Regional anesthesia
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Regional anesthesia · Nov 1996
Randomized Controlled Trial Clinical TrialSubarachnoid neostigmine does not affect blood pressure or heart rate during bupivacaine spinal anesthesia.
Intraspinal administration of neostigmine has been shown to prevent induction of hypotension in rats by bupivacaine spinal block, and thus to provide greater hemodynamic stability. This study was undertaken to determine whether subarachnoid neostigmine would prevent bupivacaine spinal anesthesia from causing hypotension or bradycardia in patients undergoing abdominal hysterectomy. ⋯ A 75-micrograms subarachnoid neostigmine dose does not affect blood pressure or heart rate during bupivacaine spinal anesthesia.
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Regional anesthesia · Nov 1996
Randomized Controlled Trial Clinical TrialKetamine potentiates analgesic effect of morphine in postoperative epidural pain control.
Ketamine is currently the only N-methyl-D-aspartate receptor channel blocker in clinical use. This study evaluated the analgesic efficacy of epidurally coadministered ketamine and morphine in postoperative pain control. ⋯ Ketamine, although not itself an epidural analgesic agent, potentiates the analgesic effect of morphine, especially when administered as a pretreatment. The resulting lowered dosage of epidural morphine needed for postoperative pain relief reduces, in turn, the incidence of side effects. Pretreatment of patients with ketamine epidurally, followed by injections of combined morphine and ketamine could be a promising new analgesic regimen.
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Regional anesthesia · Nov 1996
Randomized Controlled Trial Clinical TrialIncidence of tissue coring with the 25-gauge Quincke and Whitacre spinal needles.
Tissue cores, implanted into the subarachnoid space during subarachnoid injections, can develop into intraspinal lumbar epidermoid tumors. The availability of smaller needles has made spinal anesthesia more popular. Therefore, this prospective, randomized, blinded study was undertaken to determine whether tissue coring occurs with two of the currently used 25-gauge spinal needles. ⋯ The 25-gauge Quincke and 25-gauge Whitacre spinal needles currently used in anesthesia can produce tissue coring.
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Regional anesthesia · Nov 1996
Hemostasis-altering drugs and central neural block. A survey of anesthetic practice in Scotland and the United Kingdom.
There is debate regarding the use of central neural block in the presence of hemostasis-altering drugs. This study aims to examine current practice. ⋯ There is general agreement regarding contraindication of central neural block in the presence of full anticoagulation with either heparin or warfarin, but there is less consensus about the use of central neural block in the presence of low-dose subcutaneous heparin. There is some confusion about the role of aspirin and its duration of action.