Regional anesthesia
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Regional anesthesia · May 1989
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of pH adjustment of 2% mepivacaine on epidural anesthesia.
Two-hundred men, scheduled for elective meniscectomy under epidural anesthesia, were randomly assigned to receive either a standard 2% mepivacaine solution (n = 100) or a pH adjusted 2% mepivacaine solution (pHAS, n = 100). The pHAS was freshly prepared before the block by adding 0.1 mEq of NaHCO3 per ml of mepivacaine solution. After a test-dose, the anesthetic solution was injected to produce a level of sensory anesthesia to T10. ⋯ Patients in the pHAS group showed a significant shortening of onset time in T10 and in S2 segment (p less than .001). Grade 3 motor blockade was achieved in the same number of patients, but a faster motor block was observed in the pHAS group (p less than .05). Regression of both sensory and motor blockade in the two groups was not significantly different.
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Regional anesthesia · May 1989
Randomized Controlled Trial Comparative Study Clinical TrialEpidural morphine or butorphanol augments bupivacaine analgesia during labor.
To determine the efficacy and the safety of epidural morphine or butorphanol combined with bupivacaine, 40 healthy parturients were studied during labor and delivery. All patients received an epidural test dose of 2 ml of 0.5% bupivacaine. Patients were then randomly assigned to receive one of four epidural regimens in a double-blind fashion: 0.25% bupivacaine + 1 mg butorphanol (Group I), 0.25% bupivacaine + 2 mg butorphanol (Group II), 0.25% bupivacaine + 2 mg morphine (Group III), or 0.25% bupivacaine alone (Group IV). ⋯ All neonates were vigorous at 5 minutes and had good Apgar Scores, umbilical cord acid base status, and Neurological Adaptive Capacity Scores. The authors conclude that adding small doses of either morphine or butorphanol to epidural bupivacaine during labor is effective and safe. Butorphanol may be preferable since none of the patients experienced pruritus.