Regional anesthesia
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Regional anesthesia · Sep 1996
Clinical TrialAnalgesic efficacy and side effects of subarachnoid sufentanil-bupivacaine administered to women in advanced labor.
Previous studies of labor analgesia using subarachnoid sufentanil (alone or with adjuvants) have focused on women in the early first stage of labor. This study prospectively evaluated analgesia and side effects of subarachnoid sufentanil (10 micrograms) plus bupivacaine (2.5 mg) in parturients with cervical dilation of 7 cm or more. ⋯ In parturients with cervical dilation of 7 cm or more, subarachnoid sufentanil-bupivacaine produces rapid analgesia with an effective duration of approximately 130 minutes.
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Regional anesthesia · Sep 1996
Case ReportsContinuous spinal anesthesia for cesarean delivery in a patient with arthrogryposis multiplex congenita. A clinical report.
Arthrogryposis multiplex congenita (AMC) is a syndrome, diagnosed at birth, which presents with multiple joint contractures. Because this disease often progresses until there is dysfunction of multiple organ systems, it may have an impact on the anesthetic management. There are few anesthetic reports of this disease in the adult pregnant patient. ⋯ Continuous spinal anesthesia can be safely used for cesarean delivery in patients with AMC in the presence of appropriate monitoring.
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Regional anesthesia · Sep 1996
Clinical TrialSpinal clonidine fails to provide surgical anesthesia for transurethral resection of prostate. A dose-finding pilot study.
This study was designed to determine whether subarachnoid clonidine administration alone results in surgical anesthesia for transurethral resection of the prostate. ⋯ Subarachnoid clonidine cannot be reliably used as the sole agent for spinal anesthesia, since general anesthesia is often required or deep sedation occurs. Increasing doses of clonidine do not prolong postoperative analgesia. Thus, clonidine could be used as a spinal analgesic but not as a spinal anesthetic.
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Regional anesthesia · Sep 1996
A multivariate model to predict the distance from the skin to the epidural space in an obstetric population.
Several attempts to relate epidural space depth to individual patient parameters or details of technique have yielded modest correlations. An attempt has been made to construct a multivariate model to predict the depth from the skin of the epidural space with use of several such factors. ⋯ While this model is the best predictor of epidural space depth yet published, it is probably not sufficiently accurate to be clinically useful in confirming proper epidural catheter placement. Further work in this area is probably not justified.
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Regional anesthesia · Sep 1996
Subarachnoid bupivacaine increases human cerebrospinal fluid concentration of serotonin.
Serotonin (5-hydroxytryptamine [5-HT]) has antinociceptive properties at the spinal level. Activation of descending serotonergic neurons or topically applied 5-HT at the spinal cord inhibits rostral spread of sensory information. Epidural anesthesia has been shown to increase 5-HT in plasma, and local anesthetics may interfere with 5-HT reuptake and metabolism. For these reasons, the action of subarachnoid local anesthetics on cerebrospinal fluid (CSF) 5-HT concentrations has been studied. ⋯ Subarachnoid bupivacaine increases local 5-HT concentration. This may have implications for nociceptive gating as well as for local vasoregulation.