Regional anesthesia
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Regional anesthesia · Mar 1990
Randomized Controlled Trial Comparative Study Clinical TrialAlkalinization of 0.5% lidocaine for intravenous regional anesthesia.
Although remaining a controversial issue, alkalinization of lidocaine or bupivacaine may shorten the time to onset and increase the duration of the sensory block. The aim of this study was to evaluate the effect of pH adjustment on the sensory and motor blocks during intravenous regional anesthesia (IVRA) with lidocaine. Thirty-one patients scheduled for minor hand surgery performed under IVRA were randomized into two groups: Group 1 (n = 14): 1% lidocaine, 3 mg/kg, diluted with the same volume of physiological saline solution (pH = 6.63 +/- 0.05), and Group 2 (n = 17): 1% lidocaine, 3 mg/kg, diluted with the same volume of 1.4% sodium bicarbonate (pH = 7.34 +/- 0.05). final concentration of lidocaine was thus 0.5% in both groups. ⋯ This maneuver was performed before and every 2 minutes after injection. No statistical differences were found between the two groups whatever the parameter studied. In conclusion, there is no advantage (over plain solutions) to using pH-adjusted lidocaine during IVRA for hand surgery.
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Regional anesthesia · Mar 1990
Use of hyperbaric bupivacaine with epinephrine for spinal anesthesia in infants.
Previous studies have established the efficacy of spinal anesthesia in infants with hyperbaric lidocaine, hyperbaric tetracaine and isobaric and hyperbaric bupivacaine. Use of the commercially available hyperbaric spinal anesthesia solution of 0.75% bupivacaine in 8.25% dextrose has not heretofore been documented in this patient population. We present a series of 12 cases in which this hyperbaric bupivacaine solution with epinephrine was used for spinal anesthesia in children younger than 8 months of age.
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Regional anesthesia · Mar 1990
Randomized Controlled Trial Comparative Study Clinical TrialComparative effects of subarachnoid hyperbaric bupivacaine and tetracaine-procaine for cesarean delivery.
Hyperbaric solutions of 0.75% bupivacaine (8.25% dextrose), and 1% tetracaine mixed with an equal volume of 10% procaine were compared in a double-blind study of 22 parturients undergoing elective cesarean delivery and spinal anesthesia. The onset of sensory anesthesia and motor block was similar in the two groups. The maximal level of sensory anesthesia to pinprick was significantly higher after the use of the tetracaine-procaine mixture. ⋯ The incidence of hypotension was higher in those patients receiving the tetracaine-procaine mixture as indicated by the use of significantly higher total doses of ephedrine to maintain baseline blood pressure in this group. No differences in Apgar scores or blood gases were noted between the two groups of patients. This study suggests that hyperbaric 0.75% bupivacaine offers certain advantages over hyperbaric tetracaine-procaine when used in equal volumes for spinal anesthesia cesarean delivery.