Regional anesthesia
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Regional anesthesia · Jul 1991
Randomized Controlled Trial Comparative Study Clinical TrialComparison of onset time between 0.5% bupivacaine and 3% 2-chloroprocaine with and without 75 micrograms fentanyl.
We tested the hypothesis that the addition of 75 micrograms fentanyl to 0.5% bupivacaine would reduce the onset time of surgical anesthesia for cesarean delivery to equal the onset time of 3% 2-chloroprocaine and would have no effect when added to 3% 2-chloroprocaine. Fentanyl was found to reduce the onset time of bupivacaine to equal the onset time of 2-chloroprocaine and have no effect when added to 2-chloroprocaine.
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Regional anesthesia · Jul 1991
Comparative StudyTechnical complications during long-term subarachnoid or epidural administration of morphine in terminally ill cancer patients: a review of 140 cases.
The type and incidence of technical complications (e.g., obstruction and dislocation of the catheter and infection) in long-term (ten to 366 days) spinal morphine administration in terminally ill cancer patients by means of an epidural or subarachnoid catheter are presented. Total treatment time was 8650 days, of which patients spent 6175 at home. Portable external mini infusion pumps were used with satisfactory results in 15 patients of the epidural group (n = 110) and in all patients receiving subarachnoid morphine (n = 30). ⋯ In patients receiving subarachnoid morphine, the prevalent complication was CSF leakage, which was observed only during the first two weeks of treatment. The subarachnoid route is preferred for patients expected to live longer than one month. For patients with a shorter life expectancy, epidural administration can yield acceptable results.
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Regional anesthesia · Jul 1991
Back pain after epidural anesthesia with chloroprocaine in volunteers: preliminary report.
The incidence, character and treatment of backache associated with epidural anesthesia (EA) using 3% chloroprocaine (2-CP, Nesacaine-MPF) were observed in ten volunteers undergoing a study of the effects of EA upon plasma catecholamines. Three levels of epidural analgesia were sequentially sought, T10, T4 and C8, in ascending order. Each block was allowed to fully dissipate prior to the next injection. ⋯ Mean verbal analog scale pain scores after regression of the first, second and third blocks were 2.2, 4.3 and 6.5, respectively. Epidural fentanyl (100-200 micrograms) was effective in providing rapid relief of the pain. Large doses or possibly repeated injections of epidural Nesacaine-MPF are associated with an increased incidence and severity of postanesthesia lumbar back pain.
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Regional anesthesia · Jul 1991
Case ReportsHorner's syndrome after epidural block in early pregnancy.
Horner's syndrome after epidural block in a first-trimester parturient has not previously been reported. The authors describe a case of unilateral Horner's syndrome after single-dose epidural block in a 12-week pregnant female.