Regional anesthesia
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Regional anesthesia · Sep 1995
Randomized Controlled Trial Clinical TrialHyperosmolarity does not contribute to transient radicular irritation after spinal anesthesia with hyperbaric 5% lidocaine.
In addition to major neurologic injury, local anesthesia toxicity may also include less severe but more common neurologic side effects. The authors recently observed symptoms suggestive of transient radicular irritation in one third of patients after spinal anesthesia with hyperbaric 5% lidocaine, whereas evidence of neurologic symptoms was lacking with hyperbaric 0.5% bupivacaine. The purpose of this prospective double-blinded study was to evaluate if the high osmolarity of hyperbaric 5% lidocaine solution might contribute to the development of transient radicular irritation. ⋯ The results suggest that transient radicular irritation did not result from the marked hyperosmolarity of the hyperbaric 5% lidocaine. However, because lidocaine and bupivacaine were not administered at equipotent dosages, the relative potential for both drugs to induce transient radicular irritation remains to be determined.
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Regional anesthesia · Sep 1995
Randomized Controlled Trial Clinical TrialIntravenous ketorolac and subarachnoid opioid analgesia in the management of acute postoperative pain.
Ketorolac is a parenteral nonsteroidal anti-inflammatory drug that provides analgesia through a peripheral mechanism. The purpose of this study was to evaluate whether the scheduled administration of intravenous ketorolac improves the analgesia provided by subarachnoid opioids after surgery. ⋯ When used in conjunction with subarachnoid opioids, the scheduled administration of intravenous ketorolac during the first 24 hours after major urologic surgery significantly enhances analgesia and reduces the need for supplemental intravenous opioids without affecting the incidence of side effects. Intravenous ketorolac is a safe and useful adjuvant to subarachnoid opioids in the management of acute postoperative pain.
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Regional anesthesia · Sep 1995
Case ReportsEpidural analgesia in a preeclamptic parturient after normalization of a prolonged bleeding time with DDAVP.
Despite several advantages to the use of epidural analgesia for the management of labor pain in preeclamptic parturients, this procedure is withheld from many such patients owing to associated thrombocytopenia and platelet dysfunction. ⋯ Preeclampsia-induced platelet dysfunction might be corrected with DDAVP: A controlled study is required before its routine use can be advocated.