Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Mar 1998
Randomized Controlled Trial Clinical TrialThe recovery profile of hyperbaric spinal anesthesia with lidocaine, tetracaine, and bupivacaine.
Surgical procedures previously considered too lengthy for the ambulatory surgery setting are now being performed during spinal anesthesia. The complete recovery profile of tetracaine and bupivacaine are now of interest but are not available in the literature. This study was conducted to compare times to ambulation, voiding, and complete block resolution, as well as the incidence of back and radicular pain, after spinal anesthesia with lidocaine, bupivacaine, and tetracaine. ⋯ Among individual subjects, lidocaine exhibited the shortest recovery profile. However, the recovery profiles of the three anesthetics were very variable between subjects. Time to meeting discharge criteria after bupivacaine or tetracaine was faster in a few subjects than that after lidocaine in other subjects. For ambulatory anesthesia, times to two- and four-segment regression do not accurately predict time to readiness for discharge after spinal anesthesia.
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Reg Anesth Pain Med · Mar 1998
Does spinal anesthesia affect cerebral oxygenation during transurethral prostatectomy?
Transurethral resection of the prostate (TURP) is associated with the unique complication of transurethral resection of prostate syndrome (TURS), which is attributed to the absorption of irrigating fluid. This study was initiated to investigate the effects of spinal anesthesia and TURP on cerebral oxygen balance. ⋯ The neurologic symptoms in patients undergoing TURP during spinal anesthesia might not only be caused by absorption of irrigating fluid but also by impairment of cerebral oxygenation.
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Reg Anesth Pain Med · Mar 1998
Biography Historical ArticleThe Labat Lecture 1997--from Pauchet to today--the French connection.
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Reg Anesth Pain Med · Mar 1998
Randomized Controlled Trial Clinical TrialAddition of bupivacaine to sufentanil in patient-controlled epidural analgesia after lower limb surgery in young adults: effect on analgesia and micturition.
The usefulness of adding bupivacaine to an opioid administered by the epidural route is controversial. This study examines both the quality of pain relief and side effects, in particular urinary retention, during patient-controlled epidural analgesia (PCEA) with sufentanil alone or in combination with two different concentrations of bupivacaine. ⋯ A 0.06% bupivacaine-sufentanil combination offered the best results in terms of analgesic quality and lower side effects, mainly micturition problems, which may be explained by the higher consumption of local anesthetic at the higher bupivacaine concentration. Analgesic quality could not be improved by increasing the bupivacaine concentration.
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Reg Anesth Pain Med · Mar 1998
Randomized Controlled Trial Clinical TrialThe peripheral analgesic effect of meperidine in reducing propofol injection pain is not naloxone-reversible.
Meperidine is frequently used in general anesthesia and perioperative analgesia. In addition to its opioid action, meperidine possesses some local anesthetic properties. A preliminary study using the tourniquet venous retention technique found meperidine to be more effective in reducing propofol injection pain than fentanyl or morphine, both of which were slightly better than placebo. This study was undertaken to evaluate whether this peripheral analgesic effect of meperidine is affected by naloxone. ⋯ The peripheral analgesic effect of meperidine in reducing propofol injection pain is not mediated by its opioid activity.