Regional anesthesia
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Regional anesthesia · Mar 1995
Randomized Controlled Trial Comparative Study Clinical TrialAddition of bicarbonate to plain bupivacaine does not significantly alter the onset or duration of plexus anesthesia.
In an effort to elucidate further the effect of alkalinization of bupivacaine on its anesthetic effect, a study was undertaken using alkalinized and non-alkalinized bupivacaine for lumbar plexus block and comparing the results with those obtained previously with brachial plexus block. ⋯ The data obtained in the present study indicate that alkalinization of non-epinephrine-containing bupivacaine does not reduce the latency or increase the duration of analgesia or anesthesia after lumbar plexus block. Since most of the studies that do show such an effect of alkalinization were carried out using epinephrine-containing bupivacaine, it is postulated that in those studies alkalinization contributed to the decrease in latency and increase in duration, not so much by providing an increased amount of local anesthetic in the free base form, but by reactivating epinephrine's vasoconstrictor activity, which is inactivated by a low pH.
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Regional anesthesia · Mar 1995
Randomized Controlled Trial Clinical TrialAlkalinization of mepivacaine improves the quality of motor block associated with interscalene brachial plexus anesthesia for shoulder surgery.
Interscalene block has produced appropriate anesthesia for shoulder surgery. Success is partly determined by the quality of motor block achieved. This study was designed to evaluate the influence of alkalinization of mepivacaine on the quality of motor block achieved with interscalene brachial plexus anesthesia. ⋯ Alkalinization of mepivacaine improves the quality of motor block after interscalene brachial plexus block for shoulder surgery.
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Regional anesthesia · Mar 1995
Comparative Study Clinical TrialHypnosis as adjunct therapy in conscious sedation for plastic surgery.
Sedation is often requested during local and regional anesthesia. However, some surgical procedures, such as plastic surgery, require conscious sedation, which may be difficult to achieve. Hypnosis, used routinely to provide conscious sedation in the authors' Department of Plastic Surgery, results in high patient and surgeon satisfaction. The authors conducted a retrospective study to investigate the benefits of hypnosis in supplementing local anesthesia. ⋯ Successful hypnosis as an adjunct sedation procedure to conscious intravenous sedation provided better pain and anxiety relief than conventional intravenous sedation and allowed for a significant reduction in midazolam and alfentanil requirements. Patient satisfaction was significantly improved.
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Regional anesthesia · Mar 1995
Clinical TrialCompartment block for foot surgery. A new approach to tibial nerve and common peroneal nerve block.
The concept of single injections of local anesthetics into fascial compartments was pioneered by Winnie in reports on paravascular techniques. Winnie described an axillary approach for brachial plexus block and the inguinal route for lumbar plexus block. The compartmental principle can, with advantage, be extended to more peripheral anesthesia of the tibial and common peroneal nerves by the use of osteofascial compartments in the leg. ⋯ Further studies of compartmental anesthesia for other nerve trunks and plexuses may be of value.
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Regional anesthesia · Mar 1995
Randomized Controlled Trial Comparative Study Clinical TrialSpinal anesthesia for cesarean delivery. A comparison of two doses of hyperbaric bupivacaine.
Hyperbaric local anesthetic pools in the thoracic spinal curvature in supine patients. The authors hypothesized that patients receiving 12 or 15 mg of hyperbaric bupivacaine would achieve similar levels of sensory block but the spinal anesthetic would be denser and longer lasting in patients receiving the 15 mg dose. ⋯ Parturients receiving 15 mg of hyperbaric bupivacaine developed a higher mean level and longer duration of sensory analgesia than those receiving 12 mg.