Articles: anesthetics.
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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.
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After having been virtually completely forgotten since the Second World War, paediatric regional anaesthesia has been undergoing a renewal in the last decade. This renewed interest in old techniques is due to several converging factors: a better knowledge of the pharmacology of local anaesthetic agents in the child, the availability of equipment adapted for children, the remarkable haemodynamic stability of the very young child during an epidural block, as well as the need to treat pain not just in the operative period. The child is not, or rather, is not only a small adult. ⋯ Its ideal indication is surgery below the umbilicus in the infant and young child. Lumbar epidural anaesthesia requires greater experience as well as proper equipment, especially in the very young child. Peripheral nerve blocks are less used than in adults.(ABSTRACT TRUNCATED AT 400 WORDS)