Regional anesthesia
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Regional anesthesia · Nov 1989
Randomized Controlled Trial Comparative Study Clinical TrialBrachial plexus block with opioids for postoperative pain relief: comparison between buprenorphine and morphine.
The effectiveness of buprenorphine and morphine, administered into the brachial plexus sheath, was evaluated in 40 patients, aged 18-90 years. All patients received 40 ml of 0.5% bupivacaine, injected into the brachial plexus sheath using the supraclavicular technique. In addition, the 20 patients in Group I received morphine hydrochloride (50 micrograms/kg), while the 20 patients in Group II received buprenorphine hydrochloride (3 micrograms/kg). ⋯ A significant difference in the quality of analgesia was found; and was consistently superior with buprenorphine as compared with morphine. The duration of analgesia was nearly twice as long in the buprenorphine group as in the morphine group (35.05 +/- 1.95 hour versus 18.25 +/- 1.15 hour). We conclude that buprenorphine injection into the brachial plexus sheath is an efficient way to assure control of postoperative pain after upper limb surgery.
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Regional anesthesia · Jul 1997
Randomized Controlled Trial Clinical TrialSympathetic block during spinal anesthesia in volunteers using lidocaine, tetracaine, and bupivacaine.
Spinal anesthesia to high thoracic dermatomes is alleged to result in almost complete block of all sympathetic efferent nerves. To examine the degree of sympathectomy during spinal anesthesia, the sympathetic response to a cold pressor test (CPT) applied to unblocked dermatomes before and during spinal anesthesia was measured with use of three different local anesthetics. ⋯ Spinal anesthesia with hyperbaric solutions of tetracaine 15 mg, bupivacaine 15 mg, and lidocaine 100 mg attenuated sympathetic function but did not produce complete sympathectomy. The effects were independent of the local anesthetic used.
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Regional anesthesia · Jan 1989
Randomized Controlled Trial Comparative Study Clinical TrialTreatment of shivering after epidural lidocaine.
The effectiveness of intravenous meperidine and warm local anesthetic for prevention of postanesthetic shivering was evaluated in urology patients undergoing epidural blockade for extracorporeal shockwave lithotripsy. When administered before the blockade, meperidine, 12.5 mg or 25 mg, was not significantly better than saline placebo for preventing postepidural shivering. ⋯ The authors concluded that neither meperidine, in doses employed, nor body-temperature lidocaine prevents shivering after epidural blockade. This shivering appears to be different from that observed during emergence from general anesthesia.
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Regional anesthesia · Nov 1989
Randomized Controlled Trial Comparative Study Clinical TrialMaternal analgesia and neonatal effects of epidural sufentanil for cesarean section.
This study was designed to evaluate the maternal intraoperative and postoperative analgesia and neonatal effects of adding sufentanil to epidural anesthesia for cesarean section before the skin incision. Forty-five multipara were randomized in three equal groups to receive sufentanil 80 micrograms, 50 micrograms, or saline with the epidural lidocaine. Intraoperative and postoperative analgesia and side effects were recorded. ⋯ Postoperative analgesia was prolonged after sufentanil, but side effects increased with the greater dose. The infants whose mothers received 80 micrograms sufentanil showed a mild neurobehavioral depression. It is therefore concluded that the addition of 50 micrograms of sufentanil improves both intraoperative and postoperative analgesia without significant neonatal effects.
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Regional anesthesia · Jan 1991
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative pain treatment after open knee surgery: continuous lumbar plexus block with bupivacaine versus epidural morphine.
The anesthetic and side effects of a continuous lumbar plexus block ("3-in-1" block) were compared with that of epidurally administered morphine after open knee surgery. Twenty-two patients were randomized into two groups in this prospective, double-blind study. At the end of surgery, catheters were inserted for all the patients into both the femoral nerve sheath and the epidural space. ⋯ The pain scores and supplemental morphine consumption were low in both groups and did not differ significantly. Lumbar plexus block produced a statistically significant a lower incidence of nausea, vomiting, pruritus and urinary retention. Although no significant differences in pain relief were shown between the two methods, we conclude that postoperative lumbar plexus block is preferable for postoperative pain relief because there is a lower frequency of side effects.