Regional anesthesia
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Regional anesthesia · Mar 1996
Randomized Controlled Trial Clinical TrialSpinal anesthesia. Volume or concentration--what matters?
An investigation was made of the effects of volume and concentration of a constant dose of subarachnoid lidocaine on the extent and duration of sensory and motor anesthesia produced, as well as of the lidocaine concentration of the cerebrospinal fluid (CSF) as a function of time. ⋯ A constant 70-mg dose of subarachnoid lidocaine produced the same pinprick level of analgesia, degree of motor block, and duration of spinal anesthesia in spite of being injected over an extremely broad range of concentrations and volumes. Despite the fact that all patients received the same dose of lidocaine, the CSF concentrations at 5, 10, and 15 minutes were different and directly related to the concentration of the solution injected. at 20 minutes, the CSF concentrations were similar in all groups. These results indicate a relatively uniform distribution of lidocaine in the CSF for all solutions tested.
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Regional anesthesia · Mar 1996
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of meperidine and lidocaine for spinal anesthesia for postpartum tubal ligation.
This study compares the anesthetic potency, duration, and side effects of subarachnoid meperidine and lidocaine for postpartum tubal ligation. ⋯ Subarachnoid meperidine and lidocaine both provide adequate anesthesia for postpartum tubal ligation. Meperidine provided longer postoperative analgesia.
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Regional anesthesia · Mar 1996
Randomized Controlled Trial Clinical TrialPreoperative spinal bupivacaine does not reduce postoperative morphine requirement in women undergoing total abdominal hysterectomy.
This study was undertaken to determine whether preoperative spinal anesthesia with local anesthetics would exert a pre-emptive effect on postoperative analgesia by reducing neural afferent stimulation. ⋯ The authors were unable to demonstrate that spinal block with bupivacaine before surgery, as opposed to after surgery, decreased the requirement of morphine in the postoperative period.
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Regional anesthesia · Mar 1996
Clinical TrialEvaluation of epidural sensory block by thermal stimulation, laser stimulation, and recording of somatosensory evoked potentials.
The existence of differential sensory block during epidural analgesia has been confirmed by some authors and disputed by others. This study attempts to elucidate this issue by using quantitative methods for evaluation of sensory block. ⋯ No differential block of small nerve fibers was found during epidural analgesia by Thermotest and argon laser stimulation. Recording of somatosensory evoked potentials did not demonstrate significant difference between responses from the sites with most superficial and with most intense sensory block.
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Regional anesthesia · Mar 1996
Case ReportsHigh spinal anesthesia after epidural test dose administration in five obstetric patients.
A commonly used test dose in parturients receiving continuous lumbar epidural analgesia for labor consists of 3 mL of dextrose-free 1.5% lidocaine with 1:200,000 epinephrine. ⋯ While this test dose appears to be a sensitive indicator of an unexpected subarachnoid catheter, the resulting excessive spinal blocks in these laboring patients raise the question of its safety.