Revista brasileira de anestesiologia
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Rev Bras Anestesiol · Feb 2005
[Preemptive analgesia with epidural bupivacaine and S(+)ketamine in abdominal hysterectomy.].
This study investigates the ability of epidural S(+)ketamine, NMDA receptor antagonist, plus local anesthetic (bupivacaine) injection to promote preemptive analgesia in patients undergoing total abdominal hysterectomy, when this solution is administered before surgical incision. ⋯ This study failed to demonstrate a preemptive effect of epidural administration of bupivacaine and S(+)ketamine in the doses tested for abdominal hysterectomy.
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In addition to their major influence on human behavior, opium and opioids have been used for a long time as sedative and analgesic drugs. As from the 19th century, with the isolation of opium alkaloids and easy parenteral administration of these substances, there has been increased interest in the judicious medical use of opioids and in the analysis of social consequences of their abuse, which has justified a historical review of opium and opioids. ⋯ In the dawning of the third millennium, regardless of studies with analgesic drugs of different pharmacological groups, opioids are still the most potent analgesics, although their efficacy has been questioned for some types of pain. Current Clinical Pharmacology knowledge allows for the selection of the opioid based on patient's disease and conditions, in the search for the best cost-benefit ratio.
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Rev Bras Anestesiol · Feb 2005
[Comparison of transarterial and multiple nerve stimulation techniques for axillary block using lidocaine with epinephrine.].
High-dose transarterial technique results in highly effective axillary block. The multiple nerve stimulation technique (MNS) requires more time and experience. This prospective study aimed at comparing onset and success rate of multiple-injection axillary brachial plexus block using two methods of nerve location: transarterial or multiple nerve stimulation technique. ⋯ Both MNS technique for axillary block with nerve stimulator (3 injections) and transarterial technique (2 injections) promote similar results. Musculocutaneous nerve is more easily blocked with the aid of peripheral nerve stimulator. MNS technique has required less supplementary blocks and has delayed beginning of surgery.
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Rev Bras Anestesiol · Feb 2005
[Analgesic efficacy of dexmedetomidine as compared to sufentanil in intraperitoneal surgeries: comparative study.].
Dexmedetomidine, alpha2-adrenergic agonist with alpha1:alpha2 specificity of 1:1620, does not promote respiratory depression and is intraoperatively used for sedation and analgesia. It has been used associated to opioids in anesthesia for procedures with high painful stimulation, such as intraperitoneal surgeries, and there are no references to its use as single agent. Dexmedetomidine was compared to sufentanil during intraperitoneal procedures in patients above 60 years of age. ⋯ Dexmedetomidine may be used as single analgesic for intraperitoneal procedures in patients above 60 years of age, promoting hemodynamic stability similar to sufentanil, with better recovery profile.