Anesthesia and analgesia
-
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.
-
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.
-
Anesthesia and analgesia · May 1987
Comparative StudyThe pattern of train-of-four fade after atracurium: influence of different priming doses.
This study was designed to investigate the effect of three different priming doses of atracurium--0.06, 0.07, and 0.08 mg/kg--followed 3 min later by the remainder of a 0.5 mg/kg dose on the relationship between the depression in the first twitch of the train-of-four (T1) and train-of-four (TOF) fade. This relationship was studied after the administration of the full dose of the relaxant in all groups. ⋯ Acceleration of the onset of neuromuscular blockade was, however, evident in all groups that received atracurium in divided doses. The implication is, therefore, that prejunctional activity may not contribute significantly to the acceleration of onset of neuromuscular blockade after administration of atracurium in divided doses, as described in this study.
-
Anesthesia and analgesia · May 1987
Comparative StudyPrior carotid surgery does not affect the reliability of landmarks for location of the internal jugular vein.
Twenty-one volunteer subjects who had undergone prior carotid endarterectomy (CEA) agreed to an ultrasound study of the neck. The transducer was held as one would hold a cannulating needle and ultrasound images were obtained of the great vessels in the neck. Each of two cannulating techniques was simulated on each side of every patient's neck. ⋯ These data show that prior CEA does not affect the location of the IJV. Tissue alterations or adhesions may render actual IJV cannulation more difficult or risky. The data suggest but do not prove that prior CEA may not increase the incidence of CA puncture under clinical conditions.