Minerva anestesiologica
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Minerva anestesiologica · Dec 2004
Randomized Controlled Trial Clinical TrialHigh volume of subarachnoid levobupivacaine decreases drug requirement in first stage labor analgesia.
Using the statistic method of sequential allocation, we realized a prospective double-blind study in order to establish the minimum local anesthetic concentration (MLAC) of large intrathecal volume of levobupivacaine, during the first stage labour analgesia in spontaneous and induced laboring women. ⋯ Low intrathecally concentration of local anesthetic allows the anesthetist to reduce the total amount of drug and improves not only the differential blockade between motor and sensitive but also between sympathetic and sensitive fibers.
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Minerva anestesiologica · Dec 2004
Randomized Controlled Trial Comparative Study Clinical TrialLevobupivacaine versus ropivacaine in psoas compartment block and sciatic nerve block in orthopedic surgery of the lower extremity.
The aim of this study was to compare the clinical profiles of psoas block and sciatic nerve block performed with either 0.5% levobupivacaine or 0.75% ropivacaine. ⋯ The differences between Groups L and R were characterised by: a faster motor onset time in Group L with a longer time between motor and sensitive resolution determining a lower demand for analgesic drugs postoperatively and greater support for motor control recovery.
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Minerva anestesiologica · Dec 2004
ReviewPost-dural puncture headache in the obstetric patient: an old problem. New solutions.
More than 100 years have passed since the initial description of the postdural puncture headache (PDPH). However, this unique clinical entity still continues to fascinate anesthesiologists, and numerous studies on its pathophysiology, prevention, and treatment, have been published. There is considerable variability in the incidence of PDPH, which is affected by many factors such as age, gender, pregnancy, and needle type and size. ⋯ The incidence of epidural needle-induced PDPH in parturients following dural puncture with a large bore needle has been reported to range 76-85%. Although a few measures have been proposed to prevent PDPH (intrathecal injection of saline, insertion of the epidural catheter into the subarachnoid space through the dural hole), none have been shown to work with certainty to date. This article reviews the latest developments (maintaining cerebrospinal fluid volume) aimed at prevention of PDPH.