Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2001
Maternal satisfaction and pain control in women electing natural childbirth.
Many women who choose natural childbirth for labor ultimately request epidural analgesia to control labor pain. Unfortunately, parturients and family members may often be unprepared for epidural anesthesia, which can contribute to disappointment and dissatisfaction with their labor and delivery. This study examines how epidural analgesia for labor influences maternal satisfaction in women who initially choose natural childbirth. ⋯ This study examined the influence of epidural analgesia in parturients electing natural childbirth. Pain relief alone was not found to improve maternal satisfaction. This study highlights the importance of experience and prelabor expectations on maternal satisfaction with childbirth.
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Reg Anesth Pain Med · Jul 2001
Randomized Controlled Trial Clinical TrialBuprenorphine added to the local anesthetic for brachial plexus block to provide postoperative analgesia in outpatients.
Over the past 10 years, several studies have suggested that the addition of certain opiates to the local anesthetic used for brachial block may provide effective, long-lasting postoperative analgesia. One of these studies indicated that the agonist-antagonist, buprenorphine, added to bupivacaine provided a longer period of postoperative analgesia than the traditional opiates, but in this study, it is impossible to determine the relative contributions of the local anesthetic and the opiate to the postoperative analgesia because of the extremely long duration of the anesthesia provided by the local anesthetic, bupivacaine. By repeating the study using a local anesthetic of a shorter duration, the present study delineates more clearly the contribution of the buprenorphine to postoperative analgesia when added to a shorter-acting local anesthetic. ⋯ The addition of buprenorphine to the local anesthetic used for brachial plexus block in the present study provided a 3-fold increase in the duration of postoperative analgesia, with complete analgesia persisting 30 hours beyond the duration provided by the local anesthetic alone in 75% of the patients. This practice can be of particular benefit to patients undergoing ambulatory upper extremity surgery by providing prolonged analgesia after discharge from the hospital.
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Reg Anesth Pain Med · Jul 2001
Clinical usefulness, safety, and plasma concentration of ropivacaine 0.5% for inguinal hernia repair in regional anesthesia.
The aim of this study was to evaluate the pharmacokinetics, feasibility, and clinical effects of ropivacaine in regional anesthesia (ilioinguinal-iliohypogastric blocks [IIB], genitofemoral block plus local infiltration) for inguinal hernia repair. ⋯ A ropivacaine dose of 60 to 70 mL of 0.5% appears adequate for regional anesthesia for inguinal hernia repair regarding conditions for surgery, safety, ambulation, and postoperative pain relief.