Abstract:
BACKGROUND AND OBJECTIVES:In order to prolong labor analgesia, one may add intrathecal epinephrine to the combination of bupivacaine and fentanyl. In this study, we tested the hypothesis that the addition of intrathecal epinephrine would lessen the requirement for a rescue dose of epidural analgesia during labor. METHODS:One hundred-eight parturients randomly received intrathecal bupivacaine 2.5 mg and fentanyl 25 microgram with epinephrine 100 microgram (Group BFE) or without (Group BF). Analgesia was assessed by visual analogue pain score (VAPS) 15 and 30 minutes after drug administration. Then, epidural analgesia (0.1% bupivacaine with 0.0002% fentanyl and 1:250,000 epinephrine at 10 mL/h) was initiated. If the patient requested additional analgesia and VAPS was over 30 mm, we added 8 mL epidural bupivacaine 0.125%. The requirement for additional analgesia, the incidence of motor block assessed by a modified Bromage score, hypotension, nausea, and pruritus was noted. RESULTS:Except for 3 parturients in Group BF, satisfactory analgesia was achieved in all parturients 30 minutes after intrathecal drug administration. Following 30 minutes of intrathecal drug administration, VAPSs (mean +/- SD) were 0 +/- 4 mm in Group BFE and 4 +/- 11 mm in Group BF. The number of patients who required additional labor analgesia in Group BFE (11 patients, 20%) was significantly less than in Group BF (26 patients, 48%) (P =.003). The incidence of motor block 30 minutes after spinal analgesia in Group BFE (12 patients, 22%) was significantly higher than in Group BF (3 patients, 6%) (P =.024). Nausea and pruritus were similar in both groups. CONCLUSION:The addition of epinephrine to intrathecal bupivacaine-fentanyl lessened the requirement for additional epidural analgesia without increasing hypotension, nausea, or pruritus. However, the incidence of motor block may be increased without labor prolongation.
journal_name
Reg Anesth Pain Medjournal_title
Regional anesthesia and pain medicineauthors
Okutomi T,Mochizuki J,Amano K,Datta Sdoi
10.1053/rapm.2003.50026subject
Has Abstractpub_date
2003-03-01 00:00:00pages
108-12issue
2eissn
1098-7339issn
1532-8651pii
S1098733902277287journal_volume
28pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVE:Femoral nerve block (FNB) is increasingly used as an analgesic modality in patients with femoral fracture both in the emergency department and preoperatively. We describe an occurrence of unexpected dislocation of the fracture after FNB. CASE REPORT:An FNB was administered to treat pain in a 48-year-old pati...
journal_title:Regional anesthesia and pain medicine
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更新日期:2014-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Whether patients titrate themselves to an individualized blood or plasma opioid concentration (the so-called minimum effective concentration or [MEC]) has been debated extensively. Nevertheless, there is consistent opinion that during patient controlled analgesia (PCA) patients balance accepta...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章
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abstract:BACKGROUND:A difficult neuraxial block (DNB) may be associated with complications. The aims of this study were to estimate the prevalence of DNB, assess patient-related and organizational factors associated with DNB, and evaluate the diagnostic accuracy of an accumulated risk score for predicting DNB. METHODS:A consec...
journal_title:Regional anesthesia and pain medicine
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abstract:BACKGROUND AND OBJECTIVES:This study reports our early experience with continuous cervical paravertebral block (CCPVB) using a stimulating catheter for the management of acute pain after shoulder surgery. METHODS:This prospective observational study presents 256 CCPVB for pain relief after 14 different shoulder operat...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章
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abstract:BACKGROUND AND OBJECTIVES:The aim of this study was to compare the potency of bupivacaine, ropivacaine, and levobupivacaine in an equal dose and concentration for sympathetic block. METHODS:We measured mean arterial pressure, heart rate (HR), and right and left brachial artery blood flow (BABF) before and after cervic...
journal_title:Regional anesthesia and pain medicine
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abstract:BACKGROUND AND OBJECTIVES:The transarterial axillary block and the ultrasound-guided infraclavicular block are both effective methods of anesthetizing the upper extremity. This study compares these methods with respect to subjective postoperative dysesthesias, block adequacy, patient comfort, and patient satisfaction. ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
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abstract:OBJECTIVE:We present a case of reappearance of spinal anesthesia despite the use of plain (isobaric) lidocaine and without an associated cough or Valsalva maneuver. CASE REPORT:A 66-year-old man had spinal anesthesia for knee arthroscopy. Two hours after the induction of spinal anesthesia and after the patient's motor...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
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abstract:BACKGROUND AND OBJECTIVES:Central sensitization is often seen in chronic pain. A relevant and potent mechanism of central sensitization is the central integration of nociceptive impulses. Temporal summation in humans and the wind-up process in animals share common features of central integration. This preclinical and c...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
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journal_title:Regional anesthesia and pain medicine
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
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abstract:BACKGROUND AND OBJECTIVES:This study examined whether perioperative multimodal analgesia (MMA) improves the effectiveness of intravenous nutrition (IVN) as a means of preventing protein wasting following major upper abdominal surgery (UAS). The MMA regimen utilized combined epidural opioid/local anesthetic and the syst...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/rapm.2002.27850
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:We wished to determine which long-acting local anesthetic would produce the least pain on injection for treatment of myofascial pain disorders. We compared the pain on intramuscular injection of bupivacaine, ropivacaine, bupivacaine with dexamethasone, ropivacaine with dexamethasone, and needl...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
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abstract::Despite a growing awareness about the importance of gender equity and the rising number of women in medicine, women remain persistently underrepresented in pain medicine and anesthesiology. Pain medicine ranks among the bottom quartile of medical specialties in terms of female applicants, female trainees, and proporti...
journal_title:Regional anesthesia and pain medicine
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
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abstract:BACKGROUND AND OBJECTIVES:Perineural dexamethasone or dexmedetomidine prolongs the duration of single-injection peripheral nerve block when added to the local anesthetic solution. In a randomized, controlled, double-blinded study in patients undergoing thoracoscopic pneumonectomy, we tested the hypothesis that combined...
journal_title:Regional anesthesia and pain medicine
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journal_title:Regional anesthesia and pain medicine
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abstract:BACKGROUND AND OBJECTIVE:The study goal was to compare the effect of epinephrine in different doses on pulmonary gas exchange in a rat model of bupivacaine-induced cardiac depression. METHODS:Twenty-four adult male Sprague-Dawley rats were divided into 4 groups (n = 6), and each group received a bupivacaine infusion (...
journal_title:Regional anesthesia and pain medicine
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abstract:BACKGROUND:A growing body of evidence indicates that the use of regional anesthesia offers advantages over general anesthesia, not only in terms of reducing complications but also regarding resource utilization and patient satisfaction. Because of the paucity of data on the nationwide adoption of regional anesthesia te...
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journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Regional anesthesia and pain medicine
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journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
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更新日期:2009-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Prolongation of the QT interval may result in grave cardiac arrhythmias, polymorphic ventricular tachycardia ("torsades de pointes"), and ventricular fibrillation. We assessed the influence of spinal anesthesia on the QTc interval and the potential arrhythmogenicity of this method of anesthesi...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
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更新日期:2005-11-01 00:00:00
abstract::Pain patients can be difficult. They can provoke negative feelings of frustration and anger among clinicians and damage the doctor-patient relationship. This article helps practitioners to identify those pain patients who would be prone to difficult behavior and sheds light on some of the reasons behind the behavior t...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
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更新日期:2005-03-01 00:00:00
abstract::The Accreditation Council for Graduate Medical Education has shifted to competency-based medical education. This educational framework requires the description of educational outcomes based on the knowledge, skills and behaviors expected of competent trainees. It also requires an assessment program to provide formativ...
journal_title:Regional anesthesia and pain medicine
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abstract::This study aimed to describe the anatomical distribution of dye injected in the erector spinae plane (ESP) in a porcine living model, which could aid to reveal factors potentially relevant to the unexplained clinical effects of the ESP block. Six pigs received 0.6 mL/kg of 0.25% new methylene blue at the level of the ...
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abstract:BACKGROUND AND OBJECTIVES:This prospective, randomized, double-blind study compares the efficacy of two spinal needles in terms of their performance characteristics and associated perioperative complaints in young patients. METHODS:ASA I and II patients aged from 20 to 40 years undergoing lower limb orthopedic surgery...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
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abstract:BACKGROUND:No studies have examined the long-term benefits of regional anesthesia (RA) for pain management after combat-related injury. The objective of this prospective cohort study was to examine the relationship between RA administration and patient-reported pain-related outcomes among Operation Enduring Freedom (OE...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
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更新日期:2019-09-27 00:00:00
abstract:BACKGROUND:Subarachnoid blocks are considered routine anesthetic procedures important in the daily practices of most anesthesiologists. However, few data exist regarding modern failure rates or quality-compromising behaviors. METHODS:Sixty adult patients having orthopedic surgery under spinal anesthesia were enrolled ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e3182030863
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Epinephrine, 25 microg and 200 microg, has been found to prolong the duration of intrathecal labor analgesia when added to an opioid. In our hospital we use the standard epidural mixture, prepared by the pharmacist, containing epinephrine 1:800,000; i.e., 1.25 microg/mL for both spinal and epi...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2001-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Adenosine is an endogenous compound that may have analgesic effects. Results from clinical trials are not consistent, however, and there is a need for large-scale, randomized, placebo-controlled studies to clarify the role of adenosine in the treatment of pain states, including acute nocicepti...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2001-09-01 00:00:00