European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of EMLA and lidocaine iontophoresis for cannulation analgesia.
Eutectic mixture of local anaesthetic cream and lidocaine iontophoresis are effective in providing analgesia for peripheral venous cannulation with small gauge cannulae in adults and children. The objective of this study was to compare the analgesic efficacy of the two techniques directly in patients using larger cannulae. ⋯ Although lidocaine iontophoresis is effective more quickly than the eutectic mixture of local anaesthetic cream, the superior quality of analgesia produced by the eutectic mixture in this study should be borne in mind if these treatments are used electively.
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Randomized Controlled Trial Comparative Study Clinical Trial
Perispinal analgesia for labour followed by patient-controlled infusion with bupivacaine and sufentanil: combined spinal-epidural vs. epidural analgesia alone.
Combined spinal-epidural is an alternative technique to epidural analgesia for labour, but its benefits are not clearly identified. ⋯ The combined spinal-epidural technique provided more effective analgesia during labour than epidural analgesia alone but offered no other advantage. It induced more adverse effects and this should be considered before routinely using the combined spinal-epidural technique.
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Randomized Controlled Trial Comparative Study Clinical Trial
Do we necessarily need local anaesthetics for venous cannulation? A comparison of different cannula sizes.
This randomized, prospective study was performed to evaluate the efficacy of a subcutaneous local anaesthetic infiltration prior to venepuncture using different cannula sizes. ⋯ Patients profit from a subcutaneous infiltration with mepivacaine 1% prior to intravenous cathetherization only when cannulae of size > or = 16-G are inserted.
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Randomized Controlled Trial Clinical Trial
Effects of S(+) ketamine added to bupivacaine for spinal anaesthesia for prostate surgery in elderly patients.
Intrathecal ketamine as the sole anaesthetic agent has demonstrated a lack of cardiovascular depression that should be of advantage in an elderly population. S(+) ketamine has three-times the analgesic potency of R(-) ketamine and its antinociceptive effects after intrathecal administration in rats are known. We decided to evaluate the effects of intrathecal S(+) ketamine added to a small dose of spinal bupivacaine in elderly patients undergoing transurethral prostate surgery. ⋯ Intrathecal S(+) ketamine administered with a low dose of bupivacaine provides shorter motor and sensory block onset time, shorter duration of action and less motor blockade in elderly males.
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Randomized Controlled Trial Clinical Trial
Clonidine added to bupivacaine enhances and prolongs analgesia after brachial plexus block via a local mechanism in healthy volunteers.
The addition of clonidine to local anaesthetics enhances pain relief after peripheral nerve block, but the site of action is unproven. ⋯ The admixture of clonidine to bupivacaine plus epinephrine prolongs and enhances brachial plexus blockade. Lower clonidine plasma concentrations for block treatment strongly suggest a local effect.