Articles: analgesia.
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Regional anesthesia · May 1992
Randomized Controlled Trial Comparative Study Clinical TrialComparison of sufentanil, bupivacaine, and their combination for epidural analgesia in obstetrics.
We postulated that epidural sufentanil alone would provide adequate analgesia for labor and delivery. We also considered the possibility that a combination of epidural sufentanil and bupivacaine would demonstrate superior analgesia and fewer side effects when compared with either agent alone. ⋯ Epidural sufentanil alone does not reliably provide satisfactory analgesia for labor and delivery. Addition of small amounts of local anesthetic to bolus doses of sufentanil enhances and prolongs the analgesic effect.
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Anaesth Intensive Care · May 1992
Randomized Controlled Trial Comparative Study Clinical TrialThe addition of pethidine to epidural bupivacaine in labour--effect of changing bupivacaine strength.
The effects of varying the strength of bupivacaine used in epidurals for the relief of labour pain was examined. The trial randomly allocated sixty women in the first stage of labour to one of three groups. All women were of ASA status 1 or 2 and had uncomplicated pregnancies. ⋯ This study suggests that when epidural pethidine 25 mg is added to local anaesthetic solutions of bupivacaine, adequate analgesia for the first stage of labour is achieved with the 0.125% bupivacaine solution. The use of stronger solutions of bupivacaine achieves no greater degree of analgesia nor longer duration of action, although the onset of analgesia may be faster with the stronger solutions. Further investigations are needed to determine if 25 mg of pethidine is the best choice of dose to use under these circumstances.
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Acta Anaesthesiol Scand · May 1992
Pharmacokinetics of clonidine after epidural administration in surgical patients. Lack of correlation between plasma concentration and analgesia and blood pressure changes.
The pharmacokinetics of epidural clonidine 150 micrograms was studied in 13 patients who had undergone abdominal hysterectomy. Plasma clonidine concentrations were measured up to 19 h in eight patients. In another five patients frequent blood sampling was performed only during the first 20 min to define early vascular uptake better. ⋯ Thereafter, pain scores were not significantly different from the control score. We conclude that epidural clonidine 150 micrograms produces only moderate and short-lived postoperative analgesia. Absorption of clonidine from the epidural space into the blood is very rapid and may contribute to the hypotension that occurs.
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Six children with a mean age of 10.6 years (range, 7 to 16 years) underwent thoracotomy for pulmonary and esophageal procedures. Postoperatively, continuous paravertebral block using an infusion of bupivacaine via an extrapleural catheter was used. ⋯ There were no pulmonary complications and no complications related to the continuous extrapleural infusion. We conclude that continuous paravertebral block is an effective and safe method for ++post-thoracotomy pain relief in children.
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Rev Esp Anestesiol Reanim · May 1992
[Experience with the Du Pen epidural catheter in chronic cancer pain].
We evaluate the results obtained with the use of Du Pen's epidural catheter in a series of patients with chronic oncologic pain. There were 27 patients with neoplasms of different etiologies who received a total number of 30 catheters. Inclusion criteria were established. ⋯ Twenty patients died. Mortality was not attributed to catheter complications in any case. The present study confirms that placement of the catheter is technically easy and provides an efficacious opiate analgesia with minimal complications.