Articles: analgesia.
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Regional anaesthesia plays an important role in day case surgery because it combines reliable effects with low risk and the possibility of local postoperative analgesia without systemic side-effects. Fast-track regional anaesthesia allows short-term postoperative surveillance or even bypassing the post-anaesthesia care unit. ⋯ Multiple peripheral nerve stimulation and injection techniques may help to realize differential blockades with a pronounced analgesic rather than a motor blocking effect. Nerve blocks with local anaesthetics in combination with alpha2-adrenoceptor agonists or non-steroidal anti-inflammatory drugs and short-acting parenteral opioids represent an effective multimodal concept for ambulatory surgery.
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Anesthesia and analgesia · Dec 2000
Randomized Controlled Trial Clinical TrialThe analgesic efficacy of patient-controlled ropivacaine instillation after Cesarean delivery.
To assess the efficacy and safety of wound instillation of ropivacaine, when administered via a patient-controlled elastometric pump, 50 term parturients undergoing cesarean delivery were enrolled into this prospective, placebo-controlled, double-blinded study. In all cases, a standard spinal anesthetic was administered. After the surgery, a multihole 20-gauge epidural catheter (B. ⋯ However, blood ropivacaine accumulation was noted. All patients stated that the elastometric pump was easy to use. Ropivacaine wound instillation via an elastometric pump is a simple technique that provides safe and effective analgesia after cesarean delivery.
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Randomized Controlled Trial Clinical Trial
Addition of dextrose 3.5% to intrathecal sufentanil for labour analgesia reduces pruritus.
To determine whether the addition of a low concentration (3.5%) of dextrose would minimize pruritus while maintaining the quality of analgesia. ⋯ The addition of dextrose 3.5% to intrathecal sufentanil reduced the incidence of pruritus without affecting the duration or quality of analgesia in parturients in early labour. The distribution of pruritus in the Dex group was limited to below T6 suggesting that pruritus to intrathecal sufentanil is mediated at the spinal level.
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Obstetrics and gynecology · Dec 2000
Randomized Controlled Trial Clinical TrialTranscervical or intraperitoneal analgesia for laparoscopic tubal sterilization: a randomized controlled trial.
To test the effectiveness of analgesia administered transcervically through a uterine manipulator compared with direct topical application to the fallopian tubes for relief of postoperative pain after interval laparoscopic tubal sterilization. ⋯ There were no significant differences in postoperative pain relief between transcervical administration and topical application of analgesia for laparoscopic tubal sterilization.
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J. Cardiothorac. Vasc. Anesth. · Dec 2000
Clinical TrialPreliminary report on high thoracic epidural analgesia: relationship between its therapeutic effects and myocardial blood flow as assessed by stress thallium distribution.
To extend the duration of high thoracic epidural analgesia (HTEA) treatment compared with the authors' previous studies, to test the hypothesis that the mechanism by which HTEA reduces angina during long-term treatment includes an improvement in myocardial blood flow distribution and a reduction in stress-induced ischemia, and to show that new myocardial infarctions are not masked or missed in patients receiving HTEA. ⋯ The authors previously showed that HTEA is safe and effective in relieving refractory angina pectoris. The current study shows that this therapeutic effect persists and does not appear to be related to a change in myocardial blood flow; rather the improvement in symptoms probably results, in part, from an anesthetic effect. HTEA does not mask the development of new myocardial infarctions.