Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2000
Case ReportsTwo instances of central nervous system toxicity in the same patient following repeated ropivacaine-induced brachial plexus block.
We describe two instances of central nervous system (CNS) toxicity in the same patient following repeated brachial plexus blocks induced by high doses of ropivacaine (6 mg x kg(-1) and 4.5 mg x kg(-1), respectively). Although very high total and free plasma concentrations of ropivacaine were found up to 98 min after induction of the blocks, no signs of cardiovascular toxicity apart from hypertension and sinus tachycardia were observed. ⋯ These high doses, however, resulted in severe toxic CNS symptoms. Therefore, it is stressed that the dose in relation to the weight of the patient must be calculated when administering a large volume of local anesthetic.
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Acta Anaesthesiol Scand · May 2000
Randomized Controlled Trial Comparative Study Clinical TrialRegional anaesthesia for outpatient knee arthroscopy: a randomized clinical comparison of two different anaesthetic techniques.
The purpose of this prospective, randomized study was to evaluate the time required to perform anaesthesia, achieve surgical block and fulfil standardized discharge criteria in outpatients receiving knee arthroscopy with either spinal anaesthesia or combined sciatic-femoral nerve block. ⋯ In patients receiving elective outpatient knee arthroscopy, using a combined sciatic-femoral nerve block with 25 ml of mepivacaine 20 mg ml(-1) and a multiple injection technique results in a slightly longer preoperative time but provides similarly effective anaesthesia with no differences in home discharge times as compared to spinal anaesthesia with 8 mg hyperbaric bupivacaine.
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Acta Anaesthesiol Scand · May 2000
Randomized Controlled Trial Comparative Study Clinical TrialDay-case laparoscopy: a comparison of prophylactic opioid, NSAID or local anesthesia for postoperative analgesia.
The study was aimed to evaluate the analgesic efficacy, postoperative comfort, recovery characteristics and side effects of three different analgesic agents administered prophylactically. ⋯ Tenoxicam 20 mg i.v. was found to be ineffective whereas bupivacaine was superior to other groups in reducing pain and analgesic requirements. Bupivacaine also increased time to first analgesics and obtained better recovery characteristics, underlining its value in prophylactic pain management compared to the other two agents.
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Acta Anaesthesiol Scand · May 2000
Effects of vecuronium and rocuronium in antagonistic laryngeal muscles and the anterior tibial muscle in the cat.
Adequate vocal cord paralysis and full recovery of laryngeal muscle function are important when muscle relaxants are used perioperatively. This study was designed to compare the effects of vecuronium and rocuronium at the vocal cord abductor and adductor muscles and the anterior tibial muscle in cats. ⋯ In cats, the time course of neuromuscular blockade after vecuronium and rocuronium differs in antagonistic laryngeal muscles. The protective laryngeal function of glottis closure recovers later than vocal cord abduction after both vecuronium and rocuronium.
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Acta Anaesthesiol Scand · May 2000
Randomized Controlled Trial Comparative Study Clinical TrialNo difference between bupivacaine in 0.9% and 8% glucose for spinal anaesthesia in small children.
Baricity is one of the most important factors to influence the characteristics of distribution of the local anaesthetic and hence success and spread of the blockade. Bupivacaine is rendered hyperbaric by adding glucose. The effect of differing degrees of hyperbaricity remains to be evaluated. ⋯ These results demonstrate that bupivacaine in 0.9% glucose and in 8% glucose solutions are equally suitable for spinal anaesthesia in small children. Similar success rate, spread and duration of the sensory and motor block are achieved with both baricities of bupivacaine.