Regional anesthesia
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Regional anesthesia · Nov 1997
Randomized Controlled Trial Clinical TrialPostoperative analgesia and antiemetic efficacy after intrathecal neostigmine in patients undergoing abdominal hysterectomy during spinal anesthesia.
Postoperative analgesia and antiemetic efficacy after intrathecal neostigmine were investigated in a randomized, double-blind, placebo-controlled trial of 100 patients undergoing abdominal hysterectomy. ⋯ Intrathecal neostigmine (100 microg) was ineffective for postoperative analgesia after abdominal hysterectomy due to side effects of nausea and vomiting.
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Regional anesthesia · Nov 1997
ReviewDoes epidural analgesia during labor affect the incidence of cesarean delivery?
There is substantial evidence that there is an increased incidence of cesarean delivery among patients who receive epidural analgesia during labor. The controversy as to whether there is a causal relationship between epidural analgesia and cesarean delivery. Two prospective, randomized studies suggest that epidural analgesia may increase the incidence of operative delivery in laboring women. ⋯ It is important to consider the impact of epidural analgesia on the total population of obstetric patients. Maternal-fetal factors and obstetric management, not epidural analgesia, are the most important determinants of the cesarean delivery rate. Finally, physicians should remember that pain relief is itself a worthy goal.
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Regional anesthesia · Nov 1997
Clinical TrialFailed axillary brachial plexus block techniques result in high plasma concentrations of mepivacaine.
Unintentional extrasheath injection causes failed axillary brachial plexus block. We wanted to find out if extrasheath injections produce higher plasma concentrations of local anesthetics compared to intrasheath injections. We also studied the incidence of extrasheath injection with radiographs. ⋯ Failed extrasheath injection of 50 mL 1.5% plain mepivacaine produces higher arterial plasma concentration in axillary brachial plexus block.
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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.