Regional anesthesia
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Regional anesthesia · Jan 1997
Randomized Controlled Trial Comparative Study Clinical TrialIntravenous regional anesthesia with 0.5% articaine, 0.5% lidocaine, or 0.5% prilocaine. A double-blind randomized clinical study.
The purpose of this study was to compare the effectiveness of three local anesthetic agents for intravenous regional anesthesia in the upper limb. Side effects and plasma concentrations of the drugs in the doses administered for IVRA were also studied. ⋯ Articaine had the fastest onset of sensory block and the lowest peak plasma concentration of the three local anesthetics when used for intravenous regional anesthesia.
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Regional anesthesia · Sep 1997
Clinical TrialLidocaine does not depress reflex dilation of the pupil.
Pupillary dilation in response to dermatomal electrical stimulation is one method of determining sensory block level during combined epidural and general anesthesia. Use of this technique may, however, be confounded by systemic absorption of epidurally administered local anesthetics. Accordingly, the effects of intravenous lidocaine on the magnitude and duration of reflex pupillary dilation were evaluated. ⋯ Typical plasma lidocaine concentrations observed during epidural anesthesia are unlikely to prevent the use of pupillary responses to evaluate sensory block level.
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Regional anesthesia · Jul 1989
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of continuous epidural analgesia with sufentanil and bupivacaine during and after thoracic surgery on the plasma cortisol concentration and pain relief.
The effect of continuous epidural analgesia with bupivacaine 0.125% and sufentanil 0.83 micrograms.ml-1 on the plasma cortisol concentration and postoperative pain relief was compared with that of intermittent intravenous peroperative and on-demand intramuscular postoperative analgesia with nicomorphine 0.2 mg.kg-1. The study was performed on two groups of ten patients for three consecutive days after thoracic surgery. In the epidural group, a better quality of analgesia was found as measured with the Inverse Linear Analgesia Scale (ILAS) (1 = severe pain, 10 = no pain) than in the group that received intramuscular analgesia. ⋯ L-1 on day 1. The measured mean plasma cortisol concentration was found to exceed normal limits (150-700 nmol. L-1) only in the systemic group and only on day 1.
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Regional anesthesia · Mar 1991
Randomized Controlled Trial Comparative Study Clinical TrialVentilatory function and continuous high thoracic epidural administration of bupivacaine with sufentanil intravenously or epidurally: a double-blind comparison.
Variables of ventilation were obtained preoperatively and during the first two postoperative days in 28 patients after thoracic surgery. All patients received 0.5% bupivacaine with epinephrine, 5 micrograms.ml-1 (5-10 ml), through an epidural catheter at the thoracic level supplemented by light general anesthesia. One hour after the initial dose of bupivacaine, patients were randomly allocated to one of two groups: an epidural (EP) sufentanil and an intravenous (IV) sufentanil group. ⋯ The incidence of side effects was not different. Only the initial mean sufentanil plasma levels in patients of the IV group were higher than those of the EP group. This study shows that the variables of ventilation were not affected by sufentanil administered via the epidural or the intravenous route, and that both techniques provided excellent pain relief when employed to supplement low-dose 0.125% bupivacaine epidurally.