Regional anesthesia
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Loss of sensation to pinprick and cold are commonly used to test the extent of epidural anesthesia. To see what difference exists between the level of epidural block determined by various sensory modalities, we performed this study in ten volunteers using epidural anesthesia with plain 3% chloroprocaine hydrochloride. ⋯ This study establishes the existence of a differential epidural anesthesia during high thoracic block with chloroprocaine and suggests that the intensity of block diminishes as distance from site of injection increases.
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Regional anesthesia · Jan 1992
Continuous epidural methadone for the management of postoperative pain after lower abdominal surgery.
The efficacy of methadone administered by continuous epidural infusion for 24 hours for the management of postoperative pain has been reported. The pharmacokinetic characteristics of methadone predict that significant accumulation would occur if infusions were continued for longer than 24 hours and that this accumulation could result in serum concentrations above the threshold associated with systemic analgesia. ⋯ The accumulation of serum concentrations reported here argue that the risks of thoracic epidural placement may outweigh the potential benefits when methadone is administered alone by continuous infusion for longer than 24 hours.
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Regional anesthesia · Jan 1992
Randomized Controlled Trial Comparative Study Clinical TrialAn evaluation of epidural bupivacaine with and without meperidine in labor.
One aim of epidural analgesia during childbirth is to provide satisfactory pain relief with minimal side effects. We hypothesized that a combination of opioid and local anesthetic would better achieve this aim than either drug alone. This study compared the efficacy and side effects of epidural meperidine and bupivacaine combined to those of meperidine and bupivacaine alone. ⋯ The low-dose combination of meperidine and bupivacaine used in this trial proved a satisfactory preparation for epidural administration during the early stages of labor.
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Regional anesthesia · Jan 1992
Randomized Controlled Trial Comparative Study Clinical TrialContinuous pleural infusion of bupivacaine offers better postoperative pain relief than does bolus administration.
To determine whether continuous pleural analgesia offers better postoperative pain relief than does bolus administration in postcholecystectomy patients. ⋯ Continuous pleural analgesia offers better postoperative pain relief than does bolus administration. Pneumothorax was observed in two patients during the study.