Regional anesthesia
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Regional anesthesia · Nov 1997
Randomized Controlled Trial Clinical TrialSingle-shot spinal anesthesia with small doses of bupivacaine.
The potential risks of spinal lidocaine have generated interest in an alternative local anesthetic solution. Features of anesthetic block were therefore assessed in a double-blind randomized prospective study following administration of spinal bupivacaine in small doses. ⋯ Hyperbaric bupivacaine 6-8 mg provides a suitable alternative to spinal lidocaine for surgical procedures of short duration.
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Regional anesthesia · Nov 1997
ReviewProgress in the development of ultra-long-acting local anesthetics.
Local anesthetic agents with a duration of action longer than the currently available local anesthetics could have widespread clinical application for the treatment of both chronic and acute pain. Over the last several decades, several different approaches have been used in the development of ultra-long-acting agents. There are currently promising preparations in development which may prove clinically useful in the near future. ⋯ Although encouraging results have been reported in the literature, there is currently no agent or delivery system that has shown reliable and practical prolongation of local anesthetic effect in humans. There have been several encouraging reports in animals that have shown local anesthetic effects lasting up to several days, but these results must be validated and then performed in human studies before a clinically useful agent is found. Further research is warranted.
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Regional anesthesia · Nov 1997
Randomized Controlled Trial Clinical TrialA low-dose hypobaric bupivacaine spinal anesthesia for knee arthroscopies.
Ambulatory surgery requires anesthesia methods that allow rapid recovery and safe discharge of the patient. Spinal anesthesia is easy and quick to perform, and the use of noncutting small gauge needles reduces the occurrence of postdural puncture headache. For minimal hemodynamic consequences and faster recovery and discharge it would be optimal to limit the spread of spinal anesthesia only to the area which is necessary for surgery. In this study, the possibility in achieving unilateral spinal anesthesia with 0.18% hypobaric bupivacaine was studied. ⋯ Approximately three and a half milliliters hypobaric 0.18% bupivacaine (6.12 mg) provides a predominantly unilateral spinal block. Thirty minutes spent in the lateral position does not provide benefits over 20 minutes. The main advantages of our method are the hemodynamic stability and the patient satisfaction.