Anesthesia and analgesia
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Anesthesia and analgesia · Jul 1995
Randomized Controlled Trial Clinical TrialIntravenous ketorolac tromethamine does not worsen platelet function during knee arthroscopy under general anesthesia.
Ketorolac (KT) prolongs bleeding time and inhibits platelet aggregation and platelet thromboxane production in healthy, awake volunteers. However, platelet function may be accentuated during the stress of general anesthesia (GA) and surgery. The purpose of this study was to investigate platelet function changes during a standard GA technique and surgery, as well as after a single intraoperative dose of intravenous (i.v.) KT. ⋯ Platelet function appears to be accentuated during GA and surgery as evaluated by BT in the placebo group. Further, platelet function by BT, PA, and TEG was not inhibited after i.v. KT despite near complete abolition of TxB2 production.
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Anesthesia and analgesia · Jul 1995
Randomized Controlled Trial Clinical TrialEffects of pH adjustment and carbonation of lidocaine during epidural anesthesia for foot or ankle surgery.
We examined the onset and the quality of sensory and motor block of the lumbosacral roots during epidural anesthesia performed for foot or ankle surgery with lidocaine HCl, pH adjusted, or carbonated lidocaine in a randomized, double-blind study. Forty-five patients received 20 mL of one of three solutions: control group (n = 15), 20 mL of 2% lidocaine with epinephrine (5 micrograms/mL) plus 2 mL of NaCl 0.9% (pH 4.58 +/- 0.10); pH adjusted group (n = 15) 20 mL of lidocaine with epinephrine (5 micrograms/mL) plus 2 mL of 8.4% sodium bicarbonate (pH 6.47 +/- 0.16); and carbonated group (n = 15) 20 mL of 1.73% carbonated lidocaine with epinephrine (5 micrograms/mL) plus 2 mL of 0.9% NaCl (pH 6.42 +/- 0.04). Onset time of sensory block of the L4-S1 roots and maximum cephalad spread were similar in the three groups. ⋯ Complete motor block was observed in eight patients of the carbonated group compared to three in the pH adjusted group (P < 0.01) and one in the control group (P < 0.005). Lidocaine venous blood levels were comparable in the three groups. When compared to lidocaine HCl, only carbonated lidocaine, but not the pH adjusted solution, significantly improved epidural block of the L4-S1 roots.