Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialSpinal 2-chloroprocaine: minimum effective dose.
Recent studies using preservative-free 2-chloroprocaine (2-CP) for spinal anesthesia have shown it to be a reliable short-acting agent in the 30-mg to 60-mg range. Investigations of doses below this range have not been performed. ⋯ Spinal 2-CP 40 mg and 60 mg provide rapid and reliable sensory and motor block. Although the 20-mg and 30-mg doses can produce sensory anesthesia adequate for brief surgical procedures, less motor block and some sacral sparing should be anticipated. Because the 10-mg dose produces only brief and inconsistent sensory anesthesia, it can be considered a no-effect dose.
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Reg Anesth Pain Med · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialAnesthetic techniques and postoperative emesis in pediatric strabismus surgery.
Postoperative emesis after pediatric strabismus surgery continues to be a problem, despite the use of antiemetics. The purpose of this study was to identify an anesthetic technique associated with the lowest incidence of vomiting after pediatric strabismus surgery. ⋯ Among the three techniques, peribulbar block with propofol-based anesthesia is the technique with the lowest incidence of postoperative emesis. Fentanyl-propofol is an equally acceptable alternative; however, meperidine-propofol is associated with a high incidence of postoperative emesis.
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Reg Anesth Pain Med · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialSpinal hyperbaric ropivacaine-fentanyl for day-surgery.
Adequate intraoperative analgesia combined with faster mobilization might be achieved by replacing hyperbaric ropivacaine partly with fentanyl. ⋯ Faster mobilization but equal onset and duration of analgesia were achieved with intrathecal hyperbaric ropivacaine 10 mg plus fentanyl 20 microg as compared with hyperbaric ropivacaine 15 mg.
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Reg Anesth Pain Med · Nov 2004
Randomized Controlled Trial Clinical TrialA clinical comparison of equal concentration and volume of ropivacaine and bupivacaine for interscalene brachial plexus anesthesia and analgesia in shoulder surgery.
The aim of this study was to compare the same volume and concentration of bupivacaine and ropivacaine for interscalene brachial plexus block anesthesia and postoperative analgesia in shoulder surgery. ⋯ This study shows that the same volume and concentration of bupivacaine and ropivacaine (30 mL of 0.5%) for interscalene brachial plexus block anesthesia produce similar surgical block. When prolonging the block with a patient-controlled interscalene analgesia infusion, 0.15% bupivacaine or ropivacaine provide adequate pain relief, similar side effects, and high patient satisfaction after shoulder surgery.
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Reg Anesth Pain Med · Nov 2004
Randomized Controlled Trial Clinical TrialInterscalene brachial plexus anesthesia with ropivacaine 5 mg/mL and bupivacaine 5 mg/mL: effects on electrocardiogram.
Cardiotoxicity is the most severe complication of long-acting local anesthetics. The aim of this trial is to compare early signs of depression of cardiac conduction linked with the administration of either ropivacaine or bupivacaine for interscalene block. ⋯ Electrocardiographic recordings were similar in both groups, except for a significant prolongation of the PQ interval in the bupivacaine group at plasma levels below threshold for cardiotoxicity.