Regional anesthesia
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Regional anesthesia · Nov 1991
Low-dose thoracic epidural anesthesia induces discrete thoracic anesthesia without reduction in cardiac output.
The sensory spread and hemodynamic effects of low-dose thoracic epidural anesthesia were closely studied in 13 elective preoperative patients undergoing thoracotomy. An epidural catheter was inserted at the T4-5 or T5-6 intervertebral space and 5 ml 0.5% plain bupivacaine was injected. Cardiac output was measured by suprasternal Doppler method in all patients and also by thermodilution method with a Swan-Ganz catheter in six subjects. ⋯ Central venous pressure increased gradually and significantly, but within the normal range. Pulmonary vascular resistance slightly decreased in 15 minutes and returned to the control level after endotracheal intubation. Thus, low-dose thoracic epidural anesthesia was associated with minimal cardiovascular changes.
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Regional anesthesia · Nov 1991
Comparative StudyThe effects of epinephrine on the anesthetic and hemodynamic properties of ropivacaine and bupivacaine after epidural administration in the dog.
Ropivacaine is a new local anesthetic that is chemically related to mepivacaine and bupivacaine. Previous laboratory studies have demonstrated that ropivacaine possesses an anesthetic profile similar to that of bupivacaine and has less arrhythmogenic potential. The current study was initiated to compare the hemodynamic and anesthetic effects of epidurally administered 0.75% bupivacaine and 1% ropivacaine, with and without epinephrine (1:200,000), in the dog. ⋯ The addition of epinephrine did not alter onset or duration of sensory or motor block in this animal model. Epinephrine reduced the average anesthetic blood concentration observed in both treatment groups at the various time intervals, but not the time to achieve the mean maximum blood level. No residual adverse effects were observed in any animal.
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Regional anesthesia · Nov 1991
Temperature monitoring during epidural anesthesia for cesarean delivery.
Tympanic, rectal, and axillary temperatures were measured and compared in 12 ASA Physical Status I and II parturients during epidural anesthesia for cesarean delivery. Measurements were performed before (T0) and at 15 (T1), 30 (T2), 45 (T3), and 60 (T4) minutes after epidural anesthesia. At birth, rectal neonatal and maternal temperatures were measured. ⋯ The relative hypothermia observed in the newborns at birth after regional anesthesia was well correlated with the decrease in maternal temperature. A decrease in tympanic temperature of 1.4 degrees C developed during the course of epidural anesthesia for cesarean delivery. This decrease was underestimated by the measurement of rectal and axillary temperatures.