Regional anesthesia
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Regional anesthesia · Sep 1995
Randomized Controlled Trial Comparative Study Clinical TrialPain relief for thoracotomy. Comparison of morphine requirements using an extrapleural infusion of bupivacaine.
The effectiveness of a continuous infusion of extrapleural bupivacaine for relief of postoperative pain was assessed in patients undergoing posterolateral thoracotomy under general anesthesia by comparing morphine requirements. ⋯ Continuous extrapleural infusion of bupivacaine through unkinkable catheters sited during thoracotomy resulted in decreased intravenous patient-controlled analgesia use and decreased verbal categoric pain scores at rest and during movement.
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Regional anesthesia · Sep 1995
Randomized Controlled Trial Clinical TrialWrapping of the legs reduces the decrease in blood pressure following spinal anesthesia. A study in men undergoing urologic procedures.
Hypotension after induction of spinal anesthesia remains a common and a potentially serious complication despite acute expansion of intravascular volume. The current study evaluated the role of leg wrapping as an adjunct to acute volume expansion. ⋯ Tightly wrapping the legs with elastic bandages immediately after placing spinal anesthesia in mature men is a safe and efficient adjunct in preventing hypotension.
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Regional anesthesia · Sep 1995
Randomized Controlled Trial Comparative Study Clinical Trial0.1% bupivacaine does not reduce the requirement for epidural fentanyl infusion after major abdominal surgery.
Although local anesthesia has been demonstrated to potentiate spinal morphine analgesia in animal studies, results comparing epidural local anesthesia/opioid mixtures with opioid alone are contradictory in clinical studies. The hypothesis was that, although the concentration of bupivacaine (0.1%) was low to minimize its adverse effects, if the infusion rate of a fentanyl/bupivacaine solution was closely adjusted according to need, the presence bupivacaine would reduce the requirement for epidural fentanyl. ⋯ In low concentrations (0.1%), bupivacaine did not reduce the titrated dose of epidural fentanyl required for adequate pain relief during forced inspiration after major abdominal surgery. The incidence and severity of adverse effects were also comparable whether or not low-dose bupivacaine infusion was used.