Regional anesthesia
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Regional anesthesia · May 1997
Randomized Controlled Trial Clinical TrialTramadol and beta-cyclodextrin piroxicam: effective multimodal balanced analgesia for the intra- and postoperative period.
This study was conducted to evaluate the analgesic efficacy of tramadol, an analgesic with both opioid and nonopioid actions (norepinephrine and serotonin pathways), with beta-cyclodextrin piroxicam, a nonsteroidal antiinflammatory drug, in the perioperative setting. ⋯ The combination of tramadol and beta-cyclodextrin piroxicam provided better perioperative analgesia than tramadol alone.
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Regional anesthesia · Jul 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison between hemodynamic changes after single-dose and incremental subarachnoid anesthesia.
The depressant activity on sympathetic tone of subarachnoid anesthetic block is well known. The aim of this study was to compare cardiovascular response to an incremental dose of subarachnoid anesthesia administered through a small-bore microcatheter with the response to single-dose spinal anesthesia. ⋯ In well-hydrated, healthy patients incremental local anesthetics offer adequate subarachnoid anesthesia with minimal hemodynamic effects.
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Regional anesthesia · May 1989
Randomized Controlled Trial Comparative Study Clinical TrialEpidural morphine or butorphanol augments bupivacaine analgesia during labor.
To determine the efficacy and the safety of epidural morphine or butorphanol combined with bupivacaine, 40 healthy parturients were studied during labor and delivery. All patients received an epidural test dose of 2 ml of 0.5% bupivacaine. Patients were then randomly assigned to receive one of four epidural regimens in a double-blind fashion: 0.25% bupivacaine + 1 mg butorphanol (Group I), 0.25% bupivacaine + 2 mg butorphanol (Group II), 0.25% bupivacaine + 2 mg morphine (Group III), or 0.25% bupivacaine alone (Group IV). ⋯ All neonates were vigorous at 5 minutes and had good Apgar Scores, umbilical cord acid base status, and Neurological Adaptive Capacity Scores. The authors conclude that adding small doses of either morphine or butorphanol to epidural bupivacaine during labor is effective and safe. Butorphanol may be preferable since none of the patients experienced pruritus.
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Regional anesthesia · Jul 1997
Randomized Controlled Trial Clinical TrialContinuous axillary brachial plexus block for postoperative pain relief. Intermittent bolus versus continuous infusion.
The aim of this study was to compare the efficacy and safety of continuous axillary brachial plexus block by infusion and by intermittent injection of bupivacaine 0.25% in the management of postoperative pain. ⋯ Overall, both techniques provided safe and effective postoperative analgesia. As compared with continuous infusion, intermittent bolus administration resulted in lower plasma bupivacaine levels despite similar infusion rates.
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Regional anesthesia · Jul 1996
Clinical TrialExtended unilateral anesthesia. New technique or paravertebral anesthesia?
The authors previously reported a case in which injection of local anesthetic posterior to the endothoracic fascia at the T11 vertebral level gave rise to extended analgesia in thoracic and lumbar dermatomes. They now report a study in which this type of anesthesia was used in patients undergoing herniorrhaphy. ⋯ Injection of local anesthetic posterior to the endothoracic fascia resulted in extended unilateral anesthesia that was adequate for herniorrhaphy in 9 of the 15 patients (60%) studied.