Anesthesia and analgesia
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Anesthesia and analgesia · May 1987
Randomized Controlled Trial Comparative Study Clinical TrialEpinephrine enhances analgesia produced by epidural bupivacaine during labor.
Reports on the analgesic and hemodynamic effects of epinephrine added to bupivacaine for epidural use in obstetrics are conflicting. In this study, healthy parturients received in a random manner either 10 ml of 0.25% bupivacaine (n = 50) or 10 ml of 0.25% bupivacaine with 1:300,000 epinephrine (n = 50) epidurally. ⋯ Maternal heart rate increased only after injection of the epinephrine-containing solution. The authors conclude that epinephrine 1:300,000 modestly but statistically significantly improves the analgesic efficacy of epidurally administered 0.25% bupivacaine during labor.
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Anesthesia and analgesia · May 1987
Randomized Controlled Trial Comparative Study Clinical TrialLocal analgesia without anesthesia using peripheral perineural morphine injections.
Twenty-five patients with chronic pain were treated with nerve blocks. They were divided into two groups, A and B, according to the volume of local anesthetic required for surgical anesthesia by standard nerve block techniques. The 16 patients in group A had pain in the distribution of small nerves, which could be blocked with 5 ml or less. ⋯ Morphine (6 mg) was added, in a random, double-blind fashion, to one of the injections. A second pair of injections was subsequently done, using morphine by the alternative route. Perineural morphine provided statistically longer lasting pain relief than did either intramuscular morphine or perineural bupivacaine.
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Anesthesia and analgesia · May 1987
Randomized Controlled Trial Comparative Study Clinical TrialEpinephrine improves the quality of spinal hyperbaric bupivacaine for cesarean section.
In a double-blind randomized study, the effects of the addition of epinephrine on hyperbaric spinal bupivacaine were studied in 63 patients having elective repeat cesarean sections. In the study group (32 patients), the addition of 0.2 mg epinephrine improved the quality of analgesia since fewer patients required supplementation of the spinal anesthetic; the motor block was more profound; and the times to two-segment regression, sensory recovery, and motor recovery were prolonged.
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Anesthesia and analgesia · May 1987
Randomized Controlled Trial Comparative Study Clinical TrialProlongation of isobaric bupivacaine spinal anesthesia with epinephrine and clonidine for hip surgery in the elderly.
The effects of vasoconstrictors on the duration of isobaric bupivacaine spinal anesthesia are unknown. A prospective controlled study was conducted on 60 ASA class II or III patients aged 75 yr or more who were scheduled for spinal anesthesia for orthopedic hip surgery. The subjects were randomly allocated into three groups. ⋯ Mean time for regression to the L2 segment was also significantly longer in groups II and III than in group I. This time tended to increase more with the bupivacaine plus clonidine solution than with the bupivacaine plus epinephrine solution. Significant prolongation of motor block was also associated with the addition of clonidine.