Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 1999
Case ReportsDisappearance of wheezing during epidural lidocaine anesthesia in a patient with bronchial asthma.
Local anesthetics in blood absorbed from the epidural space attenuate bronchial hyperreactivity to chemical stimuli. However, it is not documented whether local anesthetics at clinically relevant concentrations improve active wheezing in patients with bronchial asthma. ⋯ At clinically relevant concentrations, lidocaine in the blood absorbed from the epidural space may improve bronchospasm in patients with bronchial asthma.
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Reg Anesth Pain Med · Jul 1999
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialRemifentanil versus alfentanil as analgesic adjuncts during placement of ophthalmologic nerve blocks.
Short-acting opioids are often used prior to the placement of ophthalmologic nerve blocks. This study examines whether remifentanil would provide superior analgesia compared with alfentanil, without oversedation or prolonged recovery when given either as a single dose over 30 seconds or as a single dose followed by a continuous infusion, in a dose ratio of 1:7 (remifentanil:alfentanil). ⋯ Remifentanil 1 microg/kg results in superior analgesia compared with alfentanil 7 microg/kg when used during the placement of ophthalmologic nerve blocks. The combination of a single dose of remifentanil followed by a continuous infusion was equally effective but resulted in a higher incidence of respiratory depression.
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Reg Anesth Pain Med · Jul 1999
Randomized Controlled Trial Comparative Study Clinical TrialRopivacaine for peribulbar anesthesia.
We compared the efficacy of a mixture of ropivacaine and lidocaine with a mixture of bupivacaine and lidocaine for providing peribulbar anesthesia for cataract surgery. We used the time to adequate block for surgery and ocular and eyelid movement scores as clinical end points. ⋯ Ropivacaine 1% is an effective alternative to 0.75% bupivacaine for peribulbar anesthesia, when combined with lidocaine and hyaluronidase.
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Reg Anesth Pain Med · Jul 1999
Case ReportsIntrathecal infusion of bupivacaine with or without buprenorphine relieved intractable pain in three patients with vertebral compression fractures caused by osteoporosis.
At present, there is no reliable method of relieving "refractory" pain in patients with compression fractures of the vertebral bodies caused by osteoporosis. We explored the possibility of relieving this type of pain by intrathecal (i.t.) infusion of bupivacaine with or without buprenorphine. ⋯ Continuous intrathecal infusion of bupivacaine, with or without buprenorphine, appeared to be an effective method for the long-term treatment (months to > 1 year) of "refractory" pain from vertebral compression fractures, in this small group of patients.
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Reg Anesth Pain Med · Jul 1999
Randomized Controlled Trial Clinical TrialRetrobulbar/peribulbar block with 0.2% ropivacaine or 1% lidocaine for transscleral cyclophotocoagulation or retinal panphotocoagulation.
Brief analgesia is needed to complete krypton laser cyclophotocoagulation for glaucoma patients and is advantageous in argon laser panphotocoagulation for diabetic retinopathy. We studied whether 0.2% ropivacaine, known for analgesia with minimal motor block or 1% lidocaine, with rapid onset and short duration of action, both supplemented with hyaluronidase, are suitable local anesthetics for retrobulbar/peribulbar block for these procedures. ⋯ According to our preliminary data, neither 0.2% ropivacaine nor 1% lidocaine reached acceptable frequencies of adequate analgesia during transscleral cyclophotocoagulation, while all retinal panphotocoagulations could be completed under the initial block.