Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Apr 1997
Peripheral neurologic deficits in relation to subarachnoid or epidural administration of local anesthetics for surgery. A survey of 21 cases.
Recent case reports have suggested that subarachnoid or epidural administration of local anesthetics may cause peripheral neurologic deficits. ⋯ This database study does not contain complete information for the cases reported, and a causal relationship between subarachnoid or epidural administration of local anesthetics and neurologic deficits therefore remains uncertain. The increase in the number of reports on lidocaine after the introduction of very fine-bore spinal needles is consistent with the suspicion that lidocaine at the concentration 50 mg/ml is neurotoxic and that it may not be diluted rapidly enough in the cerebrospinal fluid when injected through such needles.
-
Acta Anaesthesiol Scand · Apr 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of continuous epidural infusion of fentanyl and bupivacaine with intermittent epidural administration of morphine for postoperative pain management in children.
The aim of this study was to compare epidural infusion of bupivacaine and fentanyl and intermittent epidural morphine with regard to analgesic effect, and incidence and severity of side effects in children undergoing major abdominal or genito-urological surgery in order to improve the postoperative pain management of children. ⋯ Continuous epidural infusion of fentanyl and bupivacaine was found to be superior to intermittent epidural morphine. The initial regimen should be fentanyl 2 micrograms/ml and bupivacaine 1.0 mg/ml infused at a rate of 0.25 ml.kg-1.h-1.
-
Acta Anaesthesiol Scand · Apr 1997
Randomized Controlled Trial Clinical TrialTramadol in the treatment of postanesthetic shivering.
As an inhibitor of the reuptake of serotonin and norepinephrine in the spinal cord, the mechanism of action of tramadol resembles that of nefopam, which has been used in the treatment of postanesthetic shivering. ⋯ Tramadol's distinct features in the treatment of shivering reside in its high safety profile and weak sedative properties, particularly in patients with poor cardiorespiratory reserve, in outpatients and on recurrence of shivering.
-
Acta Anaesthesiol Scand · Apr 1997
Randomized Controlled Trial Clinical TrialThe haemodynamic effects of rocuronium and vecuronium are different under balanced anaesthesia.
Rocuronium has been reported to have minimal haemodynamic effects. However, this conclusion has been drawn primarily from investigations conducted under narcotic-based anaesthesia. This study was designed to evaluate the cardiovascular effects of rocuronium under isoflurane/N2O/fentanyl anaesthesia and to compare rocuronium's haemodynamic effects to those of vecuronium and pancuronium. ⋯ The haemodynamic effects of rocuronium and vecuronium are different under balanced anaesthesia. Rocuronium may attenuate the fall in MAP that often occurs under balanced anaesthesia without surgical stimulation.
-
Acta Anaesthesiol Scand · Apr 1997
Randomized Controlled Trial Clinical TrialPreoperative infiltration of bupivacaine--effects on pain relief and trauma response (cortisol and interleukin-6).
Subcutaneous infiltration of bupivacaine before skin incision can reduce postoperative pain and modulate the stress response. ⋯ Preoperative subcutaneous infiltration of bupivacaine significantly reduced the postoperative consumption of intravenous morphine.