Regional-Anaesthesie
-
Regional-Anaesthesie · Sep 1990
Randomized Controlled Trial Clinical Trial[The effect of volume and dosage of isobaric bupivacaine on the sensory spread of spinal anesthesia].
There is some controversy about the relationship of volume, concentration and total dose of bupivacaine in the sensory spread of spinal anesthesia. In this study the effects of volume and dose were investigated. MATERIAL AND METHODS. ⋯ Earlier studies on the effects of changes in volume, concentration and dose of bupivacaine showed similar "jumps of blockade" between 2 ml and 3 ml injected volume. Assembling the results the relation between volume and total dose does not suggest a no linear dependence. The anatomic configuration of the spinal cord at the conus medullaris may affect the distribution of the solution.
-
Regional-Anaesthesie · Sep 1990
Randomized Controlled Trial Clinical Trial[No effect of injection volume on sensory and motor blockade in isobaric spinal anesthesia].
The authors were interested to find whether the course of sensory and motor blockade in isobaric spinal anesthesia was determined by the dose or the volume of the anesthetic agent. In a randomized double-blind study in 60 patients, each underwent isobaric spinal anesthesia with 17.5 mg bupivacaine. In three groups of 20 patients, this dose was administered as 3.5 mg bupivacaine 0.5%, 7 ml bupivacaine 0.25% or 10 ml bupivacaine 0.175%. ⋯ The rate of development, the maximal spread or intensity, and the regression of sensory and motor blockade did not differ in the three groups. The only difference was that the complete regression was shorter following 10 ml bupivacaine 0.175% (P less than 0.05). It is therefore concluded that the dose, and not the volume, determines the course of sensory and motor blockade of isobaric spinal anesthesia.
-
Regional-Anaesthesie · May 1990
Randomized Controlled Trial Comparative Study Clinical Trial[The equipotency of ropivacaine, bupivacaine and etidocaine].
Ropivacaine, congenerate to bupivacaine and mepivacaine has been widely studied in laboratory animals, but there have been few investigations of its efficacy in human epidural anesthesia and peripheral nerve blocks. The aim of this study was to compare the three long-acting local anesthetics (bupivacaine 0.75%, ropivacaine 1% and etidocaine 1%) and to try, with reference to previous studies, to make some statement about the equipotency of ropivacaine relative to bupivacaine and etidocaine. METHODS. ⋯ CONCLUSION. The results of this study indicate that ropivacaine is an effective local anesthetic agent. Its potency is about equal to that of bupivacaine and much higher than that of etidocaine...
-
Regional-Anaesthesie · May 1990
Randomized Controlled Trial Comparative Study Clinical Trial[Postoperative peridural analgesia via catheter following abdominal surgery. Peridural bupivacaine versus buprenorphine].
Seventy-five patients scheduled for major abdominal operations were randomly divided into four groups, each with a different postoperative analgesic regime. Group I: buprenorphine 4 micrograms/kg was injected i.v. every 4 h. Groups II-IV: all patients were preoperatively supplied with a thoracic epidural catheter that, however, was not used during the operation. ⋯ No patient in any of the other groups, however, was dropped (P less than 0.01). Later in the 1st postoperative day analgesia in groups II and IV lost its superiority at rest, but coughing continued to be less painful in comparison to groups I and III. We noticed that the duration of action of 0.25% bupivacaine, injected as a bolus, was considerably shorter than expected (less than 2 h) and that several patients experienced pain before the next top-up was given...
-
Regional-Anaesthesie · Jul 1989
Randomized Controlled Trial Comparative Study Clinical Trial[The effect of the injection speed on the blockade characteristics of hyperbaric bupivacaine and tetracaine in spinal anesthesia].
A lack of uniform methodology used in the assessment of different injection speeds in spinal anesthesia by different authors formed the basis of the current study, which compared under randomized conditions the effects of various injection speeds during intrathecal administration of 4 ml 0.5% hyperbaric bupivacaine or 0.5% hyperbaric tetracaine. MATERIALS AND METHODS. Eighty male ASA Physical Status II and III patients scheduled for transurethral resection of the prostate under spinal anesthesia were selected. ⋯ CONCLUSIONS. The results suggest that 4 ml 0.5% hyperbaric bupivacaine or tetracaine injected at 0.25 or 0.5 ml.s-1 provides a rapid and reproducible spread of analgesia for transurethral surgery. However, our findings suggest that speed of injection is of little i