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https://www.readbyqxmd.com/read/28815798/infant-spinal-anesthesia-do-girls-need-a-larger-dose-of-local-anesthetic
#1
Geoff Frawley, Md Hamidul Huque
BACKGROUND: Gender differences in absorption, distribution, and metabolism of a number of anesthetic agents have been identified in adults. Clinically, adult studies suggest women demonstrate slower onset of opioid analgesic effects, lower spinal and epidural dose requirements, and greater sensitivity to neuromuscular blocking agents. Sex-related differences in the pharmacokinetics and pharmacodynamics of local anesthetics in neonates and infants, however, have not been well documented...
August 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28807786/dexmedetomidine-prolongs-levobupivacaine-analgesia-via-inhibition-of-inflammation-and-p38-mapk-phosphorylation-in-rat-dorsal-root-ganglion
#2
Shunsuke Yamakita, Megumi Matsuda, Yosuke Yamaguchi, Teiji Sawa, Fumimasa Amaya
Following tissue injury, phosphorylation of p38 MAPK in the primary afferent neurons drives sensitization of peripheral nerve. Dexmedetomidine extends the duration of reginal analgesia by local anesthetics. The effect of regional analgesia on the peripheral nerve sensitization is not known. The aim of this study is to investigate the effect of regional analgesia by levobupivacaine with or without dexmedetomidine on the p38 MAPK phosphorylation in the dorsal root ganglion (DRG) and inflammatory reaction in the peripheral tissue...
August 11, 2017: Neuroscience
https://www.readbyqxmd.com/read/28794528/post-operative-effectiveness-of-continuous-wound-infiltration-continuous-epidural-infusion-and-intravenous-patient-controlled-analgesia-on-post-operative-pain-management-in-patients-undergoing-spinal-surgery
#3
Anshuman Singh, Parul Jindal, Gurjeet Khurana, Ranjeet Kumar
BACKGROUND AND AIMS: Very few studies have compared continuous wound infiltration (CWI), continuous epidural infusion (CEI) and intravenous Patient Controlled Analgesia (PCA) with morphine in spine surgery. This study compared these modalities in patients undergoing microdissectomy. METHODS: This prospective, randomized control trial was conducted on 75 patients of American Society of Anesthesiologists' physical status I or II undergoing microdiscectomy. Patients in all the three groups received morphine 1 mg IV, with a lockout period of 10 min after each bolus, and the maximum allowed dose was 15 mg/5 h postoperatively...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28794527/the-effect-of-addition-of-dexamethasone-to-levobupivacaine-in-parturients-receiving-combined-spinal-epidural-for-analgesia-for-vaginal-delivery
#4
Amr Samir Wahdan, Ahmed Ibrahim El-Sakka, Hassan Mostafa Ismail Gaafar
BACKGROUND AND AIMS: Regional analgesia is commonly used for the relief of labour pain, Prolongation of analgesia can be achieved by adjuvant medications. The aim of this randomised controlled trial was to evaluate the efficacy of intrathecal levobupivacaine with dexamethasone for labour analgesia. METHODS: A total of 80 females were included in this study, all were primigravidas undergoing vaginal delivery with cervical dilatation ≥4 cm and 50% or more effacement...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28757824/effects-of-preincisional-analgesia-with-surgical-site-infiltration-of-ketamine-or-levobupivacaine-in-patients-undergoing-abdominal-hysterectomy-under-general-anesthesia-a-randomized-double-blind-study
#5
Nasr Mahmoud Abdallah, Atef Kamel Salama, Ahmed Mohamed Ellithy
CONTEXT: Postoperative pain management remains a cornerstone in patient's management to ensure a better quality of life. Preemptive analgesia is reported to inhibit the persistence of postoperative pain. AIMS: The aim of this study is to assess the analgesic effectiveness of preincisional infiltration of ketamine following elective abdominal hysterectomy as compared to levobupivacaine. SETTINGS AND DESIGN: This was a prospective, randomized, double-blind study...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28727314/transperitoneal-rectus-sheath-block-and-transversus-abdominis-plane-block-for-laparoscopic-inguinal-hernia-repair-a-novel-approach
#6
Jun Nagata, Jun Watanabe, Masato Nagata, Yusuke Sawatsubashi, Masaki Akiyama, Takehide Tajima, Koichi Arase, Noritaka Minagawa, Takayuki Torigoe, Yoshifumi Nakayama, Reiko Horishita, Kentaro Kida, Kotaro Hamada, Keiji Hirata
INTRODUCTION: A laparoscopic approach for inguinal hernia repair is now considered the gold standard. Laparoscopic surgery is associated with a significant reduction in postoperative pain. Epidural analgesia cannot be used in patients with perioperative anticoagulant therapy because of complications such as epidural hematoma. As such, regional anesthetic techniques, such as ultrasound-guided rectus sheath block and transversus abdominis plane block, have become increasingly popular. However, even these anesthetic techniques have potential complications, such as rectus sheath hematoma, if vessels are damaged...
August 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28680703/patient-pain-during-intravitreal-injections-under-topical-anesthesia-a-systematic-review
#7
Helio Francisco Shiroma, Augusto Key Karazawa Takaschima, Michel Eid Farah, Ana Luisa Höfling-Lima, Graziela de Luca Canto, Roberto Henrique Benedetti, Eduardo Buchele Rodrigues
BACKGROUND: Intravitreal injection (IVI) is a very common vitreoretinal procedure, and multiple injections are often required per patient. This systematic review was conducted to evaluate the effectiveness of various local anesthetic techniques in reducing pain during injection. METHODS: A systematic review was conducted based on searches of Cochrane, LILACS, PubMed, Scopus, Web of Science, and the gray literature (Google Scholar). The end search date was February 19, 2016, across all databases...
2017: International Journal of Retina and Vitreous
https://www.readbyqxmd.com/read/28663650/comparison-of-epidural-clonidine-and-dexmedetomidine-for-perioperative-analgesia-in-combined-spinal-epidural-anesthesia-with-intrathecal-levobupivacaine-a-randomized-controlled-double-blind-study
#8
Safiya I Shaikh, Laksmi R Revur, Marutheesh Mallappa
BACKGROUND: Epidural administrations of α2 agonists are being used as adjuvants as they lead to anxiolysis, sedation, analgesia, and hypnosis. AIM: This study aims to evaluate the analgesic effects of epidural α2 agonists-dexmedetomidine and clonidine in conjunction with intrathecal levobupivacaine in combined spinal epidural anesthesia (CSEA). METHODS: A prospective, randomized controlled study was done to assess and compare the efficacy and clinical profile of two α2 adrenergic agonists, clonidine, and dexmedetomidine administered epidurally in combination with intrathecal levobupivacaine in CSEA...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663648/comparison-of-intrathecal-levobupivacaine-and-levobupivacaine-plus-fentanyl-for-cesarean-section
#9
Manjunath Bidikar, Mahantesh Shivangouda Mudakanagoudar, M C B Santhosh
AIMS AND OBJECTIVES: The aim of this study is to compare the effects of intrathecal levobupivacaine with levobupivacaine and fentanyl in patients undergoing cesarean section. METHODS: Patients with American Society of Anesthesiologists Physical Status I and II scheduled for cesarean section under spinal anesthesia were randomly allocated with thirty patients each. Group L: levobupivacaine group - thirty patients (10 mg). Group F: levobupivacaine plus fentanyl group - thirty patients (7...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663395/a-pragmatic-randomised-controlled-trial-comparing-the-efficacy-of-a-femoral-nerve-block-and-periarticular-infiltration-for-early-pain-relief-following-total-knee-arthroplasty
#10
P D H Wall, N R Parsons, H Parsons, J Achten, S Balasubramanian, P Thompson, M L Costa
AIMS: The aim of this study was to compare the effectiveness of a femoral nerve block and a periarticular infiltration in the management of early post-operative pain after total knee arthroplasty (TKA). PATIENTS AND METHODS: A pragmatic, single centre, two arm parallel group, patient blinded, randomised controlled trial was undertaken. All patients due for TKA were eligible. Exclusion criteria included contraindications to the medications involved in the study and patients with a neurological abnormality of the lower limb...
July 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28638060/epidural-dexmedetomidine-reduces-the-requirement-of-propofol-during-total-intravenous-anaesthesia-and-improves-analgesia-after-surgery-in-patients-undergoing-open-thoracic-surgery
#11
Xianzhang Zeng, Jingjing Jiang, Lingling Yang, Wengang Ding
The aim of this study was to assess the systemic and analgesic effects of epidural dexmedetomidine in thoracic epidural anaesthesia (TEA) combined with total intravenous anaesthesia during thoracic surgery. Seventy-one patients undergoing open thoracotomy were included in this study and randomly divided into three groups: Control group (Group C): patients received TEA with levobupivacaine alone and were intravenously infused with saline; Epidural group (Group E): patients received TEA with levobupivacaine and dexmedetomidine, and were intravenously infused with saline; Intravenous group (group V): patients received TEA with levobupivacaine alone and were intravenously infused with dexmedetomidine...
June 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28625445/prospective-double-blind-randomized-placebo-controlled-clinical-trial-of-the-pectoral-nerves-pecs-block-type-ii
#12
Barbara Versyck, Geert-Jan van Geffen, Patrick Van Houwe
STUDY OBJECTIVE: The aim of this clinical trial was to test the hypothesis whether adding the pectoral nerves (Pecs) block type II to the anesthetic procedure reduces opioid consumption during and after breast surgery. DESIGN: A prospective randomized double blind placebo-controlled study. SETTING: A secondary hospital. PATIENTS: 140 breast cancer stage 1-3 patients undergoing mastectomy or tumorectomy with sentinel node or axillary node dissection...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28571238/analgesic-effect-of-intra-articular-morphine-or-dexmedetomidine-added-with-levobupivacaine-in-arthroscopic-knee-surgeries-a-comparative-evaluation
#13
Rajat Kumar Agarwal, Yashwant Singh Payal, Gaurav Chopra, Atul Agrawal
INTRODUCTION: Knee arthroscopy is associated with variable amount of postoperative pain. In an attempt to improve postoperative analgesia, intra-articular injection of local anaesthetic in combination with other agent have been studied. However, the best combination is not known. AIM: To compare the analgesic efficacy of intra-articular injection of morphine and dexmedetomidine when added with levobupivacaine in arthroscopic knee surgeries. MATERIALS AND METHODS: Seventy eight patients, scheduled to undergo elective arthroscopic procedure under spinal anaesthesia were recruited for the study...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28570980/local-infiltration-of-the-surgical-wounds-with-levobupivacaine-dexibuprofen-and-norepinephrine-to-reduce-postoperative-pain-a-randomized-vehicle-controlled-and-preclinical-study
#14
Zongwen Gao, Feng Cui, Xuemei Cao, Dejun Wang, Xiao Li, Tianzuo Li
Postoperative pain may lead to poor wound healing, insomnia, and increased postoperative hospitalization. The objective of the study was to explore the effect of local infiltration of the surgical wound with levobupivacaine, dexibuprofen, and norepinephrine in postoperative pain. A randomized, parallel experimental design was applied in 40, 9-11-week-old Wister albino rats. A laparotomy was performed in all groups of 10 rats each. During surgery, the sutured muscle was infiltrated with 40μL of a normal saline (vehicle group), a normal saline containing 0...
August 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28562541/preoperative-flap-site-injection-with-ropivacaine-and-epinephrine-in-baba-robotic-and-endoscopic-thyroidectomy-safely-reduces-postoperative-pain-a-consort-compliant-double-blinded-randomized-controlled-study-pain-brekor-trial
#15
RANDOMIZED CONTROLLED TRIAL
Joon-Hyop Lee, Yong Joon Suh, Ra-Yeong Song, Jin Wook Yi, Hyeong Won Yu, Hyungju Kwon, June Young Choi, Kyu Eun Lee
BACKGROUND: Clinical trials on bilateral axillo-breast approach (BABA) thyroidectomy show that levobupivacaine and ropivacaine significantly reduce postoperative pain, but they focused on BABA robotic thyroidectomy only and did not identify specific sites of significant pain relief. Our objective was to assess the pain reduction at various sites and safety of ropivacaine-epinephrine flap injection in BABA thyroidectomy. METHODS: This prospective double-blinded randomized controlled trial was conducted in compliance with the revised CONSORT statement (ClinicalTrials...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28546014/-anesthetic-requirements-measured-by-bilateral-bispectral-analysis-and-femoral-blockade-in-total-knee-arthroplasty
#16
Maylin Koo, Javier Bocos, Antoni Sabaté, Vinyet López, Carmina Ribes
BACKGROUND AND OBJECTIVES: A continuous peripheral nerve blockade has proved benefits on reducing postoperative morphine consumption; the combination of a femoral blockade and general anesthesia on reducing intraoperative anesthetic requirements has not been studied. The objective of this study was to determine the relevance of timing in the performance of femoral block to intraoperative anesthetic requirements during general anesthesia for total knee arthroplasty. METHODS: A single-center, prospective cohort study on patients scheduled for total knee arthroplasty, were sequentially allocated to receive 20mL of 2% mepivacaine throughout a femoral catheter, prior to anesthesia induction (Preoperative) or when skin closure started (Postoperative)...
May 22, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28545491/treatment-of-acute-sciatica-with-transforaminal-epidural-corticosteroids-and-local-anesthetic-design-of-a-randomized-controlled-trial
#17
Bastiaan C Ter Meulen, Esther T Maas, Amrita Vyas, Marinus van der Vegt, Koo de Priester, Michiel R de Boer, Maurits W van Tulder, Henry C Weinstein, Raymond W J G Ostelo
BACKGROUND: Transforaminal epidural injections with steroids (TESI) are used increasingly for patients with sciatica. However there is much debate about their safety and effectiveness. It is important to identify patients that benefit most from TESI and only few trials have yet evaluated the effects in patients with acute sciatica. METHODS: We describe a prospective, randomized controlled trial (RCT), with the aim to evaluate the hypothesis that TESI plus Levobupivacaine (TESI-plus) added to oral pain medication is more effective compared to pain medication alone or compared to transforaminal injection with a local anesthetic of short duration among patients with acute sciatica...
May 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28537969/thoracic-epidural-analgesia-with-levobupivacaine-reduces-remifentanil-and-propofol-consumption-evaluated-by-closed-loop-titration-guided-by-the-bispectral-index-a-double-blind-placebo-controlled-study
#18
RANDOMIZED CONTROLLED TRIAL
Virginie Dumans-Nizard, Morgan Le Guen, Edouard Sage, Thierry Chazot, Marc Fischler, Ngai Liu
BACKGROUND: Thoracic epidural analgesia (TEA) combined with general anesthesia decreases anesthetic requirements by half when hemodynamic criteria are used for the titration of analgesia. We therefore determined the impact of TEA on anesthetic requirements, when a closed-loop controller was used allowing the automated coadministration of propofol-remifentanil guided solely by the Bispectral index. METHODS: This single-center double-blind study enrolled patients scheduled for elective posterolateral thoracotomy using TEA...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28526464/-transient-horner-s-syndrome-after-single-shot-paravertebral-block
#19
Birzat Emre Gölboyu, Mürsel Ekinci, Pınar Karaca Baysal, Ayşe Nur Yeksan, Erkan Cem Çelik, Zeynep Bilgi, Murat Aksun
BACKGROUND: Thoracic paravertebral block can provide analgesia for unilateral chest surgery and is associated with a low complication rate. Horner syndrome also referred to as oculosympathetic paresis, is a classic neurologic constellation of ipsilateral blepharoptosis, pupillary miosis, and facial anhidrosis resulting from disruption of the sympathetic pathway supplying the head, eye, and neck. CASE REPORT: We present a patient with an ipsilateral transient Horner syndrome after ultrasound guided single shot of 15mL 0...
May 17, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28515517/a-clinical-comparison-between-0-5-levobupivacaine-and-0-5-levobupivacaine-with-dexamethasone-8-mg-combination-in-brachial-plexus-block-by-the-supraclavicular-approach
#20
Nibedita Pani, Sidharth Sraban Routray, Debasis Mishra, Basant Kumar Pradhan, Bishnu Prasad Mohapatra, Deepti Swain
BACKGROUND AND AIMS: Dexamethasone as an adjuvant to bupivacaine for supraclavicular brachial plexus (SCBP) block prolongs motor and sensory blockade. However, the effect of dexamethasone (8 mg) when added to levobupivacaine has not been well studied. This study was conducted to find out analgesic efficacy of dexamethasone as adjuvant to levobupivacaine in SCBP block. METHODS: Ultrasound- guided SCBP block was given to sixty patients, randomly assigned into two groups...
April 2017: Indian Journal of Anaesthesia
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