Acta clinica Croatica
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Acta clinica Croatica · Sep 2022
CLINICAL EFFECTS OF HYPERBARIC LIDOCAINE AND BUPIVACAINE IN SPINAL ANESTHESIA - OUR EXPERIENCE.
Various side effects and complications in the perioperative period can occur with the use of hyperbaric lidocaine and bupivacaine. ⋯ The compared incidence of adverse perioperative clinical effects and complications after administration of hyperbaric lidocaine and bupivacaine in spinal anesthesia was not statistically significant.
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Acta clinica Croatica · Sep 2022
ReviewTHE EFFECT OF REGIONAL VS. GENERAL ANESTHESIA ON THE IMMUNE RESPONSE IN BREAST CANCER SURGERY: A NARRATIVE REVIEW OF THE LITERATURE.
For breast cancer patients, surgery remains the cornerstone in treatment. Perioperative and postoperative period is associated with impaired immune function that can have profound implications for cancer patients in terms of tumor recurrence and metastases. The three main factors include surgery and related neuroendocrine stress response, anesthetic drugs, including opioid analgesics and postoperative pain. ⋯ The level of NK cells' cytotoxicity is inversely proportional to the stage and spread of cancer. Regional anesthesia and its potential beneficial effects on the perioperative immune response and long-term outcome after surgery has been investigated as an alternative to general anesthesia in patients undergoing breast cancer surgery. In this paper, we present a review of literature aimed to assess the impact of regional anesthesia techniques on the immune response in patients undergoing breast cancer surgery and how it compares to general anesthesia.
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The aim of this review article is to introduce a newer approach to multimodal anesthesia. In addition to the usual combination of epidural catheter and general anesthesia as standard techniques in surgical procedures accompanied by intense postoperative pain, we want to encourage reflection on the application of various regional techniques in equally complex surgical conditions. By simply modifying the standard neuraxial technique with a higher thoracic approach, excellent abdominal surgery can be performed to awake the patient. ⋯ It has been confirmed that PVB, ESPB, RLB blocks act on visceral and somatic pain. Therefore, their ultrasound-guided use in laparoscopic and other abdominal surgeries may be useful. With a well-designed fusion of regional techniques in operations of the upper and lower abdomen, it is possible to achieve hemodynamically and respiratory stable anesthesia in an awake patient with reduced postoperative pain.
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Acta clinica Croatica · Sep 2022
ReviewPRO AND CONTRA ON ADJUVANTS TO NEUROAXIAL ANESTHESIA AND PERIPHERAL NERVE BLOCKS.
Modern approach in surgical treatment and in managing acute and chronic pain is nowadays more and more based on the implementation of all possible techniques of regional anesthesia (RA). Local anesthetics (LA) are needed to achieve standard regional anesthesia. Local anesthetics are primarily characterized by time constraints and duration of action, and depending on the amount applied, adverse effects on the cardiac and central nervous system may occur. ⋯ So, their usage is still under a special control. Due to the positive effects shown by drugs from non-opioid adjuvants group (e.g. adrenaline, alpha adrenergic agonists, steroids, magnesium, midazolam, ketamine etc.), indications for their administration broadened. However, there are still some restrains in clinical practice based on the fact that neurotoxicity and demonstration of neurological complications in regional anesthesia haven't been properly researched yet.
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Acta clinica Croatica · Sep 2022
HEMODYNAMIC FUNCTION IN COMPARISON OF TWO TYPES OF LOCAL ANESTHESIA WITH VASOCONSTRICTOR IN DAY SURGERY: RETROSPECTIVE STUDY.
Hemodynamic changes and cardiac arrhythmias are not uncommon in clinical practice, depending on including patient features, surgical treatment and drugs administered. We describe hemodynamic changes developed in young patients, soon after a local infiltration anesthesia in day surgery. ⋯ Measured transitory changes in heart rate and blood pressure after local infiltration of vasoconstrictor anesthetics in healthy patients prior to septorinoplasty and breast augmentation may be induced by endogenous and / or exogenous epinephrine. Bupivacaine solution for local infiltration analgesia reduces hemodynamic disturbances and prolongs analgesic effect. We highlight the need for careful preoperative evaluation, including anxiety assessment and treatment in all patients in day surgery.