Medical science monitor : international medical journal of experimental and clinical research
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Randomized Controlled Trial Clinical Trial
Intrathecal labor analgesia using levobupivacaine 2.5 mg with fentanyl 25 microg--would half the dose suffice?
This randomized, double-blinded, controlled trial of 40 patients in early labor was conducted to determine whether a reduction in the total amount of intrathecal levobupivacaine and fentanyl would reduce the incidence of motor blockade and pruritus, respectively. ⋯ A reduction in the intrathecal dose of 2.5 mg levobupivacaine with 25 microg fentanyl by half is an option for CSE in labor because it can reduce the incidence of motor impairment. Although the reduced dose does not differ significantly from the full dose with respect to onset, duration, and quality of analgesia for the majority of parturients, it must be highlighted that insufficient labor analgesia may occur in certain individuals. In this respect, further studies related to dosage of intrathecal levobupivacaine in obstetric labor analgesia will be beneficial in substantiating this point.
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Randomized Controlled Trial Comparative Study Clinical Trial
The sciatic nerve block in emergency settings: a comparison between a new anterior and the classic lateral approaches.
Anterior and lateral approaches to the sciatic nerve block are performed with the patient in the supine position. This could be an important advantage when mobilization to the limb involved is limited or painful, particularly in emergency conditions. The aim of this prospective, randomized study was to compare these two sciatic nerve blockades performed in an emergency setting. ⋯ These data suggest that both techniques are of similar value in an emergency setting.
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Multicenter Study
A prospective study of the incidence of agranulocytosis and aplastic anemia associated with the oral use of metamizole sodium in Poland.
Metamizole is a common analgesic and antipyretic drug. However, its use has been associated with a risk of side-effects involving agranulocytosis and aplastic anemia. These reactions are rare and unpredictable. The aim of this prospective study was to evaluate the risks of these complications in Poland, where this medication is available without prescription. ⋯ Considering the consumption of 112,300,094 tablets of metamizole in Poland a year, the figures obtained result in an incidence of 0.25 cases of aplastic anemia per 1 million persons per day of treatment; this value being less than that for other nonsteroidal anti-inflammatory drugs. Nevertheless, caution is recommended in the application of metamizole, particularly over long periods and in large doses.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of intrathecal levobupivacaine with and without fentanyl in combined spinal epidural for labor analgesia.
The initiation of epidural infusion immediately after intrathecal (IT) injection to prolong labor analgesia has gained increasing popularity. The effect of additional intrathecal fentanyl on levobupivacaine for labor analgesia has not been fully investigated. We wished to determine if addition of IT fentanyl to IT levobupivacaine in combined spinal epidural (CSE) could prolong obstetric analgesia when epidural infusion is initiated promptly. ⋯ The addition of 25 microg intrathecal fentanyl to 2.5 mg levobupivacaine as part of CSE for labor analgesia decreased the incidence of labor breakthrough pain and resulted in a longer duration of labor pain relief. This may decrease the need for supplemental labor pain relief and the anesthetists' workload in the delivery suite.