Articles: anesthetics.
-
In regional anesthesia sudden and severe complications occur from time to time and may rapidly turn into life threatening situations. Their rarity might well be their most vicious characteristic. Therefore, awareness of the possible complications, careful preparation to cope with them, vigilance enabling prompt recognition of their occurrence and quick administration of the appropriate treatment are all essential for a safe practice of regional anesthesia. The routine use of pulse oximetry is now strongly recommended.
-
Clonidine and other clinically available alpha-2 adrenergic agonists reduce inhalational and narcotic anesthetic requirements while providing hemodynamic stability during stressful periods of surgery. Like the opiates, the alpha-2 adrenergic agonists are potent analgesics when given systemically, epidurally, or intrathecally. Their effects are reversed by alpha2 adrenergic antagonists. ⋯ They have anxiolytic properties and therefore can be potentially useful in the preanesthetic period. This drug class has the potential to provide many of the component effects required for perioperative care. For these reasons, the alpha2 adrenergic class of drugs should be important in the future of anesthesia.
-
Nephrol. Dial. Transplant. · Jan 1988
Randomized Controlled Trial Comparative Study Clinical TrialTopical anaesthesia for fistula cannulation in haemodialysis patients.
The use of a local anaesthetic cream (EMLA; Astra) for arteriovenous fistula cannulation was compared to placebo in a double-blind randomised manner in 26 patients undergoing chronic haemodialysis who were currently using injections of lignocaine. The EMLA cream was highly effective compared to placebo (P less than 0.001) on visual analogue and verbal rating scales as well as ease of venepuncture (P less than 0.01). It also gave more pain relief and improved the ease of venepuncture compared to lignocaine injections. Patients expressed a strong preference for the EMLA cream, which has advantages that outweigh the cost and convenience factors.
-
Anesthesia and analgesia · Jan 1988
Comparative StudyNeonatal neurobehavior after epidural anesthesia for cesarean section: a comparison of bupivacaine and chloroprocaine.
Reports of whether or not bupivacaine affects neonatal neurobehavior have been contradictory. The purpose of this study was to test the hypothesis that scores on the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) after epidural anesthesia with bupivacaine for cesarean section would not be different than those after chloroprocaine. Furthermore, if there were any effects, it was hypothesized that they would be related to cord blood levels of the drug. ⋯ The results indicate that infants in the bupivacaine group do significantly better than those in the chloroprocaine group in the orientation cluster of the BNBAS (F[1,49] = 22, P less than 0.001); this cluster reflects higher cortical functioning. Furthermore, there was improvement in the bupivacaine group in the regulation of state cluster with age, whereas there was no improvement in the chloroprocaine group (F[1,53] = 4.34, P less than 0.01). This study suggests that performance on the BNBAS after exposure to bupivacaine is better than that after exposure to chloroprocaine.
-
Operations on the cutaneous surfaces are mainly performed under local anesthesia. Local infiltrative anesthesia is the most frequently used form in cutaneous surgery. ⋯ In contrast to general anesthesia it can be used in risk patients e.g. with ischemic heart disease or respiratory illnesses. Adverse reactions must be taken into account, especially toxic effects, allergy, drug interactions or traumatic lesions of nerves or blood vessels.