Articles: analgesia.
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Case Reports
Thoracic epidural anaesthesia and analgesia with bupivacaine for transsternal thymectomy for myasthenia gravis.
The present study describes the management of a myasthenic patient undergoing transsternal thymectomy for whom thoracic epidural anaesthesia using 15 mL of bupivacaine 0.5% combined with isoflurane 0.4% and nitrous oxide in oxygen 50% provided good intra-operative relaxation followed by an uneventful recovery and eliminated the need for other post-operative analgesics.
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Randomized Controlled Trial Comparative Study Clinical Trial
Baricity, needle direction, and intrathecal sufentanil labor analgesia.
Intrathecal sufentanil relieves labor pain but centrally mediated side effects are common. Preventing rostral spread of intrathecal sufentanil should limit these side effects. Both direction of the lateral opening of a pencil-point needle and drug baricity modify the spread of intrathecal local anesthetics. This randomized, prospective, double-blind study examines the effects of these variables on intrathecal sufentanil labor analgesia. ⋯ Little or no labor analgesia developed for patients receiving sufentanil with dextrose. A supraspinal action may contribute to intrathecal sufentanil's analgesic efficacy.
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Randomized Controlled Trial Clinical Trial
Addition of epinephrine to intrathecal bupivacaine and sufentanil for ambulatory labor analgesia.
The intrathecal combination of sufentanil and bupivacaine provides rapid, effective analgesia for labor with a limited duration. Many anesthesiologists have concerns that the use of intrathecal local anesthetics precludes maternal ambulation. This prospective, randomized, double-blind study was designed to determine whether the addition of epinephrine to the combination of sufentanil and bupivacaine would prolong intrathecal analgesia for labor. Patients' ability to ambulate was also assessed. ⋯ The addition of 0.2 mg epinephrine to the intrathecal combination of sufentanil and bupivacaine significantly prolonged labor analgesia without causing adverse effects to the mother or fetus. The intrathecal combination of sufentanil and bupivacaine, with or without epinephrine, provided rapid, profound labor analgesia and allowed most patients to ambulate.