Regional anesthesia
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Regional anesthesia · Jul 1992
Randomized Controlled Trial Clinical TrialThe addition of epinephrine to subarachnoid administered hyperbaric bupivacaine with fentanyl for cesarean delivery: the effect on onset time.
This study examines the effect of epinephrine on the time to achieve a T4 sensory level when added to a hyperbaric bupivacaine-fentanyl mixture for spinal anesthesia. ⋯ The onset time to T4 is related inversely to patient weight, and epinephrine (100 micrograms and 200 micrograms) delays the onset of sensory block to T4 when administered with subarachnoid hyperbaric bupivacaine-fentanyl.
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Regional anesthesia · Jul 1992
Comparative StudyChronotropic and inotropic effects of ropivacaine, bupivacaine, and lidocaine in the spontaneously beating and electrically paced isolated, perfused rabbit heart.
The purpose of this study was to compare the inotropic and chronotropic effects of ropivacaine, bupivacaine, and lidocaine in an isolated, spontaneously beating rabbit heart preparation. The ability to electrically pace the heart in the presence of local anesthetic also was examined. ⋯ The results of this study indicate that bupivacaine is more cardiodepressant and arrhythmogenic than either ropivacaine or lidocaine.
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Regional anesthesia · Jul 1992
Indirect sonographic guidance for epidural anesthesia in obese pregnant patients.
Obesity and edema frequently obscure anatomic landmarks and result in technical difficulties during epidural anesthesia administration. However, the method of indirect sonographic guidance permits identification of the midline by sagittal scan of the laminae of lumbar vertebrae 2, 3, and 4. ⋯ Needle depth was measured by marker and measure, and epidural anesthesia was successfully administered to all patients. Simple linear regression analysis was performed with strong positive results. Indirect and continuous sonographic guidance studies designed to determine whether sonography reduces complications are planned.
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Regional anesthesia · Jul 1992
Hemodynamic changes associated with tourniquet use under epidural anesthesia for total knee arthroplasty.
Epidural anesthesia is administered commonly for total knee arthroplasty, a procedure using a thigh tourniquet. Tourniquet use has been associated with intraoperative hypertension and with occasional circulatory collapse after deflation. The purpose of this study was to define the hemodynamic changes in this setting. ⋯ In this setting, tourniquet-induced hypertension is rare. However, hypotension after deflation is common, occurs rapidly, and correlates poorly with clinical parameters.
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Regional anesthesia · Jul 1992
Comparative StudyHemodynamic effects of continuous spinal anesthesia: a comparative study between low and high doses of bupivacaine.
Arterial hypotension is a major side effect of spinal anesthesia. Continuous spinal anesthesia may allow titration of the amount of local anesthetic to obtain a level that is appropriate for the surgical procedure. ⋯ Continuous spinal anesthesia with small amounts of 0.125% plain bupivacaine produces effective anesthesia for orthopedic procedures in elderly patients with minimal hemodynamic changes.