Articles: analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Bupivacaine versus bupivacaine plus fentanyl for epidural analgesia: effect on maternal satisfaction.
To compare a combination of epidural fentanyl and bupivacaine with bupivacaine alone for epidural analgesia in labour and to evaluate factors in addition to analgesia that may influence maternal satisfaction. ⋯ The already high maternal satisfaction from conventional epidural analgesia can be improved; epidural fentanyl may be combined with bupivacaine to reduce operative deliveries and confer other advantages that may increase maternal satisfaction. Further investigations should be performed to determine the exact mechanisms of these findings and, in particular, to develop a safe method of delivering such analgesia to women.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intrapleural bupivacaine analgesia after thoraco-abdominal incision for oesophagectomy.
Intrapleural bupivacaine administration is said to produce good analgesia for the pain induced by a subcostal incision. However, reports of its efficacy after thoracotomy are conflicting. The goal of this study was to compare the analgesia produced by intrapleural administration of bupivacaine after oesophagectomy using a thoraco-abdominal incision with that obtained from intrapleural saline. ⋯ Plasma bupivacaine concentrations on Day 1 after the first intrapleural bupivacaine injection were less than 350 ng ml-1; on Day 4 after the last injection they were less than 1300 ng ml-1. In conclusion, intrapleural administration of bupivacaine produces effective analgesia after oesophagectomy performed with a thoracoabdominal incision. The technique is easy to perform and is safe.
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Anesthesia and analgesia · Mar 1991
Comparative StudyLow-dose bupivacaine does not improve postoperative epidural fentanyl analgesia in orthopedic patients.
Epidural infusions of 10 micrograms/mL fentanyl combined with low-dose bupivacaine (0.1%) were compared with epidural infusions of fentanyl alone for postoperative analgesia after total knee joint replacement. There were no detectable differences between the two groups in analgesia (visual analogue scale ranging between 15 and 40 mm), infusion rates (which averaged 7-9 mL/h), or serum fentanyl levels (which reached 1-2 ng/mL). ⋯ Of the patients receiving fentanyl and low-dose bupivacaine, one developed a transient unilateral motor and sensory loss, and one developed significant hypotension and respiratory depression. The addition of low-dose bupivacaine does not improve epidural fentanyl infusion analgesia after knee surgery and may increase morbidity.
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In the last decade, nurses and physicians have increasingly recognized the importance of eliminating postoperative pain in speeding a patient's recovery after surgery. In an effort to improve postoperative pain management, many regional anesthetic techniques have been continued from the operating room to the recovery room, and into the intensive care and medical-surgical units. The methods have been shown to be superior to traditional modes of postoperative pain relief. ⋯ To provide optimum care, nurses must be well-versed in the different regional techniques employed and the drugs used with these techniques. They must recognize complications attributable to these procedures and the toxic potential of the local anesthetics and narcotics. Early detection of these complications is essential.
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Rev Esp Anestesiol Reanim · Mar 1991
Randomized Controlled Trial Comparative Study Clinical Trial[Comparative study of peridural anesthesia with bupivacaine alone and combined with fentanyl during vaginal delivery].
Two groups of primiparous women with single fetus in cephalic presentation were prospectively randomized at the end of pregnancy to receive epidural analgesia with 0.25% bupivacaine, either single (n = 102) or associated with 0.05 mg of phentanyl (n = 102). Phentanyl significantly reduces the period of development of analgesia and increases the interdose period. ⋯ The evolution of delivery (dilatation and expulsion) and the perinatal results (cord pH and vitality of the newborn as assessed by the Apgar test) were similar in both groups. We conclude that the association of phentanyl with bupivacaine has advantages for epidural analgesia during delivery, as the quality of analgesia is improved, its duration is prolonged and there are no adverse effects on the evolution of delivery or on the newborn.