Regional anesthesia
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Regional anesthesia · Jan 1990
Randomized Controlled Trial Clinical TrialEphedrine as a marker of intravascular injection in laboring parturients.
Thirty healthy laboring parturients were randomly chosen to receive either normal saline (NS), ephedrine 10 mg (EPH-10), or ephedrine 15 mg (EPH-15) intravenously. Changes in maternal heart rate and blood pressure and fetal heart rate were monitored. ⋯ There was no adverse fetal outcome. Transient fetal tachycardia was seen in three fetuses in the EPH-15 group.
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Smooth emergence from general endotracheal anesthesia is frequently complicated by coughing induced by stimulation from an endotracheal tube. Lidocaine and other local anesthetics have been shown to anesthetize important rapidly adpating stretch receptors in the dog trachea. With the aim of providing a reservoir for continuous lidocaine release to adjacent tracheal tissue, we examined the ability of clinically used concentrations of lidocaine to diffuse across a commonly used endotracheal tube cuff. ⋯ The highest concentration obtained was 17.49 +/- 2.03 micrograms/mL after 360 minutes. We conclude lidocaine diffuses across endotracheal tube cuffs in a fashion that may enable the cuff to serve a potentially useful role as a reservoir for local anesthetic. This in turn appears to have the potential to smooth emergence from general endotracheal anesthesia in those patients in whom tracheal stimulation may be a complicating factor.
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Regional anesthesia · Jan 1990
Review Biography Historical ArticleThe Bier block after 80 years: a historical review.
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Regional anesthesia · Jan 1990
Randomized Controlled Trial Comparative Study Clinical TrialChloroprocaine and lidocaine decrease hospital stay and admission rate after outpatient epidural anesthesia.
Lumbar epidural anesthesia with 20 ml of either 3% 2-chloroprocaine (C), 1.5% lidocaine (L), or 1.5% mepivacaine (M) with epinephrine was studied in 84 outpatients undergoing surgery (extracorporeal shock wave lithotripsy (ESWL]. The average duration of the procedure was 31.9 minutes. The total duration of sensory anesthesia was 133 +/- 28 minutes (C), 182 +/- 38 (L), and 247 +/- 42 (M) (p less than 0.05). ⋯ There was a trend to an increasing rate of unplanned overnight hospital admission with increasing duration of the local anesthetic drug employed. Continuous epidural anesthesia with C, L or M appears safe and effective for outpatient surgical procedures such as ESWL. In contrast to previous understanding, mepivacaine produces significantly longer anesthesia and recovery times and may not be optimal for outpatient epidural use.