Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Nov 1991
[Hemodynamic repercussion of epidural bupivacaine in thoracic injuries].
Systemic and pulmonary hemodynamic effects of 8 to 10 ml of 0.25% bupivacaine containing 1:200,000 adrenaline administered at the midthoracic level were prospectively assessed in 20 patients (aged 45 +/- 16 years) with thoracic trauma presenting 6 +/- 2 rib fractures and pulmonary contusion of different extent and radiologic density. The study was carried out at comparable evolving times, 24 h after trauma, during the second or third day of treatment, and when the hemodynamic stability of the patient was achieved. ⋯ The results indicate that administration of moderate doses of epidural bupivacaine at the middle thoracic level in patients with normovolemic thoracic traumatism were not followed by alterations in the hemodynamic function except for a slight decrease in systemic arterial and pulmonary pressure. The mean arterial pressure decreased by 8% (p less than 0.05), the cardiac index showed a 4% reduction (p = 0.05), and the mean pulmonary pressure experienced a 14% decrease (p less than 0.05).
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Rev Esp Anestesiol Reanim · Nov 1991
Letter Case Reports[Unexpected heart arrest under epidural anesthesia].
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Rev Esp Anestesiol Reanim · Nov 1991
Comparative Study[Continuous epidural perfusion of morphine and bupivacaine for post-thoracotomy analgesia. Comparison between thoracic and lumbar epidural analgesia].
Relief of postoperative pain and the incidence of side effects occurring after continuous epidural infusion of morphine and bupivacaine were evaluated in patients undergoing a thoracotomy. We also studied the relevance of a close proximity of the epidural catheter to the metameric segment were the pain originated. The study involves 17 patients divided into two groups. ⋯ The epidural perfusion was interrupted in only one patient of TG due to the presence of arterial hypotension. The association of narcotics and local anesthetics in continuous epidural perfusion was an excellent method for achieving pain relief with minimum side effects. We conclude that both thoracic and lumbar epidural routes are advisable for post-thoracotomy pain relief.