Anesthesia and analgesia
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Anesthesia and analgesia · May 1988
Randomized Controlled Trial Clinical TrialContinuous infusion epidural analgesia in labor: the effect of adding sufentanil to 0.125% bupivacaine.
The purpose of this study was to determine if the addition of sufentanil would improve the quality of analgesia obtained with 0.125% epidural bupivacaine infusions given to women in active labor. Forty healthy laboring women were randomly assigned to two equal groups. Group 1 had epidural analgesia instituted with the bolus injection of 10-15 ml 0.125% bupivacaine containing sufentanil 2 micrograms/ml, followed 30 minutes later by initiation of an epidural infusion of 0.125% bupivacaine containing sufentanil 1 microgram/ml at a rate of 10 ml/hr. ⋯ Analgesia assessed by visual analog pain scores was significantly better in group 1. Significantly fewer epidural injections were required in group 1, and less motor weakness occurred in these patients. The addition of sufentanil to epidural bupivacaine infusions given in labor improves analgesia and reduces "top-up" requirements.
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Anesthesia and analgesia · May 1988
A statistical model for pain in patient-controlled analgesia and conventional intramuscular opioid regimens.
A statistical model was developed: 1) to compare the efficacy of patient-controlled analgesia (PCA) and traditional intramuscular (IM) opioids for pain relief in 40 patients after total knee replacement and, 2) to evaluate pain cycles associated with each technique. Hourly visual analog pain scores were subjected to two-way analysis of variance (ANOVA) and time-series analysis. Hourly verbal analog pain scores were used to determine predominant pain levels. ⋯ Hence, they self-administer opioids for pain relief with PCA according to their expectations. Population characteristics may modify PCA efficacy. These characteristics should be delineated and the use of PCA targeted to appropriate patients.
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Anesthesia and analgesia · May 1988
Effects of etomidate, midazolam, and thiopental on median nerve somatosensory evoked potentials and the additive effects of fentanyl and nitrous oxide.
In 30 patients undergoing spinal disc operations, the effects of bolus injections followed by intravenous infusions of thiopental, etomidate, and midazolam on median nerve somatosensory-evoked potentials (SSEPs) were studied. Possible additive effects of fentanyl and nitrous oxide were also evaluated. Serial SSEP measurements were made before and for 25 minutes after the start of anesthesia. ⋯ Midazolam had no effect on amplitude but increased latency. The addition of fentanyl and nitrous oxide had different effects in response to the three intravenous induction agents. This study emphasizes the differences in SSEP responses not only to different intravenous induction agents but also to the addition of fentanyl and nitrous oxide.