Acta anaesthesiologica Sinica
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Acta Anaesthesiol. Sin. · Jun 1997
Case ReportsPneumocephalus and respiratory depression after accidental dural puncture during epidural analgesia--a case report.
A case of pneumocephalus and respiratory depression after dural puncture during lumbar epidural analgesia is reported. The loss of resistance to air technique was employed to identify the epidural space. ⋯ We suggest that in order to avoid iatrogenic pneumocephalus by inadvertent dural puncture in the attempt to identify the epidural space the use of the loss of resistance to normal saline technique or the hanging-drop technique is more reliable than the loss of resistance to air technique. A small test dose prior to a full dose is given and should not be omitted to further confirm the proper placement of the epidural catheter during epidural analgesia.
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Acta Anaesthesiol. Sin. · Jun 1997
Intravenous infusion of low dose propofol for conscious sedation in cesarean section before spinal anesthesia.
Conscious sedation, not affecting the safety of both mother and fetus, is especially favorable in anxious patients undergoing Cesarean delivery. However, when sedation is started before performing intrathecal anesthesia, the infusion time before delivery will be prolonged. In this study, the incidence of maternal and fetal complications under propofol infusion were evaluated as well as the blood concentrations of propofol during delivery at different time of sedation. ⋯ Conscious sedation by low dose propofol infusion is safe for both mother and fetus in spite of longer infusion time.
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Acta Anaesthesiol. Sin. · Jun 1997
Randomized Controlled Trial Clinical TrialThe preemptive effect of pre-incisional bupivacaine infiltration on postoperative analgesia following lower abdominal surgery under epidural anesthesia.
In attempts to reduce central sensitization after tissue injury, the concept of preemptive analgesia has evolved. The aim of the present study was to evaluate the preemptive effect of pre-incisional infiltration of the surgical area with bupivacaine on pain following lower abdominal surgery under epidural anesthesia. ⋯ The results indicate that pre-incisional infiltration of surgical area with bupivacaine markedly decreases the intensity of pain following lower abdominal surgery under epidural anesthesia.
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Acta Anaesthesiol. Sin. · Jun 1997
Case ReportsDyspnea resulting from phrenic nerve paralysis after interscalene brachial plexus block in an obese male--a case report.
Phrenic nerve paralysis is a common complication in interscalene brachial plexus block. This complication is often ignored by most anesthesiologists because no clinical symptoms occur in patients who have no underlying lung disease. ⋯ The decreased respiratory reserve and direct compressing effect of the abdominal organs on the diaphragm in the supine position are thought to be the risk factors in this obese patient. Also discussed are the incidence, diagnostic methods, clinical presentation and treatments of phrenic nerve paralysis during interscalene brachial plexus block.
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Acta Anaesthesiol. Sin. · Jun 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of epidural butorphanol plus clonidine with butorphanol alone for postoperative pain relief.
Epidural butorphanol has been shown to produce effective analgesia with less side effects than that of morphine but relatively short duration. Clonidine, an alpha 2-adrenergic agonist, has been reported to provide [corrected] pain relief by epidural administration. Furthermore, epidural clonidine has been shown to potentiate the analgesic effect of epidural morphine. The present study was undertaken to evaluate the analgesic and side effects of epidural administration (Ep) of butorphanol and clonidine. ⋯ Our study showed that the addition of clonidine to epidural butorphanol did not enhance its analgesic effect in any significant manner nor did it reduce the adverse effects. This combination does not seem to offer any advantage for clinical use.