Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 1998
Randomized Controlled Trial Clinical TrialIntrathecal sufentanil and epidural bupivacaine for labor analgesia: dose-response of individual agents and in combination.
Combinations of local anesthetics and opioids are frequently used during spinal and epidural analgesia for the relief of labor pain. This combination allows for a dose-sparing effect which may reduce potential side effects or toxicity. The precise nature of the interaction between opioids and local anesthetics in the clinical setting, i.e., additivity versus synergism, has not been established. This trial was designed to utilize a validated technique of analysis of drug interactions, isobolography, to investigate this interaction. ⋯ Markedly reduced doses of these drugs in combination can be used to provide adequate analgesia during labor compared with either single drug alone.
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Reg Anesth Pain Med · Sep 1998
Randomized Controlled Trial Clinical TrialAnalgesic effect of interscalene block using low-dose bupivacaine for outpatient arthroscopic shoulder surgery.
Although interscalene brachial plexus block (ISBPB) is often used to provide anesthesia for arthroscopic shoulder surgery, its selective analgesic effect, provided by low-dose local anesthetic, has not been studied. We hypothesized that ISBPB using a low volume and low concentration of bupivacaine can provide effective postoperative analgesia for shoulder surgery without producing significant sensory or motor block elsewhere. ⋯ Interscalene brachial plexus block with low-dose bupivacaine is a useful and selective analgesic technique for outpatient shoulder arthroscopic surgery.
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Reg Anesth Pain Med · Sep 1998
Comparative toxicity of glucose and lidocaine administered intrathecally in the rat.
Glucose is a common component of anesthetic solutions used for spinal anesthesia. However, its possible contribution to recent injuries occurring with spinal anesthesia has not been adequately addressed. Accordingly, the present studies compare the functional and morphologic effects of intrathecally administered glucose with those of lidocaine. ⋯ These results suggest that, at clinically relevant concentrations, glucose does not induce neurologic injury, providing indirect evidence that recent clinical injuries occurring after spinal anesthesia resulted from a neurotoxic effect of the local anesthetic. Additionally, the present studies suggest that deficits resulting from neurotoxicity of intrathecally administered anesthetic result from injury to the axon.