Regional anesthesia
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Regional anesthesia · Mar 1991
Randomized Controlled Trial Comparative Study Clinical TrialNalbuphine pretreatment in cesarean section patients receiving epidural morphine.
A double-blind, placebo-controlled study of 60 patients post cesarean delivery was conducted to determine whether nalbuphine reverses the side effects of pruritus and respiratory depression associated with epidurally administered morphine. Patients randomly received either three doses of intravenous nalbuphine or the equivalent volume of saline. Vital signs, sedation, pain, pruritus and oxygen saturation were assessed hourly for 18 hours. ⋯ Five patients had respiratory depression (respiratory rate lower than 10 BPM or oxygen saturation less than 90%); three occurred in the nalbuphine group and two in the saline group. Although theoretically advantageous, nalbuphine, as administered in this study of obstetric patients, offered no prophylactic benefit against the pruritus associated with epidural morphine. Its benefit with regard to respiratory depression remains unclear.
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Regional anesthesia · Mar 1991
Case ReportsA new interabdominis approach to inguinal region block for the management of chronic pain.
The use of an indwelling catheter for repeated injections of local anesthetics has been a beneficial addition to our armamentarium for management of chronic pain syndromes. Indwelling catheters take advantage of anatomic planes, and the concept of an interabdomins muscular plane allows placement of a catheter along the course of the ilioinguinal and iliohypogastric nerves. We report the successful treatment of chronic groin pain via an interabdominis indwelling catheter. This is the first report of the use of such an indwelling catheter.
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Complications during spinal anesthesia were studied prospectively in 1881 patients. Twenty-six percent of the patients suffered from one or more complications. The most common complications were hypotension (16.4%) and bradycardia (8.9%). ⋯ Higher peak sensory level significantly increased the risk for hypotension (p less than 0.0001), bradycardia (p less than 0.0001) and nausea (p less than 0.0001). Female patients suffered significantly more hypotension (p less than 0.001), nausea (p less than 0.001) and vomiting (p less than 0.001) than males. Cementation of prosthesis and deflation of the leg tourniquet were other risk factors demonstrated in this study.