Regional-Anaesthesie
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Regional-Anaesthesie · Jan 1990
[Experimental studies on peripheral nerve injuries caused by injection needles].
Differences in neural damage due to different injection needles were investigated in vitro on sciatic nerve specimens of adult rabbits. METHODS. Three types of 22-gauge needles were tested: one typical, long-bevelled venous puncture needle; a short bevelled, typical nerve block needle; and a tapered, atraumatic spinal needle. ⋯ Fluorescence microscopy. With the tapered injection needle there was the least leakage of EBA, which suggests the least damage to the perineurium, and almost no rupture or tearing of the nerve fibers was observed. In the short- and long-bevelled needles, the damage was reduced when the face of the bevel was inserted parallel to the fibers.
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Regional-Anaesthesie · Nov 1989
Review[Hemostatic requirements for the performance of regional anesthesia. Workshop on hemostatic problems in regional anesthesia].
There is uncertainty as to which preoperative examinations are necessary before performing regional anesthesia. Therefore an interdisciplinary consensus conference was established to obtain recommendations on some of the open questions related to this topic. Preoperative laboratory examinations are not necessary prior to peripheral nerve blocks near large vessels if these are easy to compress. ⋯ If plasma expanders are administered perioperatively, the highest bleeding risk exists after dextran infusions. There is also an increased bleeding risk if nonsteroidal anti-inflammatory drugs, especially acetylsalicylic acid, are administered repeatedly within 5 days prior to spinal/epidural anesthesia. In these patients preoperative determination of the clotting time appears necessary.(ABSTRACT TRUNCATED AT 250 WORDS)
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Regional-Anaesthesie · Sep 1989
Comparative Study[Mother and child stress parameters during cesarean section with general and peridural anesthesia].
This study compared maternal and fetal stress responses during cesarean section in either general anesthesia (GA) or epidural anesthesia (EA). Ten patients received GA with thiopental induction, intubation, and controlled ventilation with nitrous oxide and oxygen. After delivery, anesthesia was supplemented with fentanyl 0.2-0.3 mg. ⋯ Maternal epinephrine levels were lower under EA and below the normal range (EA 23 pg/ml, GA 77 pg/ml, P = 0.002); levels increased during GA and decreased during EA (P = 0.01). No statistical differences were seen in maternal norepinephrine (EA 206 pg/ml, GA 354 pg/ml). MAP was lower during EA (group levels EA 81 mmHg, GA 95 mmHg, P = 0.0002) and HR was higher during GA (group levels EA 89/min, GA 104/min, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Regional-Anaesthesie · Sep 1989
Case Reports[Subdural location of a catheter. A complication of peridural anesthesia].
A case of an involuntarily placed subdural catheter (between arachnoid and dura) is described. The catheter was thought to be in the epidural space. It was placed at T9/10 in order to achieve postoperative epidural analgesia in a patient with colonic surgery. ⋯ In addition, the symptoms of 'subdural analgesia' vary to a great extent. Therefore, the diagnosis can only be verified by X-ray examination. If patients with epidural analgesia are supervised with care and uncommon dose responses are recognized, subdural catheter placement will not lead to a severe and dangerous situation for the patient.
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Regional-Anaesthesie · Jul 1989
Randomized Controlled Trial Comparative Study Clinical Trial[The effect of the injection speed on the blockade characteristics of hyperbaric bupivacaine and tetracaine in spinal anesthesia].
A lack of uniform methodology used in the assessment of different injection speeds in spinal anesthesia by different authors formed the basis of the current study, which compared under randomized conditions the effects of various injection speeds during intrathecal administration of 4 ml 0.5% hyperbaric bupivacaine or 0.5% hyperbaric tetracaine. MATERIALS AND METHODS. Eighty male ASA Physical Status II and III patients scheduled for transurethral resection of the prostate under spinal anesthesia were selected. ⋯ CONCLUSIONS. The results suggest that 4 ml 0.5% hyperbaric bupivacaine or tetracaine injected at 0.25 or 0.5 ml.s-1 provides a rapid and reproducible spread of analgesia for transurethral surgery. However, our findings suggest that speed of injection is of little i