Regional anesthesia
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Regional anesthesia · May 1994
Comment Letter Clinical TrialThoracic paravertebral block in chronic postoperative pain.
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Regional anesthesia · May 1994
Randomized Controlled Trial Comparative Study Clinical TrialComparison of patient-assisted epidural analgesia with continuous-infusion epidural analgesia for postoperative patients.
Patient-assisted epidural analgesia, a mode of epidural analgesic delivery in which self-administered epidural boluses supplement a baseline continuous epidural infusion, was compared to continuous epidural infusion in 62 postsurgical patients. ⋯ Patient-assisted epidural analgesia can provide superior pain control as compared to continuous epidural infusions while also reducing opioid dosages. Despite the reduction in total analgesic administered no reduction in side effects was seen with this mode of administration.
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Regional anesthesia · May 1994
Randomized Controlled Trial Comparative Study Clinical TrialEffects of combined perioperative epidural bupivacaine and morphine, ibuprofen, and incisional bupivacaine on postoperative pain, pulmonary, and endocrine-metabolic function after minilaparotomy cholecystectomy.
The study investigates the effects of combined perioperative continuous epidural bupivacaine and morphine, ibuprofen, and incisional bupivacaine, compared with intermittent systemic morphine, ibuprofen, and incisional bupivacaine, on postoperative pain, respiratory function, and endocrine-metabolic alterations associated with minilaparotomy cholecystectomy. ⋯ Epidural analgesia for minilaparatomy cholecystectomy improves pain relief in the immediate postoperative period, compared to intramuscular morphine. Pulmonary and endocrine-metabolic function is not changed to such degree after minicholecystectomy that epidural analgesia can be demonstrated to have beneficial effects.
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Regional anesthesia · May 1994
Comment Clinical Trial Controlled Clinical TrialEvaluation of brachial plexus anesthesia for upper extremity surgery.
Brachial plexus anesthesia is the preferred anesthetic at the authors' institution for upper extremity surgery. The article is a prospective observational evaluation of brachial plexus anesthesia for surgical success of the block and immediate and postoperative complications. ⋯ Both interscalene and axillary blocks are safe and effective techniques for upper extremity surgery.
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Regional anesthesia · May 1994
Clinical TrialAnalysis of heart rate dynamics as a measure of autonomic tone in obstetrical patients undergoing epidural or spinal anesthesia.
The purpose of this study is to determine if spectral analysis of beat-to-beat heart rate variability will provide important data on autonomic nervous system function during either spinal or epidural anesthesia that is not apparent from the monitoring of mean heart rate and blood pressure. ⋯ These data suggest that autonomic tone decreased with spinal and epidural anesthesia but the sympathetic-parasympathetic balance (expressed as PLF/PHF) did not change. Spectral measures, as well as approximate entropy, provide an independent evaluation of the integrity of the autonomic nervous system and cardiovascular control mechanisms that cannot be discerned from mean heart rate and blood pressure.