Articles: anesthesia.
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Anesthesia and analgesia · Nov 1981
Randomized Controlled Trial Clinical TrialIsobaric tetracaine spinal anesthesia and the lithotomy position.
The extent and pattern of anesthesia produced by hyperbaric and by isobaric 0.5% tetracaine spinal anesthesia were compared in this blind-observer, randomized study of 103 spinal anesthetics performed in 98 patients having genitourinary surgery in the lithotomy position. Pinprick stimulation showed no significant differences in maximum segmental sensory levels, times to maximum level, or duration of anesthesia for isobaric as compared to hyperbaric tetracaine. No parameters were significantly altered by barbotage of isobaric tetracaine solutions. With injections given to patients in the sitting position and with patients subsequently maintained in a horizontal lithotomy position before being put in the lithotomy position, the addition of dextrose to tetracaine solutions injected at room temperature into the subarachnoid space does not significantly alter the cephalad spread of spinal anesthesia.
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Acta Anaesthesiol Scand · Oct 1981
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of epidural morphine and epidural bupivacaine for postoperative pain relief.
In 32 patients subjected to total hip replacement, postoperative pain relief was achieved by random treatment with either 5 mg of morphine in 10 ml of saline (n = 15) or 6-8 ml of 0.5% bupivacaine with epinephrine (n = 17), both drugs administered by the lumbar epidural route. In an additional group of 10 patients, post-traumatic thoracic or post-operative abdominal pain was relieved first by 4-6 ml of 0.5% bupivacaine with epinephrine and subsequently by 5 mg of morphine in 10 ml of saline, both drugs being administered by the thoracic epidural route. The duration of analgesia was significantly longer, on average, with morphine (28 h) than with bupivacaine (4.3 h) when the drugs were given by the lumbar route. ⋯ Plasma concentrations of morphine were not detectable 8 h after injection, though the patients still had pain relief. One case of delayed severe respiratory depression occurred 6 h after morphine injection via the thoracic route. Epidural morphine analgesia should therefore be reserved for patients in whom continual surveillance is possible, at least until more is known about the pharmacokinetics of narcotics in the epidural and subarachnoid space.
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Randomized Controlled Trial Comparative Study Clinical Trial
Hormonal responses to high-dose fentanyl anaesthesia. A study in patients undergoing cardiac surgery.
The hormonal responses to anaesthesia and cardiac surgery were studied in 20 patients. Ten patients were anaesthetized with fentanyl 60 microgram kg-1 and nitrous oxide in oxygen and 10 with etomidate 0.3 mgkg-1 and nitrous oxide in oxygen plus halothane. ⋯ Patients anaesthetized with etomidate and halothane showed a significant increase in adrenaline and glucose concentrations not seen in the fentanyl group. Cardiopulmonary bypass was associated with marked increases in catecholamines in both groups.
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Randomized Controlled Trial Clinical Trial
The prevention of pain on injection. A study of the effect of intravenous lignocaine before methohexitone.
The effect of pre-injection of lignocaine 10 mg or physiological saline was assessed in a double blind trial on 100 unpremedicated day cases having a methohexitone induction. The incidence of pain was reduced from 64% to 22% using lignocaine.
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Randomized Controlled Trial Clinical Trial
Effect of lateral position and volume on the spread of epidural anaesthesia in the parturient.
The effect of lateral positioning and the volume of drug injected on the spread of epidural anaesthesia was assessed in 131 healthy parturients. Epidural injection for anaesthesia was done at the L3-4 interspace and a catheter was inserted into the epidural space after injection of the drug. The patients were randomly assigned to four groups. ⋯ Maintenance of the lateral position after induction of epidural anaesthesia is compatible with satisfactory analgesia for labour. Twelve ml bupivacaine 0.25 per cent provides better analgesia than 6 ml bupivacaine 0.5 per cent although the same mass is injected. The quality of analgesia is improved by turning the patients to the contralateral side after injection of 12 ml bupivacaine 0.25 per cent.