Regional-Anaesthesie
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Regional-Anaesthesie · Jan 1991
Randomized Controlled Trial Clinical Trial[The effect of continuous thoracic peridural anesthesia on the pulmonary function of patients undergoing colon surgery. Results of a randomized study of 116 patients].
In a prospective randomized clinical investigation, we examined the influence of continuous thoracic epidural analgesia (TEA) on pulmonary function and pathologic chest X-ray findings. METHODS. One hundred sixteen patients having resection and/or anastomosis of the colon participated in this study; 57 were randomly assigned to the epidural group, whereas 59 were given systemic analgesia. ⋯ There was no difference in pO2 at any time. The number of pathologic chest X-ray findings showed no difference between both groups. Looking especially for infiltrates, dystelectasis, atelectasis, and congestion, we also could not demonstrate any difference between the groups. (ABSTRACT TRUNCATED AT 400 WORDS)
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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 Comparative Study Clinical Trial[The effect of barbotage on the sensory spread in spinal anesthesia using isobaric and hyperbaric 0.5% bupivacaine].
The effect of spinal anesthesia with barbotage versus without barbotage on the spread of analgesia was investigated. For comparison, hyper- and isobaric bupivacaine 0.5% with adrenaline 1:200,000 was used. MATERIAL AND METHODS. ⋯ Sufficient analgesia was obtained with barbotage and without barbotage. Uncontrolled cephalad spread of spinal anesthesia was not observed. Barbotage has the advantage of shortening time for spread to highest dermatome and the time to onset of complete motor block.
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Regional-Anaesthesie · Sep 1990
[In electric nerve stimulation can the distance from the nerves be inferred from the intensity of muscle contraction? Possible parameters and sources of error].
Electrical nerve stimulation is a useful tool in regional anesthesia; it assists in locating the nerves. This investigation deals with electrical resistances at adhesive electrodes attached to the skin. The influence of external electrical resistance on the stimulating impulse is demonstrated. ⋯ Axillary puncture of the brachial plexus resulted in the following values: (1) A stimulating impulse (cross-wave) of 1 mA and 1 ms exerted at a distance of 4 mm to the nerve induced a contraction of strength 3. (2) Reducing the impulse at this site by one-half (0.55 mA) resulted in just-visible contractions (strength 1). (3) Advancing the cannula at a stimulating impulse of 0.55 mA inside the neurovascular sheath again produced contractions of strength 3. (4) Performing the puncture with a blunt needle and tracing a distinct resistance, the impulse of 0.6 mA elicited contractions of strength 2. The needle tip was still outside the vascular nerve sheath. If this resistance was overcome and the needle tip lay inside the neurovascular sheath, the impulse could be reduced by one-half (0.32 mA) to produce contractions of strength 2.