Articles: analgesia.
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Anesteziol Reanimatol · Nov 1990
Comparative Study[A comparative evaluation of the permeability of the dura mater in parturients and the efficacy of epidural anesthesia using morphine following cesarean section].
Spinal dura mater permeability has been compared in 15 women dead in labour or of severe multiple combined traumas. The quantitative index for the assessment of transmeningeal morphine and dicaine diffusion was permeability coefficient calculated according to Fick's equation. ⋯ However, a decrease of the diffusion barrier is not clinically manifested during epidural morphine analgesia due to an equivalent increase in the rate of intravascular opiate adsorption. The conclusion is made that it is advisable to add the usual adrenaline dose (1:200,000) to the anesthetic solution to enhance the degree of anesthesia adequacy and to decrease the danger of the onset of general narcotic and respiratory depression on the fetus in the early neonatal period.
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Anesteziol Reanimatol · Nov 1990
[The use of transcutaneous electric neurostimulation for postoperative analgesia in parturients undergoing cesarean section].
The study has been performed in 210 women with cesarean section: in 160 patients analgesia was performed with transcutaneous electrical neurostimulation and in 50 patients narcotic analgesics were used. It has been established that both techniques ensure adequate analgetic effect. At the same time transcutaneous electrical neurostimulation, ensuring good to excellent analgesia in 77.5% of women, has no negative effect on hemodynamics and respiratory function and accelerates rehabilitation processes.
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The purpose of this study was to determine the incidence and factors associated with poor analgesia during epidural block for labour pain. Emphasis was placed on determining the incidence, magnitude and factors associated with epidural catheter migration as well as any relationship between catheter migration and the quality of analgesia. Catheter movement was assessed, prospectively, in 211 consecutive parturients who had an epidural catheter placed for labour analgesia. ⋯ Seventeen per cent of the patients had unsatisfactory analgesia. There was an increase in poor analgesia in those patients whose catheters migrated compared with those in whom the catheters were stable (P less than 0.05). We conclude that catheter migration during labour results in a greater incidence of inadequate block and unsatisfactory analgesia.