Articles: analgesia.
-
Cervical epidural anaesthesia (CEA) is a method suitable for regional anaesthesia of the upper extremity. CEA seems useful for postoperative pain relief after surgery in the shoulder region or both upper extremities, especially when the postoperative pain relief must be long lasting (days), and when it is desirable that the patient be able to actively move his affected joints during rehabilitation. Potential side effects of the method are respiratory- and haemodynamic changes. Thus, CEA is inappropriate for patients with severe respiratory disease, and in patients for whom extensive sympathetic block may prove disastrous (e.g. congestive heart failure, hypovolaemia).
-
Complications associated with epidural anaesthesia include accidental intravascular or subarachnoid epidural catheter misplacement resulting in systemic toxicity and total spinal block, respectively. Epidural test doses are used routinely to prevent these events. ⋯ The ability of the epidural test dose to detect subarachnoid injection remains unknown. Studies are needed to determine 1) the reliability of the epidural test dose among different groups of patients, 2) the safety of the test dose, and 3) the incidence of epidural catheter misplacements.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Patient-maintained analgesia with target-controlled alfentanil infusion after cardiac surgery: a comparison with morphine PCA.
The performance of a patient-demand, target-controlled alfentanil infusion system was compared with that of a traditional morphine patient-controlled analgesia (PCA) pump in 120 adult patients after cardiac surgery. Patients were randomized to one of the two PCA systems for their postoperative analgesia in the intensive care unit and pain, nausea and sedation scores were recorded every 4 h for the first 24 h. ⋯ In patients using the alfentanil system the overall median visual analogue pain score was 2.3 (95% Cl 2.3-2.8) compared with 3.0 (95% Cl 2.7-3.2) in those using morphine PCA (P < 0.05), but both systems delivered high-quality analgesia. The two groups did not differ with respect to the overall sedation scores, the frequency of postoperative nausea and vomiting, haemodynamic instability, myocardial ischaemia or hypoxaemia.
-
Clin Obstet Gynecol · Jun 1998
Review Comparative StudyEpidural analgesia for labor: effect on the cesarean birth rate.