Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 1995
ReviewHuman albumin and colloid fluid replacement: their use in general surgery.
This review considers the pharmacology and indications for use of human albumin and synthetic colloids in general and transplantation surgery. The selection of a particular agent should be based on sound knowledge of their pharmacokinetic and pharmadynamic properties together with some consideration of cost. ⋯ The duration of their effect in the intravascular space and their properties for plasma volume substitution or expansion are the main factors that will influence their selection. Albumin solutions, however, remain useful for treatment of all acute situations of hypovolemia accompanied by hypoalbuminemia during and after surgery.
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Acta Anaesthesiol Belg · Jan 1995
Clinical Trial Controlled Clinical TrialEvaluation of morphine for patient controlled analgesia with the Infusor system after opiate-free locoregional anesthesia for osteotomy of the foot.
Efficacy and safety of a PCA protocol, without loading dose or background infusion, was investigated in 40 consenting patients after osteotomy of the foot. All patients had intrathecal lidocaine 5% 1.8 ml preoperatively. Postoperative pain relief was provided with morphine from a Baxter Travenol infusor with PC module. ⋯ Sweating and itching were less frequently reported. The occurrence of the side effects was the highest during the first postoperative day. We conclude that even when morphine is used in PCA without loading dose or background infusion after opiate-free locoregional analgesia, close monitoring is necessary for at least 5 hours.
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Acta Anaesthesiol Belg · Jan 1995
Case ReportsContinuous cervical intrathecal administration of morphine with a new infusion pump, the Anschütz IP 35.1: a case report.
The continuous intrathecal administration of low-dose morphine is an effective treatment for chronic neuropathic pain. Several implantable devices can be used for such treatments but they all have limitations. In this case report we opted for a new type of implantable pump, the Anschütz, for the combined cervical intrathecal administration of morphine and clonidine in a patient with severe cervicobrachialgia.
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Acta Anaesthesiol Belg · Jan 1995
Motor blockade and absence of local nerve toxicity induced by liposomal bupivacaine injected into the brachial plexus of rabbits.
Bupivacaine has been encapsulated into multilameller liposomes in order to reduce its systemic toxicity and to lengthen its action. Low, constant and sustained plasma levels have been observed after epidural injection and brachial plexus administration to rabbits. The present experiment was performed in order to study the motor block effect and the possible neurotoxicity of bupivacaine encapsulated in multilamellar liposomes applied in vivo to intact peripheral nerve bundles. ⋯ Light microscopic analyses of the nerves after 2 and 7 days revealed weak inflammatory perineural infiltration. Electron microscopy showed no changes of the myelin sheaths and no alteration of unmyelinated fibers. It may be concluded that the pharmacologically active liposomal formulation of bupivacaine did not induce alterations of the nerve tissues.