Anesthesia and analgesia
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Anesthesia and analgesia · Jun 1981
Celiac plexus block: a roentgenographic, anatomic study of technique and spread of solution in patients and corpses.
Techniques for blocking the celiac plexus were evaluated by conventional posteroanterior and lateral x-rays and computed tomography (CT) in 20 patients with intractable pain due to carcinoma of the pancreas and by determining spread of injected dye at the time of autopsy in three corpses. The results showed that (a) the site for insertion of the needles should not be more than 7.5 cm lateral to the spinous process of a lumbar vertebra, (b) needles should be placed bilaterally, (c) the depth to which needles are inserted is greater than previously recommended, and (d) at least 25 ml of solution should be injected through each needle.
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Epidural anesthesia was administered for cesarean section in 250 patients using 20 ml of 0.75% bupivacaine administered at L3-4 with the patient in a sitting position for 5 minutes. Comparing the results with those obtained in a previous study in which parturients were kept horizontal at all times, it was found that the sitting position limited cephalad spread of anesthesia only in obese patients and that the decrease in spread was in proportion to the degree of obesity. The previous findings that cephalad spread is positively correlated to body mass index BMI (weight in kilograms divided by height in meters squared) and with body weight were confirmed.
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Anesthesia and analgesia · Jun 1981
Benzodiazepines protect mice from local anesthetic convulsions and deaths.
Median convulsant (CD50) and median lethal (LD50) doses of intraperitoneal lidocaine, bupivacaine, and etidocaine were determined in 149 mice. Another 496 mice were pretreated with intramuscular diazepam, lorazepam, or midazolam, 1 mg/kg. Fifteen minutes later, lidocaine, bupivacaine, or etidocaine was given intraperitoneally and the incidence of convulsions and deaths recorded. ⋯ In equal intramuscular doses, midazolam proved to be the most effective anticonvulsant and diazepam the least. Etidocaine and bupivacaine convulsions were more difficult to suppress than those induced by lidocaine. On the other hand, the lethality of lidocaine was least reduced by these benzodiazepines.