Journal of clinical anesthesia
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The purpose of the study was to determine whether epidural analgesia is unsafe for trial of labor (TOL). ⋯ Uterine rupture presents as monitored fetal distress rather than abdominal pain. Thus, epidural analgesia can be used in patients attempting a TOL.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative pain management and respiratory depression after thoracotomy: a comparison of intramuscular piritramide and intravenous patient-controlled analgesia using fentanyl or buprenorphine.
To compare the analgesic efficacy of fentanyl, buprenorphine, and piritramide and to define the respiratory risk during conventional postoperative pain management and patient-controlled analgesia (PCA). ⋯ Opioid-induced respiratory depression occurred infrequently during postoperative pain management whether by conventional means or using PCA, even though high doses of opioid analgesics were required intermittently for adequate postoperative pain relief by either technique.
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Randomized Controlled Trial Clinical Trial
Epidural mepivacaine for cesarean section: effects of a pH-adjusted solution.
To determine the clinical effects of the alkalinization of 2% mepivacaine with epinephrine used for epidural block during cesarean section. ⋯ The alkalinization allowed the surgery to proceed more rapidly, significantly decreasing the time interval between epidural block and delivery of the infant.
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The beginnings of organized emergency care can be traced through military history dating back to the Middle Ages. In 1769, the first civilian rescue society was established to look after shipwrecked persons. Sociological and technical requirements of the late 19th century led to the formation of different rescue associations and to writing of regulations for rescue and ambulance services. ⋯ Today the rescue service functions to bring a physician, often an anesthesiologist, to the victim as quickly as possible. Modern rescue laws fix a lead time of 5 to 15 minutes for a professional rescue service to reach the scene. The medical equipment and qualifications of personnel treating life-threatening trauma and diseases have improved, and in this context, the role of the anesthesiologist is important.