Articles: postoperative-pain.
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Others have demonstrated the effectiveness of intercostal analgesia with bupivacaine hydrochloride (Marcain Plain; Astra). We present a greatly simplified method of effecting this. Our method is dependent on an intact pleura. ⋯ Only 2 patients had postoperative pulmonary complications. No complication related either to the procedure or to the infusion of bupivacaine occurred. The technique as described here is a safe and reliable method of providing analgesia without any side effects after thoracotomy.
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Southern medical journal · Oct 1988
Postoperative ketamine analgesia in children: efficacy and safety after halothane anesthesia.
This study was done to investigate the effectiveness and safety of ketamine analgesia after halothane anesthesia for surgery in children. After completion of a surgical procedure, ten children had ketamine (1 mg/kg) injected intravenously during maintenance of anesthesia with 1% halothane in a 60:40 nitrous oxide-oxygen mixture. Cardiovascular parameters measured with noninvasive oscillometry and transthoracic impedance plethysmography remained unchanged after administration of ketamine. ⋯ When ketamine and halothane are administered in combination, careful restriction of dosages of these agents is recommended. Interaction of higher doses of ketamine and halothane has been reported to produce hypotension and bradycardia, which can be avoided with use of subdissociative, analgesic doses of ketamine during light halothane maintenance before emergence. After halothane anesthesia in healthy children, ketamine may be considered a suitable alternative to narcotics for postoperative analgesia.
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Acta Anaesthesiol Scand · Oct 1988
Pharmacokinetics and protein binding of bupivacaine in postoperative epidural analgesia.
We describe a method, which is both specific and rapid, for the measurement of bupivacaine concentrations in plasma using high-performance liquid chromatography. Bupivacaine plasma concentrations, pharmacokinetics and protein binding in the postoperative period were investigated in seven patients (58-77 years old) following hip surgery. Postoperative analgesia was achieved by epidural bolus injections of 25 mg bupivacaine 0.25% every 6 h. ⋯ The free fraction decreased from 5.4% preoperatively to 2.7% in the postoperative period (P less than 0.05). Changes in plasma protein binding of bupivacaine and changes in plasma levels of the acute phase reactant alpha-1-acid glycoprotein were correlated (r = 0.8, P less than 0.05). Difficulties in interpreting the elimination parameters following epidural administration are discussed, leading to the conclusion that the derivation of dosage regimens from kinetic parameters following epidural administration is not warranted.
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Minerva anestesiologica · Oct 1988
Randomized Controlled Trial Comparative Study Clinical Trial[Stress and postoperative analgesia].