Regional anesthesia
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Regional anesthesia · Jan 1990
Randomized Controlled Trial Clinical TrialEphedrine as a marker of intravascular injection in laboring parturients.
Thirty healthy laboring parturients were randomly chosen to receive either normal saline (NS), ephedrine 10 mg (EPH-10), or ephedrine 15 mg (EPH-15) intravenously. Changes in maternal heart rate and blood pressure and fetal heart rate were monitored. ⋯ There was no adverse fetal outcome. Transient fetal tachycardia was seen in three fetuses in the EPH-15 group.
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Regional anesthesia · Jan 1990
Case ReportsAnesthetic management of a parturient with myotonia dystrophica: a case report.
We report the case of a 22-year-old parturient with myotonia dystrophica. She underwent two separate intraabdominal surgical procedures in one day, both under lumbar epidural anaesthesia. Management was directed toward prevention of shivering, a known trigger of myotonic crises. Measures used included warm ambient atmosphere, warmed IV fluids, warming blankets and administration of epidural sufentanil, an opioid recently ascribed as an inhibitor of shivering in parturients.
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Regional anesthesia · Nov 1989
Randomized Controlled Trial Comparative Study Clinical TrialMaternal analgesia and neonatal effects of epidural sufentanil for cesarean section.
This study was designed to evaluate the maternal intraoperative and postoperative analgesia and neonatal effects of adding sufentanil to epidural anesthesia for cesarean section before the skin incision. Forty-five multipara were randomized in three equal groups to receive sufentanil 80 micrograms, 50 micrograms, or saline with the epidural lidocaine. Intraoperative and postoperative analgesia and side effects were recorded. ⋯ Postoperative analgesia was prolonged after sufentanil, but side effects increased with the greater dose. The infants whose mothers received 80 micrograms sufentanil showed a mild neurobehavioral depression. It is therefore concluded that the addition of 50 micrograms of sufentanil improves both intraoperative and postoperative analgesia without significant neonatal effects.
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Regional anesthesia · Nov 1989
Randomized Controlled Trial Comparative Study Clinical TrialBrachial plexus block with opioids for postoperative pain relief: comparison between buprenorphine and morphine.
The effectiveness of buprenorphine and morphine, administered into the brachial plexus sheath, was evaluated in 40 patients, aged 18-90 years. All patients received 40 ml of 0.5% bupivacaine, injected into the brachial plexus sheath using the supraclavicular technique. In addition, the 20 patients in Group I received morphine hydrochloride (50 micrograms/kg), while the 20 patients in Group II received buprenorphine hydrochloride (3 micrograms/kg). ⋯ A significant difference in the quality of analgesia was found; and was consistently superior with buprenorphine as compared with morphine. The duration of analgesia was nearly twice as long in the buprenorphine group as in the morphine group (35.05 +/- 1.95 hour versus 18.25 +/- 1.15 hour). We conclude that buprenorphine injection into the brachial plexus sheath is an efficient way to assure control of postoperative pain after upper limb surgery.
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Regional anesthesia · Nov 1989
Randomized Controlled Trial Clinical TrialEffect of diluting fentanyl on epidural bupivacaine during labor analgesia.
In a randomized prospective study carried out on 60 laboring primiparous parturients, fentanyl 80 micrograms, either in 2 ml or in 8 ml, was added to 12 ml of 0.25% bupivacaine administered epidurally for pain relief. The aims of this protocol were to evaluate the effect of varying the volume of fentanyl added to epidural bupivacaine on the quality and duration of labor analgesia. ⋯ The incidence of pruritus was higher in the fentanyl-diluted group (43% versus 23%). No clinical advantage was found in this study, therefore, when fentanyl 80 micrograms was added to 0.25% bupivacaine.