Regional anesthesia最新文献_第2页

Subarachnoid sufentanil versus lidocaine spinal anesthesia for extracorporeal shock wave lithotripsy. 蛛网膜下腔舒芬太尼与利多卡因脊髓麻醉用于体外冲击波碎石。

Regional anesthesia Pub Date : 1997-11-01

M P Eaton, A K Chhibber, D R Green

{"title":"Subarachnoid sufentanil versus lidocaine spinal anesthesia for extracorporeal shock wave lithotripsy.","authors":"M P Eaton, A K Chhibber, D R Green","doi":"","DOIUrl":"","url":null,"abstract":"Background and objectives: Anesthetic techniques that reduce the time required for postoperative care can significantly reduce the cost of procedures. This study was designed to discover whether the use of subarachnoid sufentanil for extracorporeal shock wave lithotripsy (ESWL) would enable patients to be discharged more rapidly following surgery as compared with subarachnoid lidocaine, while providing equivalent efficacy.Methods: Thirty-nine patients undergoing 40 ESWLs were randomized to receive either 12.5 microg of sufentanil or 75 mg of lidocaine by the subarachnoid route. The need for additional analgesia, incidence of adverse effects, and time to discharge were recorded and compared.Results: Patients receiving sufentanil were discharged 52 minutes sooner than patients receiving lidocaine (166 +/- 77 vs 218 +/- 46 minutes, respectively, P < .05). Analyzed separately, women receiving sufentanil were discharged earlier than those receiving lidocaine (120 +/- 55 vs 208 +/- 42 minutes, P < .01). There was no significant difference in discharge times between men in each group. Patients in the sufentanil group had more pruritus and less change in blood pressure than patients in the lidocaine group. There was no significant difference in the incidence of other adverse effects or in the use of additional analgesia or sedation.Conclusions: Subarachnoid sufentanil provides acceptable analgesia for ESWL and offers the advantages of more rapid discharge for female patients and better hemodynamic stability as compared with lidocaine spinal anesthesia.","PeriodicalId":77347,"journal":{"name":"Regional anesthesia","volume":"22 6","pages":"515-20"},"PeriodicalIF":0.0,"publicationDate":"1997-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20352884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of the pulse oximeter for teaching axillary nerve block. 脉搏血氧仪在腋神经阻滞教学中的应用。

Regional anesthesia Pub Date : 1997-11-01

Y Okuda, T Kitajima, T Asai

引用次数: 0

Hearing loss after continuous or single-shot spinal anesthesia. 连续或单次脊髓麻醉后听力丧失。

Regional anesthesia Pub Date : 1997-11-01

T Lamberg, M T Pitkänen, T Marttila, P H Rosenberg

{"title":"Hearing loss after continuous or single-shot spinal anesthesia.","authors":"T Lamberg, M T Pitkänen, T Marttila, P H Rosenberg","doi":"","DOIUrl":"","url":null,"abstract":"Background and objectives: Hearing loss after spinal anesthesia is probably caused by cerebrospinal fluid (CSF) leakage. Spinal catheters may mechanically plug the hole in the dura and cause inflammatory swelling which should prevent cerebrospinal fluid leakage and hearing loss. An audiometric evaluation was therefore performed in patients who had spinal anesthesia by single-shot or catheter.Methods: Twenty-one patients received single-shot spinal anesthesia and 19 patients continuous spinal anesthesia for orthopedic surgery of the lower limbs. Spinal catheters were removed 24 hours after the start of anesthesia. Audiometry was performed on the day before the operation and on the first, second, and third postoperative day and repeated on the fifth postoperative day, if necessary.Results: The frequency of hearing impairment (threshold change > 10 dB) was 43% in the single-shot and 37% in the continuous spinal group. The deterioration lasted longer in the continuous spinal group (3 days vs. 1.4 days; P < .01).Conclusion: Although inflammatory swelling of the dura mater around the spinal catheter had been observed, use of such a catheter for 24 hours did not prevent hearing loss after its removal.","PeriodicalId":77347,"journal":{"name":"Regional anesthesia","volume":"22 6","pages":"539-42"},"PeriodicalIF":0.0,"publicationDate":"1997-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20353489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mepivacaine as an intravenous regional block interferes with reactive hyperemia and decreases steady-state blood flow. 甲哌卡因作为静脉局部阻滞干扰反应性充血和减少稳态血流。

Regional anesthesia Pub Date : 1997-11-01

S Kalman, K C Björhn, E K Tholén, B Lisander

{"title":"Mepivacaine as an intravenous regional block interferes with reactive hyperemia and decreases steady-state blood flow.","authors":"S Kalman, K C Björhn, E K Tholén, B Lisander","doi":"","DOIUrl":"","url":null,"abstract":"Background and objectives: Local anesthetics block propagation in nerve fibers but may also inhibit inflammation. Inflammatory phenomena such as warmth, reddening, and swelling are intimately connected with blood flow. Our primary aim was to investigate the effect of mepivacaine on cutaneous blood flow in a situation involving hyperemia, but no inflammation, namely, after arterial occlusion.Methods: The subjects were healthy volunteers (9 men, 7 women). Pain was evaluated by visual analog scale every 5 minutes. A laser Doppler probe was applied on each forearm. After baseline flow measurements during 30 minutes, a bilateral regional intravenous block (Bier block) was performed by injecting mepivacaine (1.4 mg/kg in 40 mL) in one arm and normal saline in the other in a randomized, controlled, double-blind manner. Arterial occlusion was maintained for 20 minutes, and flow was followed for 60 minutes after release of the block.Results: The ischemic pain, though modest, was less (P = .045) in the treated arm. Following release of the cuff, the blood flow had essentially stabilized after 20 minutes. The reactive hyperemia (1-20 minutes) was attenuated in the mepivacaine-treated arm (mean, 68% of placebo, P = .025). In the 21-60-minute period, flow in this arm stabilized at a lower level (mean, 73% of placebo, P = .0013).Conclusion: Mepivacaine is a vasoconstrictor of long duration. This has to be taken into account when antiinflammatory effects of mepivacaine are assessed.","PeriodicalId":77347,"journal":{"name":"Regional anesthesia","volume":"22 6","pages":"552-6"},"PeriodicalIF":0.0,"publicationDate":"1997-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20353491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intractable cancer pain: a new technique for attack in a patient with an implanted intrathecal infusion pump. 顽固性癌性疼痛:植入鞘内输液泵治疗患者的新技术。

Regional anesthesia Pub Date : 1997-11-01

A G Kowal, P S Staats

引用次数: 0

Identification of the epidural space: is loss to air a safe technique? 硬膜外腔的识别:空气丢失是一种安全的技术吗?

Regional anesthesia Pub Date : 1997-11-01

J A Aldrete

引用次数: 0

Labor analgesia and anesthesia in a patient with spinal muscular atrophy and vocal cord paralysis. 脊髓肌萎缩伴声带麻痹患者的分娩镇痛与麻醉。

Regional anesthesia Pub Date : 1997-11-01

S Golden

引用次数: 0

Progress in the development of ultra-long-acting local anesthetics. 超长效局麻药的研究进展。

Regional anesthesia Pub Date : 1997-11-01

P J Kuzma, M D Kline, M D Calkins, P S Staats

{"title":"Progress in the development of ultra-long-acting local anesthetics.","authors":"P J Kuzma, M D Kline, M D Calkins, P S Staats","doi":"","DOIUrl":"","url":null,"abstract":"Background and objectives: Local anesthetic agents with a duration of action longer than the currently available local anesthetics could have widespread clinical application for the treatment of both chronic and acute pain. Over the last several decades, several different approaches have been used in the development of ultra-long-acting agents. There are currently promising preparations in development which may prove clinically useful in the near future.Methods: A Medline search was conducted for relevant articles published in peer-reviewed journals between 1971 and 1996. Investigations related to prolongation of the effect of local anesthetics either by alterations in the local anesthetic molecule, use of new or novel agents, or use of new delivery systems were reviewed. In addition, bibliographies of relevant articles were searched to capture any articles that were missed by the Medline search.Results: Over the last several decades, numerous attempts have been made to prolong the duration of action of local anesthetics. Initially, research focused on alterations in the local anesthetic molecule or the identification of new agents with local anesthetic action. Recently, the focus of much of the work has shifted to new drug-delivery systems such as polymers and liposomes.Conclusions: Although encouraging results have been reported in the literature, there is currently no agent or delivery system that has shown reliable and practical prolongation of local anesthetic effect in humans. There have been several encouraging reports in animals that have shown local anesthetic effects lasting up to several days, but these results must be validated and then performed in human studies before a clinically useful agent is found. Further research is warranted.","PeriodicalId":77347,"journal":{"name":"Regional anesthesia","volume":"22 6","pages":"543-51"},"PeriodicalIF":0.0,"publicationDate":"1997-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20353490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of postanesthetic sequelae after clinical use of 27-gauge cutting and noncutting spinal needles. 27号切口与非切口脊柱针临床使用后后遗症的比较。

Regional anesthesia Pub Date : 1997-11-01

R Puolakka, M Jokinen, M T Pitkänen, P H Rosenberg

{"title":"Comparison of postanesthetic sequelae after clinical use of 27-gauge cutting and noncutting spinal needles.","authors":"R Puolakka, M Jokinen, M T Pitkänen, P H Rosenberg","doi":"","DOIUrl":"","url":null,"abstract":"Background and objectives: The tips of the bevels of thin spinal needles may be easily damaged by bony contact during puncture attempts. In this respect and also because they are less traumatic by design, noncutting, pencil-point-tip needles may be beneficial. A prospective clinical comparison of postanesthetic effects of the use of 27G Quincke-type and pencil-point spinal needles was therefore performed.Methods: The study included 400 spinal anesthesia patients, in 200 of whom the initial needle was a 27-gauge Quincke type, a 27-gauge pencil-point needle being used in the other 200. Altogether, 464 needles had to be used; in 30 cases the pencil-point needle was replaced by a 27- or 25-gauge Quincke-type needle. A block performance form was filled in, and the patients were interviewed personally on the first postoperative day and by means of a mailed questionnaire on the 14th day.Results: The tips of the Quincke-type needles were distorted in a blunt, bent or hooked manner in 13% of the initial and 14% of the final needles. The severity of the damage was related to the count category of bony contacts during puncture (0, 1-4, or 5 or more). The occurrence of postdural puncture headache was not, however, related either to damage of the needles or to the number of puncture attempts. Diffuse (not posture-dependent) headache occurred more often after the use of the Quincke-type needle than after use of the pencil-point needles, the tips of which remained intact in each case.Conclusion: Postanesthetic sequelae, including postdural puncture headache (overall incidence 2.5%), were not related to the shape of the spinal needles or to the damage of the Quincke-type needles.","PeriodicalId":77347,"journal":{"name":"Regional anesthesia","volume":"22 6","pages":"521-6"},"PeriodicalIF":0.0,"publicationDate":"1997-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20352885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Removal of a torn Racz catheter from lumbar epidural space. 从腰椎硬膜外腔取出撕裂的Racz导管。

Regional anesthesia Pub Date : 1997-11-01

L Manchikanti, C E Bakhit

引用次数: 0