Articles: analgesia.
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The practice of obstetric anaesthesia can be highly rewarding. The clinician prepared with an understanding of maternal-fetal physiology (obstetric requirements), systemic narcotics, and regional anaesthesia can be highly effective at relieving pain and bringing about a successful delivery. While alternative techniques should always be considered, particularly those that stress childbirth education, continuous lumbar analgesia remains the most flexible and satisfactory approach. While there is new equipment (fine needles and smaller catheters) on the horizon, it remains to be demonstrated if they can match the success and safety record of present lumbar epidural practice.
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Rev Esp Anestesiol Reanim · May 1992
[Postoperative analgesia using the intravenous PCA technique. Results in the first 400 patients treated at a general hospital].
PCA (patient controlled analgesia) has represented a remarkable advance in the treatment of postoperative pain. In this work we describe our experience with this analgesic technique. ⋯ PCA analgesia has been successfully introduced in our hospital since it is effective, safe, easy to manage.
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Randomized Controlled Trial Comparative Study Clinical Trial
Adequacy of caudal analgesia in children after penoscrotal and inguinal surgery using 0.5 or 1.0 ml.kg-1 bupivacaine 0.125%.
To determine the optimal volume of bupivacaine 0.125% for postoperative caudal analgesia, we compared the effectiveness of 0.5 ml.kg-1 and 1 ml.kg-1 of bupivacaine 0.125% with 1:200,000 epinephrine in 80 children undergoing penoscrotal and inguinal surgery. The adequacy of caudal analgesia and supplemental analgesic requirements did not differ between the two groups at any time during the first 12 hr after surgery. We conclude that 0.5 ml.kg-1 of bupivacaine 0.125% with 1:200,000 epinephrine is as effective as 1 ml.kg-1 of the same solution and recommend its use for penoscrotal surgery. The evidence for effectiveness of 0.5 ml.kg-1 of bupivacaine 0.125% for inguinal surgery, however, is inconclusive because of an insufficient number of patients studied.
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Randomized Controlled Trial Clinical Trial
Thoracic epidural infusion for postoperative pain relief following abdominal aortic surgery: bupivacaine, fentanyl or a mixture of both?
Thirty patients who had undergone elective abdominal aortic surgery were studied in a prospective, randomised double-blind comparison of thoracic epidural 0.2% bupivacaine alone, thoracic epidural fentanyl alone and thoracic epidural 0.2% bupivacaine combined with fentanyl. Pain relief, pulmonary function, cardiovascular stability and side effects were assessed. ⋯ The incidence of side effects attributable to either epidural bupivacaine or fentanyl was low. This study supports the increasing use of epidural infusion analgesia for postoperative pain management after abdominal surgery.