Regional anesthesia
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Regional anesthesia · Sep 1990
Randomized Controlled Trial Comparative Study Clinical TrialA double-blind comparison of 0.5% bupivacaine and 0.75% ropivacaine administered epidurally in humans.
In an attempt to compare equipotent doses of epidurally administered bupivacaine and ropivacaine, 44 healthy patients, aged 18-70 years, undergoing lower extremity orthopedic procedures were studied in a randomized, double-blind manner. Twenty-one patients received a single epidural injection of 20 ml 0.5% bupivacaine at the L23 or L34 interspace and 23 patients received 20 ml 0.75% ropivacaine in a similar manner. Onset of and recovery from sensory anesthesia and motor block were recorded. ⋯ Maximum block height (median (range] was T4 (T2-T8) and T5 (T2-L1) for bupivacaine and ropivacaine, respectively, and maximum motor block scores were 4 (2-6) and 4 (0-6) using the modified Bromage scale. Times to maximum height of sensory block for bupivacaine and ropivacaine, respectively, were 28 +/- 12 and 28 +/- 13 minutes; times to onset of block to T12 were 6 +/- 4 and 9 +/- 10 minutes; times to onset of maximum motor block were 32 +/- 17 and 47 +/- 29 minutes; times to two-segment regression were 2.7 +/- 0.8 and 3.4 +/- 1.0 hours (p less than 0.05); times to regression to T12 level were 4.8 +/- 0.9 and 4.7 +/- 0.95 hours; times to total recovery of sensation were 6.5 +/- 0.9 and 6.6 +/- 1.0 hours, and times to recovery of motor function were 4.4 +/- 0.9 and 4.1 +/- 0.9 hours. In two instances (both with bupivacaine), anesthesia was judged clinically inadequate.
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Regional anesthesia · Sep 1990
Clinical Trial Controlled Clinical TrialAlkalinization of mepivacaine accelerates onset of interscalene block for shoulder surgery.
Reports evaluating the effect of alkalinization of mepivacaine on the onset of regional anesthesia have been controversial. The effect of alkalinization of mepivacaine on the onset of interscalene block has not been reported and is the subject of this study. Forty patients received an interscalene block by elicitation of paresthesia with 25-gauge, blunt level needle. ⋯ The duration of block for each observation was determined. The onset was significantly faster for all tested modalities in the pH-adjusted group. No statistically significant differences in the duration of either motor or sensory were found between the study and control groups.
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Regional anesthesia · Sep 1990
Biography Historical ArticlePersonal reflections on 50 years of obstetric anesthesia.