Der Anaesthesist
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Peripartum care of parturients has contributed a great deal to the development of modern anaesthesia during the past 150 years. The introduction of general and regional anaesthesia provided new options of relieving pain during delivery and preventing suffering. ⋯ Using the MLAC model as a scientifically based pharmacodynamic measure of analgesia, empirically developed "recipes" can be compared and validated. The importance of this clinical model will be put into a pharmacological context including issues such as the up-down sequential allocation technique, dose-response curves and differential nerve blockade.
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Case Reports Comparative Study
[Cesarian section and local anaesthesia: insufficient spread of spinal anaesthesia with hyperbaric bupivacaine 0.5%/5% glucose compared to hyperbaric bupivacaine 0.5%/8% glucose?].
In our hospital hyperbaric Carbostesin 0.5% (AstraZeneca) had been substituted by hyperbaric Bucain 0.5% (Curasan) and both drugs were believed to be identical in their actions. However, both local anaesthetics differ in the amount of glucose they contain. ⋯ The third patient received the normally used combination of hyperbaric Carbostesin 0.5% and fentanyl and the subarachnoid block proceeded completely uneventfully. According to the literature the clinical efficacy of hyperbaric Carbostesin 0.5% and hyperbaric Bucain 0.5% should be identical and therefore a critical dilution of the Bucain should not have occurred because of the addition of fentanyl.
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Case Reports
[Transient neurologic symptoms after spinal anesthesia with 4% hyperbaric mepivacaine].
This is a case report of transient neurologic symptoms (TNS) after spinal anesthesia with 4% hyperbaric mepivacaine,which have not been reported before. The patient was a 44-year-old man with a meniscus lesion who received spinal anesthesia with 80 mg 4% mepivacaine while undergoing knee arthroscopy. A L3-L4 mid-line approach was used with a 26-gauge Quincke needle and a 21-gauge introducer. ⋯ The pain was described as strong and aching,occasionally decreasing when walking around. It responded well to NSAID and resolved spontaneously within 3 days. No other neurologic symptoms or signs were noted.