Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2000
Randomized Controlled Trial Clinical TrialOndansetron for treatment of intrathecal morphine-induced pruritus after cesarean delivery.
Pruritus induced by intrathecal morphine is a concern in many obstetric patients after cesarean delivery and may detract from the benefit of postoperative pain relief. This study was performed to investigate the efficacy of ondansetron (5-HT3 receptor antagonist) in treatment of pruritus following intrathecal morphine. ⋯ Ondansetron treats intrathecal morphine-induced pruritus after cesarean delivery, particularly in patients suffering from both nausea/vomiting and pruritus.
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Reg Anesth Pain Med · Sep 2000
Randomized Controlled Trial Clinical TrialEfficacy of oral mexiletine for neuropathic pain with allodynia: a double-blind, placebo-controlled, crossover study.
Mexiletine is an oral sodium channel antagonist that has been reported to be effective in a variety of neuropathic pain syndromes. However, recent reports question the efficacy of oral mexiletine in neuropathic pain. The objectives of this study were to examine the effect of oral mexiletine on pain, neurosensation, allodynia, and quality of life. ⋯ At doses of up to 900 mg/d, mexiletine has minimal effects on pain and allodynia of neuropathic pain. However, side effects may preclude higher doses.
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Reg Anesth Pain Med · Sep 2000
Randomized Controlled Trial Clinical TrialAlkalinized lidocaine and bupivacaine with hyaluronidase for sub-tenon's ophthalmic block.
Alkalinization of local anesthetics has been shown to decrease the onset and prolong the duration of block for extraconal and intraconal application in ocular surgery. The objective of this study is to determine if alkalinization is also effective in sub-Tenon's block when hyaluronidase is added to the drug mixture. ⋯ pH adjustment of the local anesthetic mixture of lidocaine, bupivacaine, and hyaluronidase offered no additional benefit in sub-Tenon's technique in ocular procedures.
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Reg Anesth Pain Med · May 2000
Randomized Controlled Trial Comparative Study Clinical TrialProcaine compared with lidocaine for incidence of transient neurologic symptoms.
Transient neurologic symptoms (TNS) have been reported to occur after 16% to 40% of ambulatory lidocaine spinal anesthetics. Patient discomfort and the possibility of underlying lidocaine neurotoxicity have prompted a search for alternative local anesthetic agents. We compared the incidence of TNS with procaine or lidocaine spinal anesthesia in a 2:1 dose ratio. ⋯ The incidence of TNS was substantially lower with procaine than with lidocaine. However, procaine resulted in a lower overall quality of anesthesia and a prolonged average discharge time. If the shortfalls of procaine as studied can be overcome, it may provide a suitable alternative to lidocaine for outpatient spinal anesthesia to minimize the risk of TNS.
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Reg Anesth Pain Med · May 2000
Randomized Controlled Trial Comparative Study Clinical TrialBupivacaine-sparing effect of fentanyl in spinal anesthesia for cesarean delivery.
Visceral pain decreases in cesarean patients under spinal anesthesia when the dose of local anesthetic is increased. However, larger doses of local anesthetic are associated with higher sensory blocks. We hypothesized that the addition of fentanyl could reduce the dose of bupivacaine necessary to achieve adequate surgical anesthesia. ⋯ The optimal dose of hyperbaric bupivacaine to produce surgical anesthesia was 12 mg, which was accompanied by high sensory block. With the addition of 10 microg of fentanyl, the dose of bupivacaine could be reduced to 8 mg in spinal anesthesia for cesarean delivery.