Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 1997
Randomized Controlled Trial Comparative Study Clinical TrialIntravenous regional anesthesia. Evaluation of 4 different additives to prilocaine.
Intravenous regional anesthesia (IVRA) is an effective method of producing anesthesia of the extremities. Disadvantages are the rapid loss of anesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. This study compared the effect of four different additives to prilocaine with saline on the development of a complete sensory block, on the return of sensory function after deflation of the tourniquet and on the development of postoperative pain after IVRA for minor orthopedic surgery of the arm. ⋯ The development of a complete sensory block proved significantly faster in the patients receiving sufentanil (4.8 min.) as compared to plain prilocaine (7.5 min.). The return of the sensory function was comparable for all groups. Postoperative pain scores were significantly better in the clonidine and tenoxicam groups.
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Pharmacokinetic and dynamic drug description aim to optimize drug dosing to a desired duration and intensity of effect. In anesthesia practice the therapeutic window is narrow and versatile. Rapid adjustments and rapid reversal of drug effect are mandatory. ⋯ Hysteresis in the concentration-affect relationship is responsible for the lag time between plasma drug concentration and effect. Hysteresis delays initiation of effect as well as recovery from effect. The development of microprocessor aided infusion devices will simplify and ameliorate to a significant extend, the sound application of intravenous drugs in anesthesia.
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Acta Anaesthesiol Belg · Jan 1997
Historical ArticleTowards a new chronology of ether anesthesia in Europe.
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Acta Anaesthesiol Belg · Jan 1997
Randomized Controlled Trial Clinical TrialTenoxicam does not enhance the spread of sensory block produced by intrathecal lidocaine.
Systemic opioids enhance the spread of spinal analgesia. This study was designed to determine whether i.v. tenoxicam, a nonsteroidal anti-inflammatory drug (NSAID), affects the spread of sensory block produced by lidocaine. Sixty patients undergoing transurethral procedures were randomly assigned in a double blind design to receive i.v. either 3 ml normal saline (N/S group, n = 20), or 150 micrograms fentanyl (F group, n = 20), or 40 mg tenoxicam (T group, n = 20), 20 minutes after spinal anesthesia. ⋯ The overall change in the level of sensory block 15 minutes after i.v. treatment was -4.6 +/- 6.3 cm in the N/S group, 2.4 +/- 6.0 cm in the F group, and -1.6 +/- 5.8 cm in the T group. The F group differed from the N/S group (P < 0.01). Intravenous administration of tenoxicam does not enhance the level of spinal analgesia produced by lidocaine.