Regional 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
Randomized Controlled Trial Clinical TrialLidocaine-clonidine retrobulbar block for cataract surgery in the elderly.
Clonidine, an alpha-2-adrenoreceptor agonist, has been shown to decrease intraocular pressure (IOP) and to have some analgesic and sedative effects when it is used in premedication for ophthalmic surgery. This study was designed to investigate the efficacy of lidocaine-clonidine retrobulbar block for cataract surgery with respect to its effect on IOP, analgesic action, and sedative effects. ⋯ Addition of clonidine to lidocaine for retrobulbar block causes a decrease in intraocular pressure, a sedative effect, and an increased duration of analgesia and akinesia, with relatively stable hemodynamic parameters.
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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 Comparative Study Clinical TrialComparison of two application techniques of EMLA and pain assessment in pediatric oncology patients.
The study was designed to compare the analgesic efficacy of the local anesthetic EMLA when applied as a patch and as a cream in combination with a Tegaderm dressing to pediatric oncology patients undergoing repeated lumbar punctures. ⋯ The EMLA patch and the EMLA cream are equally effective in alleviating pain associated with lumbar puncture. The EMLA patch simplifies and speeds up the application of EMLA. It also allows for control of the dose administered per application, thus preventing both over- and underdosing.