Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Oct 2006
Randomized Controlled TrialParavertebral ropivacaine, 0.3%, and bupivacaine, 0.25%, provide similar pain relief after thoracotomy.
This study was designed to determine whether ropivacaine plus fentanyl was as effective as bupivacaine plus fentanyl in a continuous thoracic paravertebral block after posterolateral thoracotomy. ⋯ It is concluded that both bupivacaine, 0.25%, and ropivacaine, 0.3%, with fentanyl are equally effective for post-thoracotomy pain control when used via continuous paravertebral blockade.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2006
Randomized Controlled TrialWhich is a better position for insertion of a high thoracic epidural catheter: sitting or lateral decubitus?
The purpose of this study was to compare the safety and success rates associated with the placement of a high thoracic epidural catheter in the sitting vs. the lateral decubitus position. ⋯ It is recommended to use the lateral decubitus position for high thoracic epidural catheterization in patients scheduled for OPCAB to avoid vagal reflexes.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2006
Hemodynamic effects of lidocaine in the thoracic paravertebral space during one-lung ventilation for thoracic surgery.
There is increasing interest in the use of the thoracic paravertebral block (TPVB) in association with general anesthesia for lung-resection surgery. The aim of the study was to evaluate the hemodynamic effects of a 5-mg/kg lidocaine bolus injected in the thoracic paravertebral space during one-lung ventilation (OLV) in noncardiac patients undergoing thoracic surgery. ⋯ In noncardiac patients, TPVB is associated with good hemodynamic stability, despite a small and transient decrease in myocardial contractility that could be related to the drug's systemic effects after its absorption.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2006
Assessment of thoracic epidural analgesia during general anesthesia using pupillary reflex dilation: a preliminary study.
Pupillary reflex dilation (PRD) secondary to noxious stimulation accurately predicts sensory block during combined lumbar epidural/general anesthesia. Therefore, the adequacy of PRD-guided thoracic epidural infusion during general anesthesia for thoracotomy was studied. ⋯ PRD-guided continuous thoracic epidural analgesia under low-dose remifentanil/propofol anesthesia is feasible and ensures good postoperative analgesia.