Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2001
Randomized Controlled Trial Clinical TrialEpidural fentanyl speeds the onset of sensory block during epidural lidocaine anesthesia.
Shortening the onset time of sensory block is a practical goal to improve the quality of epidural anesthesia. The addition of fentanyl to a local anesthetic solution is widely used during epidural anesthesia. This randomized double-blind study examined the onset time of sensory block during epidural lidocaine anesthesia with and without added fentanyl to the epidural solution. ⋯ Epidural injection of the mixture of 100 microg fentanyl and 2% lidocaine solution accelerated the onset of sensory block during epidural lidocaine anesthesia without increased side effects.
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Reg Anesth Pain Med · Nov 2001
Randomized Controlled Trial Comparative Study Clinical TrialEffects of intrathecal sufentanil on plasma oxytocin and cortisol concentrations in women during the first stage of labor.
Intrathecal sufentanil provides analgesia comparable to epidural bupivacaine for the first stage of labor. Both epidural local anesthetics and intrathecal opioid reduce some parameters of the neuroendocrine response to labor pain and the reflex release of oxytocin in animals. In humans, epidural local anesthetics only reduce the spurt release of oxytocin. This study compared the effect of intrathecal sufentanil and epidural bupivacaine administration on the plasma concentration of oxytocin and cortisol in women with labor pain during the first stage of labor. ⋯ Intrathecal sufentanil analgesia decreases plasma concentrations of oxytocin and cortisol in women with labor pain during the first stage of labor, but epidural bupivacaine only reduced the cortisol concentration.
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Reg Anesth Pain Med · Nov 2001
Randomized Controlled Trial Comparative Study Clinical TrialAxillary brachial plexus block using peripheral nerve stimulator: a comparison between double- and triple-injection techniques.
The multiple-injection technique for axillary block, in which the main 4 nerves of the plexus are located by a nerve stimulator and separately injected, has been shown to produce a high success rate. However, this technique may prove to be more difficult and time-consuming than other methods. Therefore, a simplified technique, with a reduced number of injections, might be desirable. A comparison between 2- and 3-injection techniques was made in the present double-blind study. ⋯ The 2-injection technique offers a success rate in blocking the 3 nerves innervating the hand similar to that obtained with the 3-injection technique. The latter approach should be considered when the musculocutaneous nerve distribution is involved in the surgical area.
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Reg Anesth Pain Med · Nov 2001
Clinical TrialAssessment of QT interval and QT dispersion following stellate ganglion block using computerized measurements.
Prolongation of QT interval and QT dispersion (QTD) may be associated with an increased risk of arrhythmias. This study was designed to investigate the effects of right or left stellate ganglion block (SGB) on RR interval, QT interval, the rate-corrected QT (QTc) interval, QTD and the rate-corrected QTD (QTcD) using computerized measurements. ⋯ Right SGB induces increases of the QT interval, QTc interval, QTD, and QTcD, and left SGB induces decreases of the QT interval and QTc interval.
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Reg Anesth Pain Med · Nov 2001
Clinical TrialVibration sense testing with a 128-Hz tuning fork as a tool to determine recovery from epidural neuraxial block.
Vibration sense testing using a 128-Hz tuning fork is a commonly used test in the diagnosis of dorsal horn dysfunction and polyneuropathy. In this open, prospective study, we tested the hypothesis that vibration sense testing is a sensitive and specific method to assess recovery from epidural block. ⋯ Based on our observations, recovery of vibration sense corresponds with recovery of motor block after epidural anesthesia and may serve as an easy means of documenting recovery with a single test before discharge.