Articles: analgesia.
-
Regional anesthesia · Sep 1989
Case ReportsGuillain-Barre syndrome after obstetrical epidural analgesia.
Guillain Barre Syndrome (GBS) occurred 24 hours post-partum following an obstetrical epidural anesthetic (OEA) procedure. Clinical diagnosis was confirmed by cerebrospinal fluid (CSF) findings and nerve conduction velocity studies. GBS is an immune mediated process. Because of short latency between the onset of symptoms and the performance of the epidural block, a cause and effect relationship between epidural block and GBS in this patient is unlikely.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Advantages of the paramedian approach for lumbar epidural analgesia with catheter technique. A clinical comparison between midline and paramedian approaches.
Forty-nine patients, scheduled for transurethral resection of the prostate or a bladder neoplasm on 50 occasions, were studied. The patients were randomly allocated to one of the two methods of puncture, midline or paramedian. Technical difficulties and the occurrence of complications were recorded. ⋯ The catheter entered a vessel at first in two patients in each group. No significant differences were demonstrated between the groups in the extent of sensory and motor blockade. The study supports the view that the paramedian approach has technical advantages over the midline approach for lumbar epidural analgesia with catheter technique.
-
Regional anesthesia · Sep 1989
Continuous high thoracic epidural administration of bupivacaine with sufentanil or nicomorphine for postoperative pain relief after thoracic surgery.
In a prospective study, 40 patients who had undergone thoracotomy for lung resection were investigated. During operation, all patients received intravenous anesthesics, halothane and an initial dose of bupivacaine 0.5% with epinephrine 5 micrograms.ml-1 (5 to 10 ml) by thoracic epidural catheter. One hour after the initial dose of bupivacaine 0.5% with epinephrine, patients were divided in two groups for analgesia, the sufentanil group (50 micrograms sufentanil in 60 ml bupivacaine 0.125%) or the nicomorphine group (3 mg nicomorphine in 60 ml bupivacaine 0.125%) by a continuous epidural infusion (5 to 10 ml.h-1) for three days. ⋯ An inverse visual analogue pain scale (0 to 10 IVAS) showed mean scores above 7.5 for all patients during the three days. Scoring pain relief during exercise showed a significant difference in favor of the sufentanil group on Days 1, 2, and 3 (p less than 0.0008). The mean plasma bupivacaine level doubled every day, 138 ng.ml-1 on Day 1, 290 ng.ml-1 on Day 2, and 596 ng.ml-1 on Day 3.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Regional anesthesia · Sep 1989
Case ReportsSpinal cord compression following labor and delivery with epidural analgesia.
Transient back pain is not uncommon during pregnancy and the postpartum period. Following an epidural anesthetic, back pain persisted in a postpartum patient beyond the expected period of soreness. Further diagnostic evaluation led to diagnosis and surgical decompression of a herniated thoracic disc.
-
Rev Esp Anestesiol Reanim · Sep 1989
[Effect of the peridural methadone concentration in postoperative analgesia].
The analgesic characteristics of 3 to 6 mg epidural methadone administered in two different concentrations for postoperative analgesia have been compared in two homogeneous groups of patients submitted to surgical procedures on trunk or legs. Methadone was given at a concentration of 0.1% in group I (70 patients) and diluted in 10 ml saline in group II (35 patients). Methadone doses were calculated on the basis of age and weight of the patient and the performed surgical procedure. ⋯ Side effects were not frequent and without clinical significance in both groups. Epidural methadone is an effective method for postoperative pain relief. Drug concentration modifies the duration of the analgesia and concentration of 0.1% gives better results than more diluted preparations.