Acta anaesthesiologica Sinica
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Acta Anaesthesiol. Sin. · Dec 1998
Randomized Controlled Trial Clinical TrialAn alternative continuous caudal block with caudad catheterization via lower lumbar interspace in adult patients.
Continuous caudal block with caudad catheterization has not yet been mentioned in literatures. We designed a preliminary study to investigate the feasibleness of this technique, spread of contrast medium under fluoroscopy, and its clinical effectiveness. ⋯ Continuous caudal block with caudawise catheterization via lower lumbar interspaces is feasible (eight of 10 patients in this study) with respect to technique and clinical effect. Paravertebral and retrorectal migrations of the catheter may occur in spite of smooth catheterization. Either migration might lead to a failure of caudal block.
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Acta Anaesthesiol. Sin. · Dec 1998
Randomized Controlled Trial Clinical TrialCombination of bupivacaine scalp circuit infiltration with general anesthesia to control the hemodynamic response in craniotomy patients.
Sudden and overwhelming increases in blood pressure (BP) and heart rate (HR) during incision of the scalp may give rise to morbidity or mortality in patients with intracranial pathology undergoing neurosurgery. A modification of the method proposed by Labat to abate this circumstantiality was applied in a group of patients receiving craniotomy. The modified method was to combine scalp circuit infiltration of local anesthetic with general anesthesia to control the hemodynamic response to craniotomy. ⋯ Our results showed that scalp circuit infiltration with 0.25% bupivacaine significantly improved the cardiovascular stability and reduced the requirement of isoflurane during craniotomy. The routine use of bupivacaine scalp circuit infiltration in patients undergoing craniotomy should be considered.
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Acta Anaesthesiol. Sin. · Sep 1998
Randomized Controlled Trial Comparative Study Clinical TrialIntradermal injection of tramadol has local anesthetic effect: a comparison with lidocaine.
We observed that intravenous retention of tramadol with a pneumatic tourniquet on the arm inflated to 70 mmHg for one minute could effectively reduce the subsequent propofol injection pain. Tramadol is a central-acting analgesic. The local analgesic effect of tramadol on reducing propofol injection pain is not well known. ⋯ We concluded that intradermal injection of tramadol or lidocaine can produce local anesthetic effect.
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Acta Anaesthesiol. Sin. · Sep 1998
Randomized Controlled Trial Clinical TrialThe maternal and fetal effects of the addition of sufentanil to 0.5% spinal bupivacaine for cesarean delivery.
Opioid added to local anesthetic for spinal anesthesia was first introduced into clinical practice in 1979 with intrathecal morphine as a forerunner. As morphine is water soluble and has prolonged action, late respiratory depression following spinal anesthesia is not infrequent and is the most serious complication that causes our concern. Sufentanil which is more hydrophobic than morphine also with shorter duration of action and quicker onset when injected into the subarchnoid space could be more effective and a safer drug as an adjuvant to local anesthetic in spinal anesthesia. ⋯ The addition of intrathecal sufentanil to 0.5% bupivacaine for spinal anesthesia improved perioperative discomfort and significantly reduced the demand of post-operative analgesia but on the other hands, it tended to increase perioperative hypotension and cause mild pruritus.
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Acta Anaesthesiol. Sin. · Sep 1998
Randomized Controlled Trial Clinical TrialThe effect of coagulation protection with combination of epsilon aminocaproic acid and plasma saver in open-heart surgery.
Bleeding remains a major complication and a major determinant in the prognosis of open-heart surgery. Coagulopathy related to cardiopulmonary bypass (CPB) seems to be the culprit. Since homologous blood transfusion in many occasions is not only responsible for mobidity and mortality but also increases medical costs. Therefore, the application of autologous blood transfusion including components such as PRBC, FFP and platelets concentrate is inevitable and comes in its stead. To reduce the use of homologous plasma and platelets transfusion in open-heart surgery, we designed a study to utilize the combination of autologous platelet rich plasma (PRP) and epsilon aminocaproic acid (EACA) to evaluate its effects on blood loss and blood component transfusion in open-heart patients. ⋯ With Pre-CPB EACA as protection, reduction of both blood loss and blood transfusion could be realized in open-heart surgery.