Regional-Anaesthesie
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Regional-Anaesthesie · Jan 1991
Randomized Controlled Trial Clinical Trial[The effect of 6% (40/0.5) hydroxyethyl starch and Ringer's lactate on blood coagulation, laboratory parameters and circulation during peridural anesthesia].
We investigated the effects of 6% hydroxyethyl starch (HES 40/0.5) and lactated Ringer solution (LRS) on blood coagulation tests and laboratory parameters during epidural anesthesia. Additionally, the efficacy of this prophylactic intravenous fluid supply in preventing sympathetic blockade induced hypotension was studied. METHODS. ⋯ The temporary increase in plasma volume after infusion of 6% HES 40/0.5 results in a greater hemodilution with a concomitant decrease of blood viscosity and improved microcirculation flow. These might be of interest in prevention of thromboembolic complications. The specific effects of the two solutions were also determinable during epidural blockade.
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Regional-Anaesthesie · Nov 1990
[The blood level and a pharmacokinetic model of prilocaine during a continuous brachial plexus blockade].
Continuous brachial plexus blockade achieved by repeated injections through an axillary catheter is used increasingly often for microsurgical procedures and for postoperative pain relief. Repetitive administration, especially of long-acting agents, can cause problems with local anesthetic toxicity. Based upon a pharmacokinetic analysis of prilocaine serum concentrations after single-dose axillary plexus blockade in 14 patients, a pharmacokinetic model was established from which to predict serum concentrations after successive doses. ⋯ Methemoglobinemia resulting from metabolites of prilocaine did not lead to complications in our study. It may, however, be a problem with repetitive dosages. Further investigations concerning this question would be useful.
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Regional-Anaesthesie · Sep 1990
Randomized Controlled Trial Clinical Trial[No effect of injection volume on sensory and motor blockade in isobaric spinal anesthesia].
The authors were interested to find whether the course of sensory and motor blockade in isobaric spinal anesthesia was determined by the dose or the volume of the anesthetic agent. In a randomized double-blind study in 60 patients, each underwent isobaric spinal anesthesia with 17.5 mg bupivacaine. In three groups of 20 patients, this dose was administered as 3.5 mg bupivacaine 0.5%, 7 ml bupivacaine 0.25% or 10 ml bupivacaine 0.175%. ⋯ The rate of development, the maximal spread or intensity, and the regression of sensory and motor blockade did not differ in the three groups. The only difference was that the complete regression was shorter following 10 ml bupivacaine 0.175% (P less than 0.05). It is therefore concluded that the dose, and not the volume, determines the course of sensory and motor blockade of isobaric spinal anesthesia.