Regional-Anaesthesie
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Regional-Anaesthesie · Aug 1991
Randomized Controlled Trial Comparative Study Clinical Trial[Continuous spinal anesthesia versus continuous epidural anesthesia in surgery of the lower extremities. A prospective randomized study].
Continuous epidural anesthesia (CEA) is generally accepted as a routine method of regional anesthesia while there has been only limited application of continuous spinal anesthesia (CSA), due mainly to a lack of adequate spinal catheters. With the introduction of a new, ultra-thin spinal catheter (32 G) inserted via a thin puncture needle, some of the complications reported after CSA can be eliminated. We studied CSA versus CEA in lower-extremity operations. ⋯ The catheter designed for CSA is easy to use, although because of its small diameter a certain manual dexterity is required. In addition, CSA resulted in a more rapid onset of action and more pronounced sensorimotor blockade than did CEA. Hemodynamic alterations and side effects were comparably low in both groups.
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Regional-Anaesthesie · Jan 1991
Randomized Controlled Trial Clinical Trial[Alkalinization of mepivacaine for axillary plexus anesthesia using a catheter].
One disadvantage of perivascular axillary block using a catheter technique is delayed temporal development of the blockade. Some clinical studies have concluded that pH-adjusted solutions of local anesthetics produce a more rapid onset of blockade. Alkalinization of mepivacaine for brachial block produced conflicting results. ⋯ RESULTS. The bicarbonate and saline groups were similar with respect to age, height, weight, and sex distribution. Significantly more patients in the bicarbonate group showed onset of motor blockade (grade 1) after 2 min with respect in the axillary, musculocutaneous, radial, and median nerves as well as onset of sensory blockade in the same nerves with a significant difference in blockade of the radial nerve. (ABSTRACT TRUNCATED AT 400 WORDS)
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Regional-Anaesthesie · Jan 1991
Randomized Controlled Trial Clinical Trial[The effect of continuous thoracic peridural anesthesia on the pulmonary function of patients undergoing colon surgery. Results of a randomized study of 116 patients].
In a prospective randomized clinical investigation, we examined the influence of continuous thoracic epidural analgesia (TEA) on pulmonary function and pathologic chest X-ray findings. METHODS. One hundred sixteen patients having resection and/or anastomosis of the colon participated in this study; 57 were randomly assigned to the epidural group, whereas 59 were given systemic analgesia. ⋯ There was no difference in pO2 at any time. The number of pathologic chest X-ray findings showed no difference between both groups. Looking especially for infiltrates, dystelectasis, atelectasis, and congestion, we also could not demonstrate any difference between the groups. (ABSTRACT TRUNCATED AT 400 WORDS)
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Regional-Anaesthesie · Jan 1991
Randomized Controlled Trial Clinical Trial[The effect of 6% (40/0.5) hydroxyethyl starch and Ringer's lactate on blood coagulation, laboratory parameters and circulation during peridural anesthesia].
We investigated the effects of 6% hydroxyethyl starch (HES 40/0.5) and lactated Ringer solution (LRS) on blood coagulation tests and laboratory parameters during epidural anesthesia. Additionally, the efficacy of this prophylactic intravenous fluid supply in preventing sympathetic blockade induced hypotension was studied. METHODS. ⋯ The temporary increase in plasma volume after infusion of 6% HES 40/0.5 results in a greater hemodilution with a concomitant decrease of blood viscosity and improved microcirculation flow. These might be of interest in prevention of thromboembolic complications. The specific effects of the two solutions were also determinable during epidural blockade.
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Regional-Anaesthesie · Sep 1990
Randomized Controlled Trial Comparative Study Clinical Trial[The effect of barbotage on the sensory spread in spinal anesthesia using isobaric and hyperbaric 0.5% bupivacaine].
The effect of spinal anesthesia with barbotage versus without barbotage on the spread of analgesia was investigated. For comparison, hyper- and isobaric bupivacaine 0.5% with adrenaline 1:200,000 was used. MATERIAL AND METHODS. ⋯ Sufficient analgesia was obtained with barbotage and without barbotage. Uncontrolled cephalad spread of spinal anesthesia was not observed. Barbotage has the advantage of shortening time for spread to highest dermatome and the time to onset of complete motor block.