Regional anesthesia
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Regional anesthesia · Mar 1991
An electronic device (Episensor) for detection of the interpleural space.
Complications associated with interpleural block are often related to difficulty with needle and catheter placement. Thus there exists need for refinement of the puncture technique. We present our initial experience identifying the interpleural space with a new electronic detector (Episensor, Palex, Spain) that is sensitive to negative pressure. ⋯ Pain relief during the 48-hour observation period was good. Supplemental analgesia was required in nine nephrectomy patients. We believe the Episensor may be a valuable adjunct to the initiation of interpleural anesthesia.
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Regional anesthesia · Mar 1991
Cardiovascular and central nervous system effects of co-administered lidocaine and bupivacaine in piglets.
The toxic profile of bupivacaine (1 mg/kg/minute) when administered intravenously alone or with lidocaine (1 mg/kg loading dose, then 1 mg/kg/minute) was examined in 12 2-day-old pigs anesthetized with 70% N2O/30% O2 and paralyzed with 0.15 mg/kg pancuronium. Bupivacaine doses producing arrhythmias, seizures, isoelectric EEG and asystole were about 24% lower in the lidocaine plus bupivacaine group (n = 6) than in the bupivacaine group (n = 6). However, the incidence of cardiac arrhythmias in the combination local anesthetic group (3/6) was half that in the bupivacaine group (6/6). Administration of lidocaine with bupivacaine under conditions of this study apparently reduces the risk of cardiac arrhythmias and acts along with bupivacaine to produce seizures, cerebral depression (isoelectric EEG) and asystole.