Abstract:
BACKGROUND:In this study we sought to determine and compare the minimum local anesthetic volumes (MLAV) and doses (MLAD) of two concentrations of bupivacaine for epidural pain relief in labor, and to quantify the effect on dose. METHODS:Eighty women were randomized in a double-blind manner to receive a first bolus of either plain bupivacaine 0.125% (w/v) or 0.25% (w/v). The arbitrary starting volume was 15 mL. Subsequent volumes were decided by sequential allocation according to analgesic efficacy. A visual analog pain score < or =10 (0-100) within 30 min, indicated effective analgesia. The next woman received a decrement of 2 mL. A failure of the visual analog pain score to reach < or =10 was followed by a 2 mL increment for the next woman. RESULTS:Using the formula of Dixon and Massey, MLAV and MLAD, with 95% confidence intervals (CI) were calculated for each concentration. MLAV was 13.6 mL (95% CI 12.4-14.8), with bupivacaine 0.125% (w/v), and 9.2 mL (95% CI 6.9-11.5) with bupivacaine 0.25% (w/v). The difference was highly significant (P = 0.002). MLAD for these volumes were 17.0 mg (95% CI 15.5-18.5), and 23.1 mg (17.2-28.9), respectively (P = 0.045). CONCLUSIONS:Bupivacaine 0.125% (w/v) when compared with 0.25% (w/v) produced equivalent analgesia with a 50% increase in volume, but with a 25% reduction in dose. Any reduction in dose, without loss of efficacy, reduces risk of toxicity and improves safety.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Lyons GR,Kocarev MG,Wilson RC,Columb MOdoi
10.1213/01.ane.0000252458.20912.efsubject
Has Abstractpub_date
2007-02-01 00:00:00pages
412-5issue
2eissn
0003-2999issn
1526-7598pii
104/2/412journal_volume
104pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Hypoxemia, as measured by pulse oximetry (SpO2), is common in postanesthesia care unit (PACU) patients. The temporal distribution of desaturation has managerial implications because treatment may necessitate the presence of an anesthesiologist. METHODS:We retrieved SpO2 values recorded electronically every ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000410
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:In this prospective observational study, we compared changes in cardiac index (CI) during fluid challenge using photoplethysmography (PPG; Nexfin™) (CIPPG) versus esophageal Doppler (ED) (CIED) in major noncardiac surgery patients. METHODS:Measurements were obtained when the attending anesthesiologist decid...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001113
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Various different interventions can be used to reduce surgical blood loss; however, there is no "gold standard" for accurately measuring the volume of perioperative blood loss, and this makes it difficult to assess the efficacy of these interventions. METHODS:We used data from a previous multicenter double-...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1213/ANE.0000000000001992
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Topical anesthesia of the upper airway is often recommended when difficulty in airway management is anticipated. There are published reports, however, of administration of topical anesthesia resulting in complete loss of airway control. Adverse effects are mostly attributed to interference with involuntary p...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3182455b71
更新日期:2012-04-01 00:00:00
abstract:UNLABELLED:We studied the in vitro effects of sevoflurane, isoflurane, and propofol anesthesia on platelet function. Thirty patients undergoing minor surgical procedures were divided into three groups (n = 10 each). Induction of anesthesia was achieved by using 5 mg/kg thiopental i.v., and 0.1 mg/kg vecuronium i.v. was...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199902000-00039
更新日期:1999-02-01 00:00:00
abstract::A 19-year-old African American man with a T12 spinal cord lesion underwent a T4-L5 thoracolumbar spinal fusion. Intraoperatively, his arterial blood pressure acutely increased from 110/60 to 260/130 mm Hg without a change in heart rate. The patient did not have pheochromocytoma, carcinoid syndrome, or thyroid storm. T...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181f334b8
更新日期:2010-11-01 00:00:00
abstract:IMPLICATIONS:The number of patients supported by ventricular assist devices (VADs) that present for noncardiac surgery is increasing in our institution. Our recent experience with eight such patients is reported, along with a review of the most commonly implanted VADs and the anesthetic implications and considerations ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200207000-00007
更新日期:2002-07-01 00:00:00
abstract::Sevoflurane appears to have several properties that make it an attractive alternative to the currently available anesthetics for outpatient anesthesia. The relative low solubility of sevoflurane, as well as an impressive lack of airway irritation, makes it a very useful anesthetic for inhalation induction of anesthesi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1097/00000539-199512001-00009
更新日期:1995-12-01 00:00:00
abstract::The importance of timely administration of antibiotics for prophylaxis of surgical site infections has led to pressure on anesthesiologists to administer antibiotics. We present a survey of members of the American Association of Clinical Directors designed to evaluate the role of the anesthesiologist in the selection ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000195551.35172.86
更新日期:2006-04-01 00:00:00
abstract::The effects of different intubating doses of atracurium on the time of onset, and the effect of an additional dose of thiopental on intubating conditions, were studied in 72 patients divided into six groups (n = 12 in each). Stratified sampling was used to obtain an even sex distribution. Groups I, III, and V (control...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1986-12-01 00:00:00
abstract::The influence of preoxygenation in the supine (n = 10) versus the 45 degrees head-up (n = 10) position on the duration of apnea leading to a decrease in arterial oxygen saturation to 95%, as monitored by pulse oximetry, was investigated in 20 women undergoing elective cesarean section at term of pregnancy. The results...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199211000-00018
更新日期:1992-11-01 00:00:00
abstract::The charts of 1553 patients who were anesthetized for ambulatory surgery were analyzed retrospectively to determine the effect of the type of surgery, the age of the patient, the use of premedication, the duration of anesthesia, and the anesthetic technique on the duration of recovery and the rate of complications. In...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1982-11-01 00:00:00
abstract:BACKGROUND:There are three basic types of decision aids to facilitate operating room (OR) management decision-making on the day of surgery. Decision makers can rely on passive status displays (e.g., big screens or whiteboards), active status displays (e.g., text pager notification), and/or command displays (e.g., text ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000268539.85847.c9
更新日期:2007-08-01 00:00:00
abstract:UNLABELLED:A new infraclavicular brachial plexus block method has the patient supine with an adducted arm. The target is any of the three cords behind the pectoralis minor muscle. The point of needle insertion is the intersection between the clavicle and the coracoid process. The needle is advanced 0 degrees -30 degree...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000094337.75996.ae
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Sigma (sigma)-receptor agonists attenuate brain injury after experimental focal cerebral ischemia in several species. We tested the hypothesis that the potent, prototypical sigma(1)-receptor agonist, 4-phenyl-1-(4-phenylbutyl) piperidine (PPBP), protects neurons by a mechanism involving the antiapoptotic pro...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000260267.71185.73
更新日期:2007-05-01 00:00:00
abstract::We report a case of possible air embolism during a three-port pars plana vitrectomy and air-fluid exchange of the vitreous cavity of the eye. After the start of intraocular air flushing, sudden tachycardia, a decrease in oxygen saturation and end-tidal carbon dioxide tension, and a distinct "mill-wheel" murmur were ob...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000154304.63828.C0
更新日期:2005-06-01 00:00:00
abstract::We compared laryngeal aperture (LA) exposure and endotracheal intubation difficulty scale (IDS) scores between balloon-assisted and conventional laryngoscopy. Thirty-two anesthetized and paralyzed elective surgery patients underwent laryngoscopy with a standard number 4 and a modified number 4 curved blade carrying a ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200012000-00040
更新日期:2000-12-01 00:00:00
abstract::We determined the heart rate (HR) response to enflurane, halothane, and isoflurane and the effects of narcotics on this response in 81 healthy patients scheduled for elective surgery. Patients were randomly assigned to one of six treatment groups: one of the three anesthetics (approximately 0.9 MAC) in 60% nitrous oxi...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1987-02-01 00:00:00
abstract:BACKGROUND:Ten to fifteen percent of awake patients develop neurological deficits secondary to cerebral hypoperfusion after carotid artery cross-clamping. The reversal of such deficits by increasing the inspired oxygen fraction (Fio(2)) has been demonstrated, and regional cerebral oxygenation (rSO(2)) has been shown to...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181c5f160
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:The primary objective of this study was to compare the characteristics of culture-positive and culture-negative status in septic patients. We also determined whether culture status is associated with mortality and whether unique variables are associated with mortality in culture-positive and culture-negative...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000004072
更新日期:2019-11-01 00:00:00
abstract:UNLABELLED:Because perfluorocarbon (PFC) liquid contacts closely with the alveolar capillaries during partial liquid ventilation (PLV), PLV with cold PFC may be used for the induction of hypothermia. Twenty rabbits were randomized to PFC-induced hypothermia (PH) (n = 7; core temperature 35 degrees +/- 1 degrees C), sur...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200201000-00030
更新日期:2002-01-01 00:00:00
abstract::The purpose of this canine study was to examine the cerebral vascular and metabolic effects of adding nitrous oxide to isoflurane from 1.4% expired (1 MAC) up to a concentration giving an isoelectric electroencephalogram (EEG). Cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRO2) were determined us...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199101000-00013
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Hyperkalemia poses serious hazards to patients undergoing orthotopic liver transplantation (OLT), and its predictors have not been thoroughly examined. METHODS:We retrospectively studied 1124 consecutive adult patients who underwent OLT. Hyperkalemia was defined as serum K+ > or =5.5 mmol/L. A total of 47 r...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000271914.54261.17
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:In patients with mitral regurgitation (MR), the effective regurgitant orifice area can be estimated by measuring the vena contracta area (VCA). We hypothesize that the VCA has characteristic temporal dynamics related to the underlying mechanism of functional mitral regurgitation (FMR) versus degenerative mit...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001056
更新日期:2016-02-01 00:00:00
abstract:UNLABELLED:This study was performed to evaluate both the effects of pentobarbital on disruption of the blood-brain barrier (BBB) by hyperosmolar mannitol and the relationship between its effect on blood pressure and the integrity of the BBB. Under isoflurane anesthesia, rats in the control group were infused with 25% m...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199806000-00018
更新日期:1998-06-01 00:00:00
abstract::Spontaneous ventilation may offer advantages over controlled mechanical ventilation (CMV), but increase in work of breathing may diminish its usefulness. During general anesthesia, respiratory depression and increased work of breathing often preclude spontaneous ventilation, and patients then receive CMV. We compared ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199208000-00003
更新日期:1992-08-01 00:00:00
abstract::Antagonists of the serotonergic 5-hydroxytryptamine 3A receptor (5-HT(3A)R) and muscle nicotinic acetylcholine receptors (nAChR) are widely used in anesthesia practice. Both 5-HT(3A)R and nAChR are ligand-gated ion channels with known pharmacological overlap between some of their agonists and antagonists. We studied t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000160531.65953.77
更新日期:2005-09-01 00:00:00
abstract:IMPLICATIONS:Tizanidine was given systemically to rats with experimental postoperative pain. Partial pain relief was obtained, but the effect was not clinically significant. Although systemic tizanidine is effective in relieving experimental neuropathic pain, it is not as effective for postoperative pain. ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200111000-00056
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:In clinical anesthesia, robust surgical stress occasionally causes unintended light anesthesia during operation. To test the hypothesis that neural input condition could modify actions of general anesthetics as a result of presynaptic alteration in the central nervous system, we investigated the mechanisms b...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181dd25a5
更新日期:2010-06-01 00:00:00
abstract::Transesophageal Doppler (TED) monitoring provides continuous, noninvasive monitoring of cardiac output by measurement of aortic flow velocities. Because of the effects on aortic flow dynamics resulting from atherosclerosis, aortic cross-clamping, and wide variations in arterial blood pressure, the validity of TED moni...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199112000-00006
更新日期:1991-12-01 00:00:00