Regional anesthesia and pain medicine
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Reg Anesth Pain Med · May 2000
Clinical TrialPlasma lidocaine, monoethylglycinexylidide, and glycinexylidide concentrations after epidural administration in geriatric patients.
The purpose of this study was to evaluate the effect of age on the pharmacokinetics of lidocaine after epidural administration. ⋯ The increase in plasma lidocaine concentration after epidural anesthesia in elderly patients was not as high as anticipated. However, the elderly patients showed longer MRTs, lower clearance, and lower ratios of MEGX/lidocaine than did the adult (middle-age) patients.
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Reg Anesth Pain Med · May 2000
Clinical TrialThe minimum effective concentration of opioids: a revisitation with patient controlled analgesia fentanyl.
Whether patients titrate themselves to an individualized blood or plasma opioid concentration (the so-called minimum effective concentration or [MEC]) has been debated extensively. Nevertheless, there is consistent opinion that during patient controlled analgesia (PCA) patients balance acceptable pain relief against unacceptable side effects. This study sought to characterize fentanyl used by PCA with respect to MEC and factors influencing PCA use. ⋯ This study found evidence to support the concepts of an individual MEC and a therapeutic window of fentanyl used with PCA.
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The Internet is increasingly an important resource for both the Pain Medicine physician and the patient. Considerable high-quality information exists within numerous government, university, professional association, and private sites. ⋯ Clinicians may communicate about complex patient management issues via a list-serve, which delivers entire discussions to their E-mail accounts. These multiple resources offer an enriched environment for patient care, education, and research in pain management.