compared before and after intravenous naloxone. Changes in mean arterial pressure, heart rate, plasma norepinephrine, epinephrine, and dopamine levels were not statistically significant in any group. This study suggests that intravenous naloxone, per se, alters neither mean arterial pressure, heart rate, or plasma catecholamine levels in normotensive or hypertensive humans.
-
Anesthesia and analgesia · Mar 1982
Randomized Controlled Trial Clinical TrialEpidural morphine for postoperative analgesia: a double-blind study.
Postoperative analgesia and the side effects of epidurally injected morphine were investigated in a double-blind study. Following lumbar epidural anesthesia for orthopedic operations, 174 patients received, in a randomized, double-blind fashion, either 0.1 mg/kg of morphine epidurally, 0.1 mg/kg of morphine intramuscularly, or saline epidurally at the end of surgery. Following epidural morphine, postoperative pain was les frequent, less intense and of shorter duration, use of analgesics and sedative was less frequent; and the postoperative feeling of well-being rated better than after systemic morphine or epidural saline. ⋯ The results were age independent. Side effects following epidural morphine included pruritus and disturbances of micturition. Nausea, vomiting, fatigue, and headache were of comparable frequency in the three groups.
-
Anesthesia and analgesia · Mar 1982
Neurologic effects of subarachnoid administration of 2-chloroprocaine-CE, bupivacaine, and low pH normal saline in dogs.
The purpose of this study was to evaluate the neurologic consequences of deliberate subarachnoid injection of large volumes of 2-chloroprocaine-CE in experimental animals. The possible role of low pH as well as total volume as potential factors in causing neurotoxicity was evaluated. The 65 dogs in the study received injections in the subarachnoid space as follows: 6 to 8 ml of bupivacaine (N = 15), 2-chloroprocaine-CE (N = 20), low pH normal saline (pH 3.0) (N = 20), or normal saline (N = 10). ⋯ None of the animals that received bupivacaine, normal saline, or normal saline titrated to a pH 3.0 developed hind-limb paralysis. Of the 15 spinal cords of the animals that received 2-chloroprocaine-CE, 13 showed subpial necrosis; the nerve roots and subarachnoid vessels were normal. The spinal cords of the animals that received bupivacaine, low pH normal saline (pH 3.0), or normal saline did not show abnormal findings.
-
Anesthesia and analgesia · Feb 1982
Randomized Controlled Trial Comparative Study Clinical TrialEpidural morphine for postoperative pain relief: a comparative study with intramuscular narcotic and intercostal nerve block.
The relatively new technique of epidural morphine analgesia was compared with two well established method of pain relief in 90 patients undergoing gallbladder surgery and divided randomly into three groups of 30 patients each. The first group received intramuscular narcotic analgesic ketobemidone, the second group was given 0.5% bupivacaine-epinephrine intercostal nerve block, and the third group received a single dose of 4 mg of epidural morphine for postoperative pain relief. The mean duration of analgesia after ketobemidone was 5.5 hours, and after intercostal block 11 hours. ⋯ Delayed respiratory depression was not encountered after epidural morphine. It is concluded that a single dose of 4 mg of epidural morphine provides excellent regional analgesia of long duration without drowsiness or circulatory of respiratory depression thus facilitating early ambulation. The technique is superior to more common methods of pain relief after gallbladder surgery, e.g., intercostal nerve block and intramuscular narcotics.