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https://www.readbyqxmd.com/read/27917806/comparison-of-intrathecal-plain-articaine-and-levobupivacaine-with-fentanyl-for-caesarean-section
#1
Rüveyda I Demircioglua, Muhammet Gozdemira, Burhanettin Ustaa, Hüseyin Serta, Safinaz Karabayirlia, Bünyamin Muslua, Esra A Keskinb
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
#2
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...
November 22, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27870737/the-influence-of-body-mass-index-on-sensorimotor-block-and-vasopressor-requirement-during-spinal-anesthesia-for-elective-cesarean-delivery
#3
T C Ngaka, J F Coetzee, R A Dyer
BACKGROUND: It has been suggested that the dose requirement for spinal anesthesia (SA) is lower in obese patients for cesarean delivery (CD). In this prospective, observational, noninferiority study, we tested the hypothesis that obesity would not have a clinically important effect on vasopressor requirements or block height. METHODS: Two groups of 25 parturients, group O (body mass index [BMI] >40 kg/m) and group N (BMI <32 kg/m) requiring elective CD were recruited...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27866119/group-iii-iv-locomotor-muscle-afferents-alter-motor-cortical-and-corticospinal-excitability-and-promote-central-fatigue-during-cycling-exercise
#4
Simranjit K Sidhu, Joshua C Weavil, Tyler S Mangum, Jacob E Jessop, Russell S Richardson, David E Morgan, Markus Amann
OBJECTIVE: To investigate the influence of group III/IV muscle afferents on the development of central fatigue and corticospinal excitability during exercise. METHODS: Fourteen males performed cycling-exercise both under control-conditions (CTRL) and with lumbar intrathecal fentanyl (FENT) impairing feedback from leg muscle afferents. Transcranial magnetic- and cervicomedullary stimulation was used to monitor cortical versus spinal excitability. RESULTS: While fentanyl-blockade during non-fatiguing cycling had no effect on motor-evoked potentials (MEPs), cervicomedullary-evoked motor potentials (CMEPs) were 13±3% higher (P<0...
October 26, 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27797093/a-comparison-of-selective-and-conventional-spinal-anaesthesia-for-ambulatory-surgery
#5
Andrzej Daszkiewicz, Andrzej Janik, Magdalena Śliwczyńska, Jacek Karpe, Hanna Misiołek
BACKGROUND: Selective spinal anaesthesia is the practice of employing minimal doses of intrathecal agents so that only the nerve roots supplying a specific area and only the modalities that require to be anaesthetised are affected. The study is based on the hypothesis that small dose lidocaine spinal anaesthesia may be adequate for elective surgical procedures, providing limited motor and sensory block, and thus enabling earlier patient's discharge. The aim of this study was the comparison of the low and the conventional dose of lidocaine spinal anaesthesia discharge time...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27746562/a-comparative-study-on-effect-of-addition-of-clonidine-and-fentanyl-as-adjuvants-to-local-anaesthetics-for-subarachnoid-block-in-patients-undergoing-lumbar-laminectomies
#6
Umesh K Dash, S Kiran, Urvashi Tandon, Kavitha Jinjil
BACKGROUND: The synergism between local anesthetic agents such as bupivacaine with intrathecal adjuvants such as opioids and clonidine is well established. AIMS: This study evaluates the clinical efficacy of clonidine75 μg versus fentanyl 25 μg as adjuvants to bupivacaine for spinal anesthesia. SETTINGS AND DESIGN: A prospective, randomized, parallel arm study was conducted over a period of 12 months in a tertiary care hospital. MATERIALS AND METHODS: Sixty patients were divided randomly into two groups, Group C and Group F...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746546/comparison-of-clonidine-and-fentanyl-as-adjuvant-to-ropivacaine-in-spinal-anesthesia-in-lower-abdominal-surgeries
#7
Radhe Sharan, Rajan Verma, Akshay Dhawan, Jugal Kumar
BACKGROUND: Ropivacaine, a newer local anesthetic, is gaining increased acceptance due to its improved safety profile over bupivacaine and lignocaine. Analgesic adjuvants have proved to be valuable in improving the quality of anesthesia and duration of analgesia. AIM: To compare the efficacy of clonidine and fentanyl as adjuvants to ropivacaine in spinal anesthesia in lower abdominal surgeries. MATERIALS AND METHODS: A randomized, double-blind control study was carried out in 100 patients who were randomly divided into two groups...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746542/a-randomized-controlled-study-between-fentanyl-and-butorphanol-with-low-dose-intrathecal-bupivacaine-to-facilitate-early-postoperative-ambulation-in-urological-procedures
#8
Arvind Kumar, Ritesh Kumar, Vinod Kumar Verma, Chandrakant Prasad, Rajesh Kumar, Shashi Kant, Gunjan Kumar, Neha Singh, Rupam Kumari
INTRODUCTION: Opioids are widely used in conjunction with local anesthetics as they permit the use of lower dose of local anesthetics while providing adequate anesthesia and analgesia. It both provides adequate anesthesia as well as lower drug toxicity neuraxial administration of opioids in conjunction with local anesthetics improves the quality of intraoperative analgesia and prolongs the duration of postoperative analgesia. Bupivacaine is the most commonly used drug for subarachnoid block due to its lesser side effects...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746539/levobupivacaine-for-labor-analgesia
#9
Joginder Pal Attri, Reena Makhni, Savinder Sethi
BACKGROUND: Combined spinal-epidural analgesia has become the preferred technique for labor analgesia as it combines the benefits of both spinal analgesia and flexibility of epidural catheter. Study was carried out with the primary aim to compare levobupivacaine and ropivacaine with fentanyl in terms of onset and duration of sensory block and to know maternal and fetal outcome. MATERIALS AND METHODS: In a prospective randomized double-blind study, 60 primipara of the American Society of Anesthesiologists health status Class I and II with singleton pregnancy in active stage of labor were randomly allocated into two groups of 30 each...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746526/efficacy-of-lipophilic-vs-lipophobic-opioids-in-addition-to-hyperbaric-bupivacaine-for-patients-undergoing-lower-segment-caeserean-section
#10
Amit Agrawal, Veena Asthana, J P Sharma, Vineeta Gupta
BACKGROUND: Subarachnoid block is the preferred technique for providing anesthesia for patients undergoing cesarean section. Various pharmacological agents in added to local anesthetics (LA) modify their original effects in terms of block characteristics and quality of analgesia. However, there is ongoing debate about this practice of using adjuncts with LA. We tested whether addition of lipophilic versus lipophobic opioids to LA gives any clinical benefits to maternal and fetal outcome when used in these patients requiring spinal anesthesia...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27729811/prolongation-of-greater-occipital-neural-blockade-with-10-lidocaine-neurolysis-a-case-series-of-a-new-technique
#11
David Daewhan Kim, Nabil Sibai
INTRODUCTION: Greater occipital nerve blocks (GONB) have been used for headache but their benefit may be short. Ready et al performed intrathecal injections on rabbits and reported neurologic/histologic changes that required concentrations of at least 8%. Our study tests the hypothesis that the neurolytic effects of GONB with 10% lidocaine can prolong relief. METHODS: After an approval from Henry Ford Hospital Institutional Review Board, a chart review was performed for patients who had GONB with 10% lidocaine...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27718435/suspected-total-spinal-in-patient-having-emergent-caesarean-section-a-case-report-and-literature-review
#12
H Virgin, E Oddby, J G Jakobsson
INTRODUCTION: Epidural analgesia is commonly used for management of pain during childbirth. Need for emergent Caesarean section e.g. because of signs of foetal distress or lack of progress is however not an uncommon event. In females having an established epidural; general anaesthesia, top-up of the epidural or putting a spinal are all possible options. Dosing of the spinal anaesthesia in females having epidural is a matter of discussion. PRESENTATION OF CASE: We describe a healthy 32 years, 0 para mother in gestation week 36 having labour epidural analgesia but due to foetal distress scheduled for an emergent Caesarean section category 2 that developed upper extremity weakness and respiratory depression after administration of standard dose high density bupivacaine/morphine/fentanyl intrathecal anaesthesia...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27717635/dose-response-of-intrathecal-morphine-when-administered-with-intravenous-ketorolac-for-post-cesarean-analgesia-a-two-center-prospective-randomized-blinded-trial
#13
J S Berger, A Gonzalez, A Hopkins, T Alshaeri, D Jeon, S Wang, R L Amdur, R Smiley
BACKGROUND: The appropriate dose of intrathecal morphine for post-cesarean analgesia is unclear. With the inclusion of routine non-steroidal anti-inflammatory drugs, the required dose of morphine may be significantly less than the 200-300μg common a decade ago. We performed a two-center, prospective, randomized, blinded trial comparing three doses of intrathecal morphine, combined with routine intravenous ketorolac, in 144 healthy women undergoing elective cesarean delivery. METHODS: Patients received an intrathecal injection of hyperbaric bupivacaine 12mg, fentanyl 15μg and a randomized dose of 50, 100, or 150μg morphine in a volume of 2...
December 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27703394/survey-of-pain-specialists-regarding-conversion-of-high-dose-intravenous-to-neuraxial-opioids
#14
Andrew W Gorlin, David M Rosenfeld, Jillian Maloney, Christopher S Wie, Johnathan McGarvey, Terrence L Trentman
The conversion of high-dose intravenous (IV) opioids to an equianalgesic epidural (EP) or intrathecal (IT) dose is a common clinical dilemma for which there is little evidence to guide practice. Expert opinion varies, though a 100 IV:10:EP:1 IT conversion ratio is commonly cited in the literature, especially for morphine. In this study, the authors surveyed 724 pain specialists to elucidate the ratios that respondents apply to convert high-dose IV morphine, hydromorphone, and fentanyl to both EP and IT routes...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27641091/determination-of-ed50-of-hydromorphone-for-postoperative-analgesia-following-cesarean-delivery
#15
G C Lynde
BACKGROUND: Morphine is the most common opioid injected into the intrathecal space for postoperative analgesia following cesarean delivery, but ongoing medication shortages have resulted in limited availability. One proposed morphine alternative is hydromorphone. Studies investigating its use in post-cesarean analgesia are limited. This study was conducted to determine the median effective dose of intrathecal hydromorphone 12h postpartum. METHODS: Twenty healthy women undergoing elective cesarean delivery were recruited into this study...
December 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27555137/levobupivacaine-vs-racemic-bupivacaine-in-spinal-anesthesia-for-sequential-bilateral-total-knee-arthroplasty-a-retrospective-cohort-study
#16
Chee Kean Chen, Francis C S Lau, Woo Guan Lee, Vui Eng Phui
STUDY OBJECTIVES: To compare the anesthetic potency and safety of spinal anesthesia with higher dosages of levobupivacaine and bupivacaine in patients for bilateral sequential for total knee arthroplasty (TKA). DESIGN: Retrospective cohort study. SETTING: Operation theater with postoperative inpatient follow-up. PATIENTS: The medical records of 315 patients who underwent sequential bilateral TKA were reviewed. INTERVENTIONS: Patients who received intrathecal levobupicavaine 0...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27549335/continuous-spinal-labor-analgesia-for-two-deliveries-in-a-parturient-with-severe-subvalvular-aortic-stenosis
#17
Shunsuke Hyuga, Toshiyuki Okutomi, Rie Kato, Yuki Hosokawa
Various degrees of left ventricular outflow tract (LVOT) obstruction have been seen in patients with subvalvular aortic stenosis (SAS). Regional analgesia during labor for parturients with SAS is relatively contraindicated because it has a potential risk for hemodynamic instability due to sympathetic blockade as a result of vasodilation by local anesthetics. We thought continuous spinal analgesia (CSA) using an opioid and minimal doses of local anesthetic could provide more stable hemodynamic status. We demonstrate the management of a 28-year-old pregnant patient with SAS who received CSA for her two deliveries...
August 22, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27505059/primary-hydromorphone-related-intrathecal-catheter-tip-granulomas-is-there-a-role-for-dose-and-concentration
#18
I Elias Veizi, Salim M Hayek, Michael Hanes, Ryan Galica, Sivakanth Katta, Tony Yaksh
BACKGROUND: Intrathecal drug delivery therapy has been used effectively in treating patients with intractable chronic pain. The development of an intrathecal catheter tip granuloma (ICTG) related to delivery of intrathecal opiates is a relatively infrequent, but potentially devastating complication. While there are many morphine-related ICTG cases described, reports of hydromorphone-related ICTG are limited. In addition, studies suggest a strong correlation between the use of higher doses and concentrations of intrathecal opiates and ICTG formation...
October 2016: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/27382813/effect-of-preoperative-intravenous-oxycodone-on-low-dose-ropivacaine-spinal-anesthesia-combined-with-intrathecal-fentanyl
#19
RANDOMIZED CONTROLLED TRIAL
Na Wang, Songling Zhang, Yaowen Fu, Jinguo Wang
BACKGROUND: Low-dose ropivacaine combined with intrathecal fentanyl can provide adequate anaesthesia with minimal haemodynamic variation. Preemptive analgesia can enhance analgesic effect of spinal anaesthesia without obvious side effects. AIMS: To assess the efficacy of preoperative intravenous oxycodone on transurethral resection of prostate (TURP) under 10 mg ropivacaine spinal anaesthesia combined with intrathecal 25 pg fentanyl. METHODS: Sixty patients undergoing TURP were randomly divided into two groups: Group o (n=30), in which the patients were administered 0...
February 2016: Middle East Journal of Anesthesiology
https://www.readbyqxmd.com/read/27382812/comparison-of-postoperative-analgesic-effect-of-intrathecal-ketamine-and-fentanyl-added-to-bupivacaine-in-patients-undergoing-cesarean-section-a-prospective-randomized-double-blind-study
#20
RANDOMIZED CONTROLLED TRIAL
Marzieh Beigom Khezri, Elham Tahaei, Amir Hossein Atlasbaf
OBJECTIVES: To compare the analgesic efficacy of intrathecal Ketamine and fentanyl added to bupivacaine in patients undergoing cesarean section. METHODS: Ninety patients 18-40 years old were recruited in a prospective double-blinded, randomized way. Spinal anesthesia was performed in the three groups by using bupivacaine 10mg combined with 0.1mg/kg ketamine in group K, bupivacaine 10mg combined with 25 µg fentanyl in group F and bupivacaine 10mg combined 0.5 ml distilled water in group P...
February 2016: Middle East Journal of Anesthesiology
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