Articles: analgesia.
-
Acta Anaesthesiol. Sin. · Sep 1995
Randomized Controlled Trial Clinical TrialThe effect of intrathecal bupivacaine with combined fentanyl in cesarean section.
The use of neuraxial opioids has gained popularity over the last few years; they may augment the analgesia produced by the local anesthetic through direct binding with the specific spinal receptors. Morphine, a lipophobic opioid, may not be optimal as an intrathecal drug for intraoperative analgesia because of its slow onset. The lipophilic opioid, fentanyl for instance, if administered intrathecally, its onset is fast and many of its merits by virtue of its lipophilic property may be seen intraoperatively. ⋯ The combination of bupivacaine with a dose of fentanyl as low as 7.5 micrograms did not produce actual clinical effects. As the dose of fentanyl was increased to 12.5 micrograms or 15 micrograms the quality of surgical analgesia was better and the postoperative analgesia lasted longer. It seemed that the clinical effect might reach its ceiling at the dose of 12.5 micrograms. Pruritus was the most common side effect, but it was mild.
-
Cervical epidural blockade provides effective regional analgesia in clinical anesthesia and pain clinics. However, the risk for performing cervical epidural block is higher than lumber epidural anesthesia. We studied the distance from the skin to the cervical epidural space to determine whether there is any relationship between patient age, height, body weight, body mass index (BMI) and the distance from the skin to the epidural space. ⋯ These results indicated that body weight and BMI could be a guideline for identification of epidural space during cervical epidural anesthesia.
-
Regional anesthesia · Sep 1995
Case ReportsEpidural analgesia in a preeclamptic parturient after normalization of a prolonged bleeding time with DDAVP.
Despite several advantages to the use of epidural analgesia for the management of labor pain in preeclamptic parturients, this procedure is withheld from many such patients owing to associated thrombocytopenia and platelet dysfunction. ⋯ Preeclampsia-induced platelet dysfunction might be corrected with DDAVP: A controlled study is required before its routine use can be advocated.
-
Regional anesthesia · Sep 1995
Randomized Controlled Trial Comparative Study Clinical Trial0.1% bupivacaine does not reduce the requirement for epidural fentanyl infusion after major abdominal surgery.
Although local anesthesia has been demonstrated to potentiate spinal morphine analgesia in animal studies, results comparing epidural local anesthesia/opioid mixtures with opioid alone are contradictory in clinical studies. The hypothesis was that, although the concentration of bupivacaine (0.1%) was low to minimize its adverse effects, if the infusion rate of a fentanyl/bupivacaine solution was closely adjusted according to need, the presence bupivacaine would reduce the requirement for epidural fentanyl. ⋯ In low concentrations (0.1%), bupivacaine did not reduce the titrated dose of epidural fentanyl required for adequate pain relief during forced inspiration after major abdominal surgery. The incidence and severity of adverse effects were also comparable whether or not low-dose bupivacaine infusion was used.