Articles: anesthetics.
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Randomized Controlled Trial Comparative Study Clinical Trial
In vivo assessment of percutaneous local anaesthetic preparations.
This study has demonstrated greater efficacy of a new percutaneous amethocaine preparation relative to Eutectic Mixture of Local Anaesthetics (EMLA). Initially, a double-blinded trial was undertaken on each preparation individually against placebo, as the recommended method of application was different for EMLA (2.5 g applied for 60 min under an occlusive dressing) and the amethocaine formulation (0.5 g applied for 30 min). Thereafter, the two preparations were compared directly, in a double-blinded study using a standardized application for both formulations. ⋯ The amethocaine preparation produced significant anaesthesia (chi-square, P less than 0.001) after 30 min application. Furthermore, the amethocaine formulation demonstrated both increased rapidity of action and increased duration of effect, as determined by a two-tailed unpaired t test, in comparison with EMLA when application times of both 30 and 60 min were used for each preparation. The results of this study indicate that the amethocaine preparation provided more rapid and prolonged anaesthesia than EMLA.
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Lidocaine, tetracaine, and bupivacaine are the local anesthetic agents most commonly employed for spinal anesthesia in the U. S. Lidocaine provides a short duration of anesthesia and is primarily useful for surgical and obstetrical procedures lasting less than one hour. ⋯ Lidocaine and bupivacaine do not appear to benefit as much from the addition of vasoconstrictors. In general, the local anesthetic agents that are currently available for spinal anesthesia provide significant versatility. By carefully considering the planned surgical procedure, the surgeon's requirements, and the patient's characteristics (e.g., age, height, gravidity), and by understanding the factors that influence spinal anesthesia, the anesthesiologist can select a local anesthetic agent that will assure adequate and satisfying spinal anesthesia.
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Southern medical journal · Jan 1989
Review Case ReportsSubdural injection of local anesthetics and morphine: a complication of attempted epidural anesthesia.
We have reported a case of unintentional, roentgenographically proven cannulation of the lumbar subdural space. Injection of 13 ml of local anesthetic provided satisfactory anesthesia for cesarean section, and administration of 1 mg of morphine resulted in postcesarean analgesia for 22 hours. Subdural catheterization is a possible explanation for the occasionally irregular course of an apparent "epidural" anesthetic.
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Acta Anaesthesiol Belg · Jan 1989
ReviewCentral anticholinergic syndrome (CAS) in anesthesia and intensive care.
Many of the drugs used in anesthesia and intensive care may cause blockade of the central cholinergic neurotransmission. Acetylcholine is of significance in modulation of the interaction among most other central transmitters. The clinical picture of the central cholinergic blockade, known as the central anticholinergic syndrome (CAS), is identical with the central symptoms of atropine intoxication. ⋯ In some intoxications with psychoactive agents, physostigmine is useful for reversal of the central nervous symptoms of the acute intoxication itself. In addition it can be used for prevention of some withdrawal states. In
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Regional anesthesia represents a selective method for surgery of the lower limbs because of its simplicity and its handiness. The various techniques of regional anesthesia are analysed with their risks and benefits. ⋯ Nervous blocks of the lower limbs represents also safe techniques especially for elderly patients and for day-case surgery. Intravenous regional anesthesia does not represent an usefull technique because of the possible toxicity due to a great volume of local anesthetic drugs.