Regional anesthesia
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Regional anesthesia · Sep 1996
Subarachnoid bupivacaine increases human cerebrospinal fluid concentration of serotonin.
Serotonin (5-hydroxytryptamine [5-HT]) has antinociceptive properties at the spinal level. Activation of descending serotonergic neurons or topically applied 5-HT at the spinal cord inhibits rostral spread of sensory information. Epidural anesthesia has been shown to increase 5-HT in plasma, and local anesthetics may interfere with 5-HT reuptake and metabolism. For these reasons, the action of subarachnoid local anesthetics on cerebrospinal fluid (CSF) 5-HT concentrations has been studied. ⋯ Subarachnoid bupivacaine increases local 5-HT concentration. This may have implications for nociceptive gating as well as for local vasoregulation.
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Regional anesthesia · Sep 1996
Comparative Study Clinical Trial Controlled Clinical TrialPostdural puncture headache and back pain after spinal anesthesia with 27-gauge Quincke and 26-gauge Atraucan needles.
The purpose of this study was to determine whether the 26-gauge Atraucan needle shows any benefit on the incidence of postdural puncture headache (PDPH) and back pain as compared with the 27-gauge Quincke needle. ⋯ Both needles are associated with very low incidences of PDPH and back pain, which are not affected by which needle is chosen.
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Regional anesthesia · Sep 1996
Clinical TrialSpinal clonidine fails to provide surgical anesthesia for transurethral resection of prostate. A dose-finding pilot study.
This study was designed to determine whether subarachnoid clonidine administration alone results in surgical anesthesia for transurethral resection of the prostate. ⋯ Subarachnoid clonidine cannot be reliably used as the sole agent for spinal anesthesia, since general anesthesia is often required or deep sedation occurs. Increasing doses of clonidine do not prolong postoperative analgesia. Thus, clonidine could be used as a spinal analgesic but not as a spinal anesthetic.