Medical science monitor : international medical journal of experimental and clinical research
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Randomized Controlled Trial
Combined spinal epidural analgesia for labor with and without 3 ml of 1.5% epidural lidocaine.
Lidocaine is used as a 'test dose' to detect misplacement of epidural catheters. When administered immediately after the initiation of a combined spinal epidural for labor analgesia, it was found to interfere with motor function. The authors hypothesized that an epidural test dose of 3 ml of 1.5% lidocaine injected immediately after the initiation of combined spinal epidural analgesia and followed by a continuous epidural infusion would prolong the duration of analgesia and decrease the incidence of breakthrough pain. ⋯ The administration of epidural lidocaine and saline immediately after intrathecal levobupivacaine 2.5 mg and fentanyl 25 microg did not reduce the incidence of breakthrough pain in combined spinal epidural labor.
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The current view holds that gastric emptying is effected by the force of the antral peristaltic wave squeezing food particles through pyloric sphincter resistance. Whether this is accomplished by a reflex action was investigated. ⋯ Pyloric sphincter relaxation upon antral distension implies a reflex relationship the authors call the "antro-sphincteric inhibitory reflex". Pyloric sphincter distension effected antral contraction, which is suggested to be a reflex in nature and which they term the "sphinctero-antral excitatory reflex". It is postulated that these two reflexes act to churn and transport gastric contents to the duodenum.