Revista brasileira de anestesiologia
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Restricted sympathetic block during spinal anesthesia may minimize hemodynamic changes. In theory, the use of non-isobaric local anesthetics may induce unilateral anesthesia and limit sympathetic blockade to one side of the body. The local anesthetic dose and the time patients need to remain in the lateral position for achieving unilateral spinal anesthesia are not known. This prospective study investigated the incidence of unilateral spinal anesthesia following injection through a 27G Quincke needle of 0.15% hypobaric bupivacaine, prepared with 1.5 ml standard isobaric bupivacaine plus fentanyl (25 microg), in patients in the lateral position with the limb to be operated upwards. ⋯ Hypobaric 0.15% bupivacaine (7.5 mg) associated to fentanyl provided a predominantly unilateral block after twenty minutes in the lateral position. Major advantages of unilateral spinal anesthesia were hemodynamic stability, patient satisfaction and the absence of post-dural puncture headache.
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Rev Bras Anestesiol · Sep 2002
[The influence of sevoflurane and isoflurane on the recovery from cisatracurium-induced neuromuscular block.].
The effects of neuromuscular blockers on the neuromuscular junction are potentiated by volatile anesthetics. This study aimed at evaluating the influence of sevoflurane and isoflurane on the recovery of cisatracurium- induced neuromuscular block. ⋯ The recovery from cisatracurium-induced neuromuscular block was longer during anesthesia with volatile agents as compared to propofol. The most pronounced effect was observed with sevoflurane.
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Chronic pain is a challenge for modern medicine. New methods and drugs have been proposed to control pain. Intrathecal administration is a feasible and safe option, but still requires further investigations. This study aimed at reviewing available and well established drugs as well as new promising alternatives for the daily practice. ⋯ Several advances were achieved in controlling pain with intrathecal administration of the above-mentioned drugs. Certainly some will be used, thus enriching therapeutic armamentarium, and others will be temporarily or permanently abandoned. However, several clinical and experimental studies will still be needed for knew knowledge to be incorporated and safely used by professionals dealing with chronic pain.