Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2008
The effects of spinal anesthesia with lidocaine and sufentanil on lower urinary tract functions.
Spinal local anesthetics interrupt the micturition reflex; bladder function remains impaired until sensory block had regressed to the S3 segment. Intrathecal opioids cause dose-dependent suppression of detrusor contractility. We studied the effects of spinal anesthesia with a combination of lidocaine and sufentanil on lower urinary tract function. ⋯ Bladder contractility returns much later than recovery of sensory function in sacral dermatomes (S3) when hyperbaric lidocaine combined with sufentanil is used for spinal anesthesia.
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Anesthesia and analgesia · Dec 2008
Elastomeric pump reliability in postoperative regional anesthesia: a survey of 430 consecutive devices.
Postoperative analgesia via continuous perineural infusion of local anesthetics compares favorably with systemic analgesia. Elastomeric pumps increase patient satisfaction compared with electronic models. In in vitro investigations, infusions remained within 15% of their designated set rates. We assessed in vivo the infusion rate of elastomeric pumps in regional analgesia after orthopedic surgery. ⋯ In vivo reliability of elastomeric pumps is different than in vitro. In the event of early insufficient postoperative perineural analgesia, an absence of deflation of the elastomeric pump must be considered. We recommend weighing these devices every 3 h during the first 24 h of infusion.
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Anesthesia and analgesia · Dec 2008
Randomized Controlled Trial Comparative StudyLow volume and high concentration of local anesthetic is more efficacious than high volume and low concentration in Labat's sciatic nerve block: a prospective, randomized comparison.
Various factors markedly affect the onset time and success rate, of peripheral nerve blockade. This prospective, randomized, double-blind study, compared a dose of mepivacaine 300 mg, in a 20 or 30 mL injection volume for sciatic nerve blockade using Labat's posterior approach. ⋯ In Labat's sciatic nerve blockade, administering a low volume and a high concentration of local anesthetic (1.5% mepivacaine) is associated with a higher success rate and a shorter onset time than a high volume and a low concentration of solution (1% mepivacaine).
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Anesthesia and analgesia · Dec 2008
Randomized Controlled TrialThe transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy.
Patients undergoing total abdominal hysterectomy suffer significant postoperative pain. The transversus abdominis plane (TAP) block is a recently described approach to providing analgesia to the anterior abdominal wall. We evaluated the analgesic efficacy of the TAP block in patients undergoing total abdominal hysterectomy via a transverse lower abdominal wall incision, in a randomized, controlled, double-blind clinical trial. ⋯ The TAP block, as a component of a multimodal analgesic regimen, provided superior analgesia when compared to placebo block up to 48 postoperative hours after elective total abdominal hysterectomy.