Regional anesthesia
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Regional anesthesia · Nov 1995
Comment Letter Comparative StudyOutcome of epidural analgesia versus patient-controlled analgesia in cancer patients.
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Regional anesthesia · Nov 1995
Letter Clinical TrialDiaphragmatic motion during continuous interscalene brachial plexus block.
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Regional anesthesia · Nov 1995
Randomized Controlled Trial Comparative Study Clinical TrialA double-blind comparison of the abdominal wall relaxation produced by epidural 0.75% ropivacaine and 0.75% bupivacaine in gynecologic surgery.
Ropivacaine is a long-acting local anesthetic agent with similar potency to that of bupivacaine when administered for epidural anesthesia. Ropivacaine, however, may be less cardiotoxic than bupivacaine. Epidural bupivacaine and ropivacaine have been shown to be equally effective in providing sensory block for lower extremity surgery, but they have not been compared for their ability to produce abdominal wall relaxation. ⋯ Both 0.75% ropivacaine and 0.75% bupivacaine provide adequate surgical anesthesia for lower abdominal surgery when administered epidurally. However, lower extremity motor block with ropivacaine is significantly shorter and of slower onset and sensory block shorter at these concentrations.
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Regional anesthesia · Nov 1995
Randomized Controlled Trial Comparative Study Clinical TrialInfluence of baricity on the outcome of spinal anesthesia with bupivacaine for lumbar spine surgery.
Although the majority of elective lumbar spine surgical procedures are performed under general anesthesia, successful use of spinal and epidural anesthesia has been reported. This study was designed to evaluate the influence of baricity on the performance of spinal anesthesia for lumbar spine surgery. ⋯ Plain bupivacaine is superior to hyperbaric bupivacaine for spinal anesthesia for elective lumbar spine surgery.
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Regional anesthesia · Nov 1995
Comparative StudyComparison of thrombelastography with common coagulation tests in preeclamptic and healthy parturients.
Epidural analgesia/anesthesia is often beneficial in the management and treatment of preeclampsia. However, some preeclamptic patients have a coagulopathy that is a contraindication to regional anesthesia. A routine coagulation battery (RCB) consisting of prothrombin time, partial thromboplastin time, platelet count, and bleeding time, is commonly performed to assess coagulation status. Thrombelastography (TEG) is a measure of clotting that allows evaluation of overall coagulation activity. The goal of this study was to examine whether TEG can predict normal and abnormal coagulation as diagnosed by RCB in healthy and preeclamptic parturients. ⋯ Thrombelastography is not an effective means of predicting abnormal coagulation, as diagnosed by RCB, in preeclamptic parturients, using currently defined normal TEG values for nonpregnant patients. However, an abnormal TEG maximum amplitude value always correlated with a prolonged bleeding time. Therefore, TEG may be useful in assessing platelet function in the presence of thrombocytopenia. Further studies are warranted.