Regional anesthesia
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Regional anesthesia · Jul 1995
Randomized Controlled Trial Clinical TrialUltrasound imaging for stellate ganglion block: direct visualization of puncture site and local anesthetic spread. A pilot study.
Stellate ganglion block (SGB) inhibits sympathetic innervation and is a common treatment for reflex sympathetic dystrophy. During the positioning of the needle, there is a risk of injury to the adjacent structures. The aim of the study was to develop an ultrasonographic imaging technique for the performance of SGB. ⋯ Ultrasonographic guided SGB may improve safety and allows the visualization of the local anesthetic depot. Studying the local anesthetic spread might allow the avoidance of side effects as well as typical complications of SGB.
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Regional anesthesia · Jul 1995
Randomized Controlled Trial Clinical TrialEffects of epidural bupivacaine after thoracotomy.
Combinations of bupivacaine and fentanyl are popular for postoperative epidural analgesia. However, there are little data from which to select a rational dose of bupivacaine. The study examined the effects of increasing amounts of epidural bupivacaine on postoperative analgesia, epidural fentanyl consumption, and side effects after thoracotomy. ⋯ The results demonstrate improved analgesia with physiotherapy and significant opioid sparing when 10 and 5 mg/h doses of bupivacaine are used. However, the incidence of orthostasis may be increased with the use of 10 mg/h. Thus, 5 mg/h of epidural bupivacaine (.05% at 10 mL/h) improved analgesia, decreased opioid requirements, and did not have detectable hemodynamic effects.
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Regional anesthesia · Jul 1995
Randomized Controlled Trial Clinical TrialCan pre-emptive interpleural block reduce perioperative anesthetic and analgesic requirements?
The hypothesis that preoperative interpleural block might reduce intraoperative anesthetic and analgesic requirements and modify the intensity of postoperative pain was examined in this double-blind, randomized, saline-controlled study. ⋯ Preoperative interpleural block, during a background isoflurane anesthetic, reduces the hemodynamic response to surgery and the intraoperative anesthetic and analgesic requirements. Preoperative interpleural block with plain bupivacaine results in significant reductions in mean arterial pressure and heart rate, probably related to unilateral sympathetic block and the concomitant use of isoflurane. The timing of interpleural block, that is, pre-emptive versus postoperative, does affect the intensity of postoperative pain or the request for supplementary analgesia.