Anesthesia and analgesia
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Anesthesia and analgesia · Sep 2007
Randomized Controlled TrialThe effect of neuromuscular block and noxious stimulation on hypnosis monitoring during sevoflurane anesthesia.
There are conflicting results on the influence of neuromuscular block (NMB) on the bispectral index (BIS). We investigated the influence of two degrees of NMB on BIS, Alaris auditory-evoked potential index (AAI), and the electromyogram (EMG) obtained with needle electrodes from the frontal and temporal muscles, immediately adjacent to the BIS-sensor. ⋯ BIS and AAI responses to noxious tetanic electrical stimulation are affected by the degree of NMB during sevoflurane anesthesia whereas NMB does not affect BIS or AAI in the absence of noxious stimulation.
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Anesthesia and analgesia · Sep 2007
Randomized Controlled TrialImproving the analgesic efficacy of intrathecal morphine with parecoxib after total abdominal hysterectomy.
The addition of parecoxib to intrathecal morphine and bupivacaine may improve analgesia and reduce morphine's opioid-related side effects. ⋯ Perioperative parecoxib enhanced the postoperative analgesia of intrathecal morphine and bupivacaine and improved patient satisfaction.
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Anesthesia and analgesia · Sep 2007
Randomized Controlled TrialTransdermal scopolamine for prevention of intrathecal morphine-induced nausea and vomiting after cesarean delivery.
Intrathecal morphine for cesarean delivery provides excellent postoperative analgesia but is associated with significant nausea and vomiting. ⋯ Scopolamine is an effective medication for prophylactic use in parturients receiving intrathecal morphine while undergoing cesarean delivery. Its use, however, was associated with a higher incidence of side effects such as dry mouth and blurry vision.
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Anesthesia and analgesia · Sep 2007
Randomized Controlled Trial Comparative StudyLocal anesthetics and mode of delivery: bupivacaine versus ropivacaine versus levobupivacaine.
The influence of the labor epidural local anesthetic (LA) on mode of delivery has not been adequately studied. In this study, we sought to determine if there is a difference in mode of delivery among parturients who receive epidural bupivacaine, ropivacaine, or levobupivacaine. ⋯ Bupivacaine, ropivacaine, and levobupivacaine all confer adequate labor epidural analgesia, with no significant influence on mode of delivery, duration of labor, or neonatal outcome.
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Anesthesia and analgesia · Sep 2007
Randomized Controlled TrialContinuous positive airway pressure breathing increases cranial spread of sensory blockade after cervicothoracic epidural injection of lidocaine.
Continuous positive airway pressure (CPAP) increases the caudad spread of sensory blockade after low-thoracic epidural injection of lidocaine. We hypothesized that CPAP would increase cephalad spread of blockade after cervicothoracic epidural injection. ⋯ Applying CPAP during cervicothoracic epidural injection of lidocaine resulted in a more cranial extension of sensory blockade when compared with breathing at ambient pressure.