Regional anesthesia
-
Regional anesthesia · Nov 1997
Randomized Controlled Trial Comparative Study Clinical TrialSubarachnoid sufentanil versus lidocaine spinal anesthesia for extracorporeal shock wave lithotripsy.
Anesthetic techniques that reduce the time required for postoperative care can significantly reduce the cost of procedures. This study was designed to discover whether the use of subarachnoid sufentanil for extracorporeal shock wave lithotripsy (ESWL) would enable patients to be discharged more rapidly following surgery as compared with subarachnoid lidocaine, while providing equivalent efficacy. ⋯ Subarachnoid sufentanil provides acceptable analgesia for ESWL and offers the advantages of more rapid discharge for female patients and better hemodynamic stability as compared with lidocaine spinal anesthesia.
-
Regional anesthesia · Nov 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of postanesthetic sequelae after clinical use of 27-gauge cutting and noncutting spinal needles.
The tips of the bevels of thin spinal needles may be easily damaged by bony contact during puncture attempts. In this respect and also because they are less traumatic by design, noncutting, pencil-point-tip needles may be beneficial. A prospective clinical comparison of postanesthetic effects of the use of 27G Quincke-type and pencil-point spinal needles was therefore performed. ⋯ Postanesthetic sequelae, including postdural puncture headache (overall incidence 2.5%), were not related to the shape of the spinal needles or to the damage of the Quincke-type needles.
-
Regional anesthesia · Nov 1997
Randomized Controlled Trial Clinical TrialSingle-shot spinal anesthesia with small doses of bupivacaine.
The potential risks of spinal lidocaine have generated interest in an alternative local anesthetic solution. Features of anesthetic block were therefore assessed in a double-blind randomized prospective study following administration of spinal bupivacaine in small doses. ⋯ Hyperbaric bupivacaine 6-8 mg provides a suitable alternative to spinal lidocaine for surgical procedures of short duration.
-
Regional anesthesia · Nov 1997
ReviewProgress in the development of ultra-long-acting local anesthetics.
Local anesthetic agents with a duration of action longer than the currently available local anesthetics could have widespread clinical application for the treatment of both chronic and acute pain. Over the last several decades, several different approaches have been used in the development of ultra-long-acting agents. There are currently promising preparations in development which may prove clinically useful in the near future. ⋯ Although encouraging results have been reported in the literature, there is currently no agent or delivery system that has shown reliable and practical prolongation of local anesthetic effect in humans. There have been several encouraging reports in animals that have shown local anesthetic effects lasting up to several days, but these results must be validated and then performed in human studies before a clinically useful agent is found. Further research is warranted.