Articles: anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Caudal analgesia for perianal surgery. A comparison between bupivacaine and diamorphine.
Seventy-three patients undergoing elective perianal surgery were randomly divided into a control group, a group who received a caudal injection of 20 ml bupivacaine 0.5% plain and a group who received diamorphine 2.5 mg in 10 ml normal saline by caudal injection; a comparison was then made of postoperative analgesia requirements. The bupivacaine group had better analgesia than the control group for the first 8 hours, after which there was no difference. ⋯ In particular, 41% of the bupivacaine group complained of some degree of urinary retention and one patient required temporary catheterisation. It is concluded that caudal diamorphine gives good postoperative analgesia for perianal operations, particularly when motor blockade is not wanted by the surgeon.
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Randomized Controlled Trial Clinical Trial
Regional analgesia with bupivacaine in dental anaesthesia.
Sixty (ASA 1) patients were studied to determine the effect of bilateral local infiltration with 0.25% bupivacaine plain during third molar extraction under general anaesthesia. Bupivacaine infiltration significantly reduced the incidence of wide complex extrasystoles (P less than 0.05) during surgery and the severity of dental pain (P less than 0.05), when assessed at 6 h after operation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the incidence and nature of cardiac arrhythmias occurring during isoflurane or halothane anaesthesia. Studies during dental surgery.
Seventy-six Chinese patients aged between 15 and 30 yr, undergoing 3rd molar extraction, were randomly allocated to two groups. One group received halothane and the other isoflurane. The incidence of arrhythmia during surgery under anaesthesia with isoflurane was significantly less than with halothane. ⋯ The frequency and nature of arrhythmias during surgery on right and left sides were similar. In three patients a slight decrease in arterial pressure was recorded in association with the arrhythmia, but on stopping the stimulus, both rhythm and arterial pressure returned to normal. The incidence of arrhythmia with halothane in the Chinese population in this study was significantly higher than that reported previously in non-Chinese patients.
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Acta Anaesthesiol Scand · Apr 1986
Randomized Controlled Trial Clinical TrialComparative effects of intrathecal bupivacaine and tetracaine on analgesia, cardiovascular function and plasma catecholamines.
Forty otherwise healthy male patients, scheduled for elective inguinal herniotomy, were randomly allocated to spinal anaesthesia with 3 ml 0.5% hyperbaric tetracaine or bupivacaine under double-blind conditions. The extent of blockade (pin-prick and cold sensation), blood pressure and heart rate and plasma catecholamines were measured before and 5, 10, 15, 20 and 30 min after injection, before skin incision. Cephalad spread of sensory and temperature analgesia was insignificantly higher after tetracaine. ⋯ Plasma norepinephrine and epinephrine measurements before spinal puncture and at maximal decrease in mean arterial pressure showed a depressed response to fall in blood pressure in the tetracaine group. It is concluded that spinal anaesthesia with 3 ml hyperbaric 0.5% tetracaine is followed by a more pronounced fall in blood pressure compared to an identical dose of bupivacaine. The more pronounced sympathetic blockade, confirmed by plasma catecholamine measurements, following tetracaine is probably due to a higher cephalad spread of neurogenic blockade, rather than a differential effect on sympathetic nerve fibres.
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Anesthesia and analgesia · Apr 1986
Randomized Controlled Trial Comparative Study Clinical TrialProlongation of lidocaine spinal anesthesia with epinephrine and phenylephrine.
The effect of vasoconstrictors on the duration of lidocaine spinal anesthesia is controversial. We conducted a double-blind study of 28 neurologically normal ASA Class I or II patients to determine the effect of vasoconstrictors (epinephrine and phenylephrine) on the duration of lidocaine spinal anesthesia. The patients were randomized into three groups. ⋯ Time for regression by two sensory dermatomes were significantly prolonged in both Groups 2 and 3, 102.9 +/- 18.1 and 105.7 +/- 33.1 min, respectively, compared to 78.1 +/- 12.6 min in Group 1. Times for regression to T-12 was also significantly prolonged in both Groups 2 and 3, 153.7 +/- 27.6 and 156.8 +/- 26.7 min, respectively, compared to 117.71 +/- 10.0 min in Group 1. In the doses used in the present study, both epinephrine and phenylephrine significantly prolong the duration of lidocaine spinal anesthesia.