Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jul 2001
The effect of distance from injection site to the brainstem using spinal sufentanil.
Intrathecal (IT) sufentanil is commonly used in parturients to provide rapid onset of labor analgesia without motor block. This practice, although widely used, has been associated with severe respiratory depression in some patients. The mechanism of this respiratory depression is unclear, however, rapid cephalad movement and interaction with parenteral opioids are 2 frequently cited explanations for this complication. Because this complication has occurred only in women with heights between 150 and 157 cm, we elected to study the effect of the distance from injection site to the cisterna magna (CM) on peak brainstem cerebrospinal fluid (CSF) concentrations. ⋯ Our results suggest that sufentanil migrates relatively large distances in the IT space. Injection site (distance from the brainstem) appears to be a prominent factor in determining brainstem concentrations and subsequent respiratory depression after spinal administration. Reg Anesth Pain Med 2001;26:306-309.
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Reg Anesth Pain Med · Jul 2001
Addition of clonidine increases duration and magnitude of vasodilative effect induced by sympathetic block with mepivacaine in dogs.
The aim of this study is to examine the duration and magnitude of vasodilative effect induced by sympathetic block with the addition of clonidine to mepivacaine. ⋯ The addition of clonidine increases both duration and magnitude of the vasodilative effect induced by sympathetic block over that caused by mepivacaine alone.