Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Sep 2003
Randomized Controlled Trial Comparative Study Clinical TrialHemodynamic and blockade effects of high/low epinephrine doses during axillary brachial plexus blockade with lidocaine 1.5%: A randomized, double-blinded study.
Although epinephrine commonly is added to local anesthetics for regional anesthesia, rarely it may cause undesirable hemodynamic side effects. This study compared the hemodynamic and blockade effects of 25 and 200 microg epinephrine during axillary brachial plexus blockade with lidocaine 1.5%. ⋯ Low-dose epinephrine offers more stable hemodynamics and similar blockade, and thus may be beneficial for patients undergoing forearm and hand surgery who are at risk for tachycardia and/or hypertension.
-
Reg Anesth Pain Med · Sep 2003
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of levobupivacaine 0.5% and racemic bupivacaine 0.5% for extradural anesthesia for caesarean section.
Bupivacaine is available as a racemic mixture of its enantiomers, dextrobupivacaine and levobupivacaine. Both in vitro and in vivo studies show that dextrobupivacaine has a greater inherent central nervous system (CNS) and cardiovascular toxicity than levobupivacaine. Clinical studies show levobupivacaine to have similar local anesthetic potency to the racemate. The aim of this study was to investigate the clinical efficacy and safety of levobupivacaine compared with racemic bupivacaine for extradural anesthesia. ⋯ Levobupivacaine produces an extradural block that is similar to bupivacaine, and is a suitable local anesthetic agent for caesarean delivery.
-
Reg Anesth Pain Med · Sep 2003
Randomized Controlled Trial Clinical TrialNo anesthetic or analgesic benefit of neostigmine 1 mg added to intravenous regional anesthesia with lidocaine 0.5% for hand surgery.
Neostigmine has shown analgesic benefit when used as an adjunct to epidural or intrathecal anesthesia and analgesia, but evidence of benefit in the peripheral nervous system is controversial. This study aimed to determine if neostigmine 1 mg added to intravenous regional anesthesia (IVRA) provided any advantage in terms of intraoperative anesthesia or postoperative analgesia. ⋯ Neostigmine 1 mg provides no anesthetic or analgesic advantage when added to IVRA for upper limb surgery.
-
Reg Anesth Pain Med · Sep 2003
Comparative StudyPortable infusion pumps used for continuous regional analgesia: delivery rate accuracy and consistency.
Multiple benefits of postoperative perineural local anesthetic infusion have been shown including potent analgesia, decreased opioid requirements, and improved rehabilitation. Consequently, portable infusion pumps have been used with increasing frequency to provide perineural infusion for medically unsupervised ambulatory patients. We believe that the infusion rate accuracy and reliability of these pumps infusing potentially toxic doses of medication should be investigated independently. Therefore, we studied the flow-rate accuracy and consistency of various portable infusion pumps that have not been examined previously. ⋯ Factors such as infusion rate accuracy and consistency, infusion profile, temperature sensitivity, and battery life affect the dose of medication administered by various portable pumps used for continuous regional analgesia. Health care providers should take these factors into consideration when choosing and using a portable infusion pump for local anesthetic administration.