Articles: analgesia.
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Randomized Controlled Trial Clinical Trial
The effect of transdermal nitroglycerin on spinal S(+)-ketamine antinociception following orthopedic surgery.
To determine whether combination of transdermal nitroglycerine (a nitric oxide generator) would enhance analgesia from epidural S(+)-ketamine (a N-methyl-D-aspartate antagonist) in patients undergoing orthopedic surgery with combined spinal anesthesia. ⋯ Epidural S(+)-ketamine resulted in antinociception, which was enhanced by transdermal nitroglycerin.
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Anesthesia and analgesia · Dec 2001
Randomized Controlled Trial Clinical TrialNeostigmine combined with bupivacaine, clonidine, and sufentanil for spinal labor analgesia.
We previously found that spinal clonidine prolongs labor analgesia when combined with spinal bupivacaine and sufentanil. We sought to determine whether the addition of spinal neostigmine to these drugs would further enhance labor analgesia. By use of a combined spinal/epidural technique, 36 patients were randomized to receive a hyperbaric spinal injection of bupivacaine 2.5 mg plus clonidine 50 microg and sufentanil 10 microg with or without neostigmine 10 microg. Pain, maternal hemodynamics, fetal heart rate, nausea, pruritus, sedation, motor block, sensory levels to pinprick, and maternal oxygen saturation were assessed at regularly specified intervals after spinal injection until additional analgesia was requested. The duration of spinal analgesia was similar between groups (215 +/- 60 min in the Control group versus 205 +/- 62 min in the Neostigmine group). Likewise, pain scores, the duration of labor, Apgar scores, and side effects were similar between groups except that patients administered neostigmine experienced significantly more nausea and vomiting (53% vs 7%, P = 0.01). We conclude that spinal neostigmine 10 microg produces severe nausea and does not potentiate the duration of spinal analgesia in laboring women from spinal bupivacaine, clonidine, and sufentanil. ⋯ Spinal neostigmine 10 microg as an adjunct to spinal bupivacaine, clonidine, and sufentanil produces severe nausea and fails to potentiate analgesia in laboring women.
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J. Korean Med. Sci. · Dec 2001
The flow rate of the elastomeric balloon infusor is influenced by the internal pressure of the infusor.
The purpose of this study was to evaluate the flow rate of elastomeric balloon infusor composed of rubber or silicone materials. Two models were studied: the Baxter Twoday Infusor and Advance Silicone Infusor. Each infusion device has a preset flow rate of 2 mL/hr. ⋯ Both devices initially infused at a relatively high rate, followed by a somewhat steady flow rate. The flow rate distinctly increased in the small residual volume. The flow rate of the balloon infusor used in this study was not sustained uniformly during the entire delivery period and was in proportion to the internal pressure of the infusor regardless of the materials.
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Randomized Controlled Trial Clinical Trial
Transcutaneous electrical nerve stimulation does not augment epidural labor analgesia.
To evaluate whether transcutaneous electrical nerve stimulation (TENS) can increase the quality and duration of an initiation dose of bupivacaine used for the establishment of epidural labor analgesia. ⋯ In healthy laboring parturients, the application of a TENS unit did not alter the quality or duration of an initiation dose of bupivacaine utilized for the establishment of epidural labor analgesia.
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Anaesth Intensive Care · Dec 2001
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of the biopatch, a chlorhexidine impregnated dressing, on bacterial colonization of epidural catheter exit sites.
We performed a prospective, randomized study in 55 ASA I to 3 women undergoing elective gynaecological surgery followed by postoperative epidural analgesia. We compared the incidence of bacterial colonization at the epidural exit site following catheter removal between a control group and an experimental group who received a chlorhexidine impregnated dressing (Biopatch, Johnson and Johnson, Arlington, TX, U. ⋯ Positive culture results were found in 11 of 27 (40.1%) patients in the control group compared with one of 29 (3.4%) patients whose epidural catheters were dressed with the Biopatch. We concluded that the Biopatch was effective in reducing bacterial colonization of the epidural catheter exit site.