Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Sep 1998
Randomized Controlled Trial Comparative Study Clinical TrialComparison of intravenous nalbuphine infusion versus naloxone in the prevention of epidural morphine-related side effects.
Epidural morphine is accepted as an efficient means of postoperative pain management. However, development of side effects such as nausea and vomiting and pruritus has been reported. This study compared the efficacy of intravenous infusions of nalbuphine or naloxone in the prevention of epidural morphine-related side effects. ⋯ We found that coadministration of either nalbuphine or naloxone with epidural morphine reduces the incidence of morphine-related side effects. However, unlike naloxone, nalbuphine did not attenuate the analgesic effect of epidural morphine.
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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.