Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 2003
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of a triple-injection axillary brachial plexus block with the humeral approach.
This prospective, randomized, and single-blind study compared effectiveness, performance, onset, and total anesthetic time and complications of the multiple axillary block (median, radial, and musculocutaneous nerves) with the humeral approach. ⋯ The triple-injection axillary block was more effective than the humeral approach as it was associated with more cases of sensory and complete motor block and gave shorter performance and onset times.
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Reg Anesth Pain Med · Nov 2003
Randomized Controlled Trial Comparative Study Clinical TrialLateral approach to the sciatic nerve in the popliteal fossa: a comparison between 1.5% mepivacaine and 0.75% ropivacaine.
Ropivacaine and mepivacaine are commonly used local anesthetics for peripheral nerve blockade. The purpose of the present study was to compare onset time, quality of anesthesia, and duration of analgesia with ropivacaine 0.75% and mepivacaine 1.5% for lateral popliteal nerve block. ⋯ Both ropivacaine and mepivacaine provided effective sciatic nerve blockade. Mepivacaine 1.5% displayed a significantly shorter onset time than ropivacaine 0.75%. Postoperatively, ropivacaine 0.75% resulted in longer-lasting analgesia and less need for oral pain medication.
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Reg Anesth Pain Med · Sep 2003
Randomized Controlled Trial Clinical TrialNo anesthetic or analgesic benefit of neostigmine 1 mg added to intravenous regional anesthesia with lidocaine 0.5% for hand surgery.
Neostigmine has shown analgesic benefit when used as an adjunct to epidural or intrathecal anesthesia and analgesia, but evidence of benefit in the peripheral nervous system is controversial. This study aimed to determine if neostigmine 1 mg added to intravenous regional anesthesia (IVRA) provided any advantage in terms of intraoperative anesthesia or postoperative analgesia. ⋯ Neostigmine 1 mg provides no anesthetic or analgesic advantage when added to IVRA for upper limb surgery.
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Reg Anesth Pain Med · Sep 2003
Randomized Controlled Trial Comparative Study Clinical TrialHemodynamic and blockade effects of high/low epinephrine doses during axillary brachial plexus blockade with lidocaine 1.5%: A randomized, double-blinded study.
Although epinephrine commonly is added to local anesthetics for regional anesthesia, rarely it may cause undesirable hemodynamic side effects. This study compared the hemodynamic and blockade effects of 25 and 200 microg epinephrine during axillary brachial plexus blockade with lidocaine 1.5%. ⋯ Low-dose epinephrine offers more stable hemodynamics and similar blockade, and thus may be beneficial for patients undergoing forearm and hand surgery who are at risk for tachycardia and/or hypertension.
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Reg Anesth Pain Med · Sep 2003
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of levobupivacaine 0.5% and racemic bupivacaine 0.5% for extradural anesthesia for caesarean section.
Bupivacaine is available as a racemic mixture of its enantiomers, dextrobupivacaine and levobupivacaine. Both in vitro and in vivo studies show that dextrobupivacaine has a greater inherent central nervous system (CNS) and cardiovascular toxicity than levobupivacaine. Clinical studies show levobupivacaine to have similar local anesthetic potency to the racemate. The aim of this study was to investigate the clinical efficacy and safety of levobupivacaine compared with racemic bupivacaine for extradural anesthesia. ⋯ Levobupivacaine produces an extradural block that is similar to bupivacaine, and is a suitable local anesthetic agent for caesarean delivery.