Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2003
Randomized Controlled Trial Clinical TrialTopical amitriptyline in healthy volunteers.
The antidepressant amitriptyline is used as an adjuvant in the treatment of a variety of chronic pain conditions. This drug interacts with many receptors and ion channels, such as Na+ channels. In a randomized, double-blinded, and placebo-controlled trial, we investigated whether amitriptyline also is capable of providing cutaneous analgesia when applied topically in 14 healthy volunteers. ⋯ Topically applied amitriptyline is effective as an analgesic in humans. Different vehicles may improve its efficacy and decrease the skin redness observed.
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Reg Anesth Pain Med · Jul 2003
Randomized Controlled Trial Comparative Study Clinical TrialComparison of continuous 3-in-1 and fascia Iliaca compartment blocks for postoperative analgesia: feasibility, catheter migration, distribution of sensory block, and analgesic efficacy.
Efficacy and technical aspects of continuous 3-in-1 and fascia iliaca compartment blocks were compared. ⋯ The authors conclude that a catheter for continuous lumbar plexus block can be placed more quickly and at lesser cost using the fascia iliaca technique than the perivascular technique with equivalent postoperative analgesic efficacy.
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Reg Anesth Pain Med · May 2003
Randomized Controlled Trial Clinical TrialPosterior perineal block with ropivacaine 0.75% for pain control during and after hemorrhoidectomy.
As perioperative pain management is a difficult challenge during hemorrhoidectomy, we tested the hypothesis that posterior perineal block (PPB) with local anesthetics alone is able to provide adequate pain control during and after surgery. ⋯ The present study shows that PPB with 40 mL 0.75% ropivacaine (300 mg) was a simple, effective, and safe method to provide better postoperative analgesia than PCA alone following surgical hemorrhoidectomy. In addition, PPB was shown to significantly reduce opioid consumption intraoperatively and during the first postoperative day.
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Reg Anesth Pain Med · May 2003
Randomized Controlled Trial Comparative Study Clinical TrialEfficacy of 1% ropivacaine at sacral segments in lumbar epidural anesthesia.
It is suggested that the potency of 1% ropivacaine is comparable to that of 0.75% bupivacaine and higher than that of 2% lidocaine. Alkalinized lidocaine reportedly enhances the block of sacral segments during lumbar epidural anesthesia. We hypothesized that 1% ropivacaine might also block at the lumbosacral segments adequately during lumbar epidural anesthesia. ⋯ We conclude that 1% ropivacaine does not improve block of sacral segments within 20 minutes following epidural ropivacaine administration.
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Reg Anesth Pain Med · Mar 2003
Randomized Controlled Trial Clinical TrialThe effect of intrathecal epinephrine on epidural infused analgesics during labor.
In order to prolong labor analgesia, one may add intrathecal epinephrine to the combination of bupivacaine and fentanyl. In this study, we tested the hypothesis that the addition of intrathecal epinephrine would lessen the requirement for a rescue dose of epidural analgesia during labor. ⋯ The addition of epinephrine to intrathecal bupivacaine-fentanyl lessened the requirement for additional epidural analgesia without increasing hypotension, nausea, or pruritus. However, the incidence of motor block may be increased without labor prolongation.