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intrathecal fentanyl

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https://www.readbyqxmd.com/read/28723831/effect-of-intrathecal-bupivacaine-dose-on-the-success-of-external-cephalic-version-for-breech-presentation-a-prospective-randomized-blinded-clinical-trial
#1
Laurie A Chalifoux, Jeanette R Bauchat, Nicole Higgins, Paloma Toledo, Feyce M Peralta, Jason Farrer, Susan E Gerber, Robert J McCarthy, John T Sullivan
BACKGROUND: Breech presentation is a leading cause of cesarean delivery. The use of neuraxial anesthesia increases the success rate of external cephalic version procedures for breech presentation and reduces cesarean delivery rates for fetal malpresentation. Meta-analysis suggests that higher-dose neuraxial techniques increase external cephalic version success to a greater extent than lower-dose techniques, but no randomized study has evaluated the dose-response effect. We hypothesized that increasing the intrathecal bupivacaine dose would be associated with increased external cephalic version success...
July 19, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28663648/comparison-of-intrathecal-levobupivacaine-and-levobupivacaine-plus-fentanyl-for-cesarean-section
#2
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/28623089/optimal-intrathecal-hyperbaric-bupivacaine-dose-with-opioids-for-cesarean-delivery-a-prospective-double-blinded-randomized-trial
#3
Eiko Onishi, Mamoru Murakami, Keiji Hashimoto, Miho Kaneko
BACKGROUND: Single-shot spinal anesthesia is commonly used for cesarean delivery. Achieving adequate anesthesia throughout surgery needs to be balanced with associated complications. We investigated the optimal dose of intrathecal hyperbaric bupivacaine, co-administered with opioids, for anesthesia for cesarean delivery. METHODS: This prospective, randomized, double-blinded, dose-ranging trial included parturients scheduled to undergo cesarean delivery under spinal anesthesia...
April 13, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28598894/left-lateral-table-tilt-for-elective-cesarean-delivery-under-spinal-anesthesia-has-no-effect-on-neonatal-acid-base-status-a-randomized-controlled-trial
#4
Allison J Lee, Ruth Landau, James L Mattingly, Margaret M Meenan, Beatriz Corradini, Shuang Wang, Stephanie R Goodman, Richard M Smiley
BACKGROUND: Current recommendations for women undergoing cesarean delivery include 15° left tilt for uterine displacement to prevent aortocaval compression, although this degree of tilt is practically never achieved. We hypothesized that under contemporary clinical practice, including a crystalloid coload and phenylephrine infusion targeted at maintaining baseline systolic blood pressure, there would be no effect of maternal position on neonatal acid base status in women undergoing elective cesarean delivery with spinal anesthesia...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28538591/intrathecal-morphine-and-oral-analgesics-provide-safe-and-effective-pain-control-after-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#5
Ying Li, Rebecca A Hong, Christopher B Robbins, Kathleen M Gibbons, Ashlee E Holman, Michelle S Caird, Frances A Farley, Matthew D Abbott, Michelle C Burke
STUDY DESIGN: Retrospective comparative study. OBJECTIVE: To demonstrate that intrathecal morphine (ITM) and oral analgesics provide effective pain control after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS), and this protocol has a low complication rate so patients can be admitted to a general care floor. SUMMARY OF BACKGROUND DATA: Previous studies have shown that ITM combined with intravenous patient-controlled analgesia or epidural infusion (EPI) provides effective pain control after PSF for AIS...
May 23, 2017: Spine
https://www.readbyqxmd.com/read/28489932/camkii%C3%AE-may-modulate-fentanyl-induced-hyperalgesia-via-a-celc-pag-rvm-spinal-cord-descending-facilitative-pain-pathway-in-rats
#6
Zhen Li, Pingping Yin, Jian Chen, Shenglan Jin, Jieqiong Liu, Fang Luo
Each of the lateral capsular division of central nucleus of amygdala(CeLC), periaqueductal gray (PAG), rostral ventromedial medulla(RVM) and spinal cord has been proved to contribute to the development of opioid-induced hyperalgesia(OIH). Especially, Ca2+/calmodulin-dependent protein kinase IIα (CaMKIIα) in CeLC and spinal cord seems to play a key role in OIH modulation. However, the pain pathway through which CaMKIIα modulates OIH is not clear. The pathway from CeLC to spinal cord for this modulation was explored in the present study...
2017: PloS One
https://www.readbyqxmd.com/read/28476919/v%C3%AC-o2-kinetics-associated-with-moderate-intensity-exercise-in-heart-failure-impact-of-intrathecal-fentanyl-inhibition-of-group-iii-iv-locomotor-muscle-afferents
#7
Erik H Van Iterson, Bruce D Johnson, Michael J Joyner, Timothy B Curry, Thomas P Olson
Heart failure (HF) patients demonstrate impaired pulmonary, circulatory, and nervous system responses to exercise. While HF demonstrates prolonged [time constant (τ)] pulmonary O2 uptake (V̇o2) on-kinetics, contributing to exercise intolerance, it is unknown whether abnormal V̇o2 kinetics couple with ventilatory and circulatory dysfunction secondary to impaired group III/IV afferents in HF. Because lower lumbar intrathecal fentanyl inhibits locomotor muscle afferents, resulting in improved exercise ventilation and hemodynamics, we tested these hypotheses: HF will demonstrate 1) rapid V̇o2 on-kinetics and 2) attenuated steady-state V̇o2 amplitude and O2 deficit (O2def) during exercise with fentanyl versus placebo...
July 1, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28448397/prophylactic-pentazocine-reduces-the-incidence-of-pruritus-after-cesarean-delivery-under-spinal-anesthesia-with-opioids-a-prospective-randomized-clinical-trial
#8
Masato Hirabayashi, Katsushi Doi, Noritaka Imamachi, Tomomune Kishimoto, Yoji Saito
BACKGROUND: The incidence of pruritus after cesarean delivery under spinal anesthesia with opioids is high, ranging from 50% to 100%. Pruritus is difficult to prevent; however, pentazocine has been shown to be an effective treatment. Despite this, the prophylactic effect of pentazocine on pruritus has not been defined. This randomized double-blind trial aimed to evaluate the effect of intraoperative IV pentazocine on the incidence of opioid-induced pruritus within the first 24 hours after administration of neuraxial opioids...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28435667/neuraxial-opioids-as-analgesia-in-labour-caesarean-section-and-hysterectomy-a-questionnaire-survey-in-sweden
#9
Anette Hein, Caroline Gillis-Haegerstrand, Jan G Jakobsson
Background: Neuraxial opioids improve labour analgesia and analgesia after caesarean section (CS) and hysterectomy. Undesirable side effects and difficulties in arranging postoperative monitoring might influence the use of these opioids. The aim of the present survey was to assess the use of intrathecal and epidural morphine in gynaecology and obstetrics in Sweden. Methods: A questionnaire was sent to all anaesthetic obstetric units in Sweden concerning the use and postoperative monitoring of morphine, sufentanil and fentanyl in spinal/epidural anaesthesia...
2017: F1000Research
https://www.readbyqxmd.com/read/28413281/a-comparative-study-of-the-effect-of-clonidine-fentanyl-and-the-combination-of-both-as-adjuvant-to-intrathecal-bupivacaine-for-postoperative-analgesia-in-total-abdominal-hysterectomy
#10
Fareed Ahmed, Mamta Khandelwal, Anil Sharma
BACKGROUND AND AIMS: The aim of this study was to evaluate the level of sensory block, onset and duration of motor block, postoperative analgesia, and adverse effects of combination of clonidine and fentanyl given intrathecally with hyperbaric bupivacaine (HB). MATERIAL AND METHODS: Three hundred and twenty eight patients were randomized into four groups. Group bupivacaine (group B) received 15 mg of HB; group bupivacaine clonidine (group BC) received 15 mg of HB plus 25 μg clonidine; group bupivacaine fentanyl (group BF) received 15 mg of HB plus 25 μg fentanyl and group bupivacaine clonidine fentanyl (group BCF) received 15 mg of HB plus 25 μg clonidine and 25 μg fentanyl intrathecally...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28386739/analgesia-and-side-effects-of-the-addition-of-10-or-20%C3%A2-%C3%A2%C2%B5g-fentanyl-to-articaine-in-spinal-anesthesia-for-knee-arthroscopy-a-randomized-and-observer-blinded-study
#11
Paula Stenman, Merja Salonen, Pekka Tarkkila, Per Rosenberg
OBJECTIVES: Articaine, a popular and rapidly acting local anesthetic in dentistry, has been also found to be beneficial in ambulatory spinal anesthesia. Analgesia in the intraoperative and immediate postoperative period may be further improved by adding fentanyl to the local anesthetic solution for spinal anesthesia. The aim was to evaluate dose-dependency of analgesia and side effects associated with intrathecal fentanyl additive to articaine for spinal anesthesia in knee arthroscopy patients...
June 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28372680/the-impact-of-anesthesia-on-hemodynamic-and-volume-changes-in-operative-hysteroscopy-a-bioimpedance-randomized-study
#12
Ehab E Moharram, Ahmed M El Attar, Moustafa A Kamel
BACKGROUND: Operative hysteroscopy is accompanied by the use of distention medium. Its absorption can lead to volume overload and hemodynamic disturbances that can lead to serious complications. We investigated the impact of the type of anesthesia on decreasing these complications with the use of noninvasive thoracic bioimpedance. DESIGN: A prospective, randomized, blind study. METHOD: Sixty women, with American Society of Anesthesiologists classifications I-III, undergoing operative hysteroscopy were randomly allocated into 2 groups...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28217051/comparison-of-intrathecal-clonidine-and-fentanyl-in-hyperbaric-bupivacaine-for-spinal-anesthesia-and-postoperative-analgesia-in-patients-undergoing-lower-abdominal-surgeries
#13
Baljit Singh Bajwa, Arwinder Pal Singh, Angelina K Rekhi
BACKGROUND: There are many adjuvant used along with bupivacaine for subarachnoid block, but fentanyl and clonidine are commonly used as adjuvant to intrathecal bupivacaine for prolonging both sensory and motor blockade as well as postoperative analgesia in patients undergoing lower abdominal surgeries. OBJECTIVE: There is a paucity of studies comparing the efficacy of fentanyl and clonidine as adjuvant to intrathecal bupivacaine for improving intraoperative effect and postoperative analgesia in lower abdominal surgeries instigated us compare the effect of these drugs...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28099291/transcutaneous-carbon-dioxide-measurements-in-women-receiving-intrathecal-morphine-for-cesarean-delivery-a-prospective-observational-study
#14
Jeanette R Bauchat, Robert McCarthy, Paul Fitzgerald, Stephen Kolb, Cynthia A Wong
BACKGROUND: Neuraxial morphine is the most commonly used analgesic technique after cesarean delivery. The incidence of respiratory depression is reported to be very low (0%-1.2%) in this patient population as measured by pulse oximetry and respiratory rates. However, hypercapnia may be a more sensitive measure of respiratory depression. In the current study, the incidence of hypercapnia events (transcutaneous CO2 [TcCO2] >50 mm Hg) for ≥2-minute duration was evaluated using the Topological Oscillation Search with Kinematical Analysis monitor in women who received intrathecal morphine for postcesarean delivery analgesia...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28095795/intrathecal-magnesium-sulfate-does-not-reduce-the-ed50-of-intrathecal-hyperbaric-bupivacaine-for-cesarean-delivery-in-healthy-parturients-a-prospective-double-blinded-randomized-dose-response-trial-using-the-sequential-allocation-method
#15
Fei Xiao, Wenping Xu, Ying Feng, Feng Fu, Xiaomin Zhang, Yinfa Zhang, Lizhong Wang, Xinzhong Chen
BACKGROUND: Addition of intrathecal magnesium sulfate to local anesthetics has been reported to potentiate spinal anesthesia and prolong analgesia in parturients. The current study was to determine whether intrathecal magnesium sulfate would reduce the dose of hyperbaric bupivacaine in spinal anesthesia with bupivacaine and sufentanil for cesarean delivery. METHODS: Sixty healthy parturients undergoing scheduled cesarean delivery were randomly assigned to receive spinal anesthesia with 0...
January 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28067707/dural-puncture-epidural-technique-improves-labor-analgesia-quality-with-fewer-side-effects-compared-with-epidural-and-combined-spinal-epidural-techniques-a-randomized-clinical-trial
#16
RANDOMIZED CONTROLLED TRIAL
Anthony Chau, Carolina Bibbo, Chuan-Chin Huang, Kelly G Elterman, Eric C Cappiello, Julian N Robinson, Lawrence C Tsen
BACKGROUND: The dural puncture epidural (DPE) technique is a modification of the combined spinal epidural (CSE) technique, where a dural perforation is created from a spinal needle but intrathecal medication administration is withheld. The DPE technique has been shown to improve caudal spread of analgesia compared with epidural (EPL) technique without the side effects observed with the CSE technique. We hypothesized that the onset of labor analgesia would follow this order: CSE > DPE > EPL techniques...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27956847/predictors-for-moderate-to-severe-acute-postoperative-pain-after-cesarean-section
#17
Natalia de Carvalho Borges, Lilian Varanda Pereira, Louise Amália de Moura, Thuany Cavalcante Silva, Charlise Fortunato Pedroso
Background. Moderate to severe postoperative pain affects performance of daily activities and it contributes to persistent postoperative pain. In patients submitted to cesarean section, this pain can also interfere with women's ability to care for their babies, to effectively breastfeed, and to satisfactorily interact with their children. Factors influencing the pain perception during the immediate postoperative period have not been widely pursued. Objective. To investigate the incidence and predicting factors of postoperative pain after cesarean section...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/27932148/low-dose-spinal-block-with-continuous-epidural-infusion-for-renal-transplantation-in-a-patient-with-alport-syndrome-a-case-report
#18
F Gobbi, G Sales, P Bretto, P P Donadio, L Brazzi
OBJECTIVE: We aim to describe management of a patient receiving renal transplantation for chronic renal failure due to Alport syndrome with low dose of intrathecal bupivacaine and continuous epidural infusion of local anesthetic. CASE REPORT: A 38-years-old man with chronic renal failure secondary to Alport syndrome underwent kidney transplantation. Because of a high risk of respiratory and cardiovascular complications related to the patient's baseline lung disease and abnormalities in heart conduction, we selected combined spinal-epidural anesthesia...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27917806/comparison-of-intrathecal-plain-articaine-and-levobupivacaine-with-fentanyl-for-caesarean-section
#19
RANDOMIZED CONTROLLED TRIAL
Rüveyda I Demircioglu, Muhammet Gozdemir, Burhanettin Usta, Hüseyin Sert, Safinaz Karabayirli, Bünyamin Muslu, Esra A Keskin
PURPOSE: Articaine is used as a local anesthetic for outpatient surgery because it offers rapid onset of anesthesia and short duration motor block. Levobupivacaine is often preferred for Caesarean section. We evaluated the anesthetic characteristics of fentanyl-supplemented plain articaine and levobupivacaine for Caesarean section under combine spinal epidural anesthesia. METHODS: Patients undergoing Caesarean section received in random order plain articaine 40 mg (Group A, n=50) or plain levobupivacaine 10 mg (Group L, n=50) mixed with fentanyl 20 µg intrathecally...
December 1, 2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/27878902/a-retrospective-comparison-of-intrathecal-morphine-and-epidural-hydromorphone-for-analgesia-following-posterior-spinal-fusion-in-adolescents-with-idiopathic-scoliosis
#20
Rebecca A Hong, Kathleen M Gibbons, G Ying Li, Ashlee Holman, Terri Voepel-Lewis
BACKGROUND: Posterior spinal fusion to correct idiopathic scoliosis is associated with severe postoperative pain. Intrathecal morphine is commonly used for analgesia after adolescent posterior spinal fusion; however, anticipating and managing the increase in pain scores after resolution of analgesic effect of intrathecal morphine analgesia is challenging. In 2014, we developed a clinical protocol detailing both the administration of intrathecal morphine intraoperatively and the transition to routine, scheduled oral analgesics at 18 h postoperatively...
January 2017: Paediatric Anaesthesia
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