Regional anesthesia
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Regional anesthesia · Jul 1992
Comparative StudyFentanyl and lidocaine versus lidocaine for Bier block.
The present study was designed to assess the efficacy of fentanyl combined with dilute lidocaine solution for intravenous regional anesthesia of the arm. ⋯ Results of this and other studies indicate there is no value in adding fentanyl to local anesthetics for intravenous regional anesthesia.
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During performance of epidural injection, entry into the epidural space has traditionally been determined by identification of negative pressure to the advancing needle by indirect means such as hanging drop; loss of resistance to air, saline, or water; or use of a MacIntosh balloon. Confusion in the literature regarding entry pressures versus postentry (baseline) pressures and zero reference pressure was noted. ⋯ Lumbar epidural pressure is greater than atmospheric pressure when referenced to zero at the dorsal spine level.
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Regional anesthesia · May 1992
Randomized Controlled Trial Comparative Study Clinical TrialComparison of sufentanil, bupivacaine, and their combination for epidural analgesia in obstetrics.
We postulated that epidural sufentanil alone would provide adequate analgesia for labor and delivery. We also considered the possibility that a combination of epidural sufentanil and bupivacaine would demonstrate superior analgesia and fewer side effects when compared with either agent alone. ⋯ Epidural sufentanil alone does not reliably provide satisfactory analgesia for labor and delivery. Addition of small amounts of local anesthetic to bolus doses of sufentanil enhances and prolongs the analgesic effect.
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Regional anesthesia · May 1992
Randomized Controlled Trial Clinical TrialEffect of epidural analgesia on colorectal anastomotic healing and colonic motility.
To examine the effect of epidural local anesthetic and narcotic agents on colonic anastomotic healing. ⋯ These findings suggest in this model that postoperative epidural analgesia is a safe technique after colorectal resection and anastomosis.
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Regional anesthesia · May 1992
A dual-chambered syringe that allows identification of the epidural space using the loss of resistance technique with air and with saline.
Each of the two most widely used techniques for identification of the epidural space, the loss of resistance technique with air and the loss of resistance technique with liquid, has certain advantages and disadvantages. A new syringe is described that has two chambers, one to contain air and the other to contain liquid, to combine the advantages of air with the advantages of liquid, and to prevent the disadvantages of each. ⋯ The successful use of the EpIdent syringe in this preliminary study of 20 patients indicates that it provides a simple, safe, and effective means of identifying the epidural space. It allows the use of a plastic syringe (instead of glass) and avoids the unpleasant or untoward effects associated with currently used loss of resistance techniques.