Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 2001
Randomized Controlled Trial Clinical TrialAddition of fentanyl to bupivacaine prolongs anesthesia and analgesia in axillary brachial plexus block.
To evaluate the analgesic and anesthetic effects of 40 mL bupivacaine 0.25%, 40 mL bupivacaine 0.25% plus fentanyl 2.5 microg/mL, and 40 mL bupivacaine 0.125% plus fentanyl 2.5 microg/mL for axillary brachial plexus block. ⋯ The addition of 100 microg/mL fentanyl to 0.25% bupivacaine almost doubles the duration of analgesia following axillary brachial plexus block when compared with 0.25% bupivacaine alone.
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Reg Anesth Pain Med · Sep 2001
Maternal satisfaction and pain control in women electing natural childbirth.
Many women who choose natural childbirth for labor ultimately request epidural analgesia to control labor pain. Unfortunately, parturients and family members may often be unprepared for epidural anesthesia, which can contribute to disappointment and dissatisfaction with their labor and delivery. This study examines how epidural analgesia for labor influences maternal satisfaction in women who initially choose natural childbirth. ⋯ This study examined the influence of epidural analgesia in parturients electing natural childbirth. Pain relief alone was not found to improve maternal satisfaction. This study highlights the importance of experience and prelabor expectations on maternal satisfaction with childbirth.
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Reg Anesth Pain Med · Sep 2001
Randomized Controlled Trial Clinical TrialEffect of systemic adenosine on pain and secondary hyperalgesia associated with the heat/capsaicin sensitization model in healthy volunteers.
Adenosine is an endogenous compound that may have analgesic effects. Results from clinical trials are not consistent, however, and there is a need for large-scale, randomized, placebo-controlled studies to clarify the role of adenosine in the treatment of pain states, including acute nociceptive pain and pain involving central sensitization. ⋯ We conclude that adenosine has no effect on acute nociceptive pain induced by heat stimulation or on secondary hyperalgesia induced by heat/capsaicin sensitization in healthy volunteers.
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Reg Anesth Pain Med · Sep 2001
Randomized Controlled Trial Clinical TrialIntrathecal labor analgesia with bupivacaine and sufentanil: the effect of adding 2.25 microg epinephrine.
Epinephrine, 25 microg and 200 microg, has been found to prolong the duration of intrathecal labor analgesia when added to an opioid. In our hospital we use the standard epidural mixture, prepared by the pharmacist, containing epinephrine 1:800,000; i.e., 1.25 microg/mL for both spinal and epidural labor analgesia. We wanted to evaluate whether such a low dose, depending on its effect on duration or quality of analgesia, should be maintained or deleted in future mixtures. ⋯ It was concluded that epinephrine in a dose as low as 2.25 microg significantly prolonged the duration of intrathecal analgesia of bupivacaine-sufentanil by 15 minutes. No other differences were noticed. Diluting the commercially available bupivacaine 0.5% with epinephrine 1:200,000 may avoid the need of freshly prepared epinephrine solutions.
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Reg Anesth Pain Med · Sep 2001
Randomized Controlled Trial Clinical TrialSuccess rate of unilateral spinal anesthesia is dependent on injection flow.
The dependence of unilateral spinal anesthesia on injection flow is controversial. We hypothesized that it is possible to achieve strictly unilateral sympathetic block (as assessed by temperature measurements of the limbs) and unilateral sensory and motor block, respectively, during spinal anesthesia by a slow and steady injection of a hyperbaric local anesthetic solution. ⋯ For hyperbaric spinal anesthesia, the injection flow is an important factor in achieving unilateral sympathetic block. A slow injection proves useful to restrict spinal anesthesia to the side of surgery.