Abstract:
BACKGROUND:Paravertebral analgesia is useful for breast surgery. Patient controlled analgesia by IV or epidural routes is well established for delivering postoperative analgesia. Our objective was to apply patient control to paravertebral analgesia and evaluate the efficacy and tolerability of two distinct dosing regimens. METHODS:Patients undergoing major breast cancer surgery were recruited for this prospective, double-blind, randomized trial of two patient-controlled paravertebral analgesia regimens: 19 patients received levobupivacaine 0.2% at 8 mL/h with 3-mL bolus and 15-min lockout (15-min lockout group); 18 received levobupivacaine 0.2% at 4 mL/h with 8-mL bolus and 30-min lockout (30-min lockout group). Our primary outcome was dynamic pain scores (visual analog scale) at 4-hourly intervals for 36 h. Secondary outcomes were resting pain scores, rescue analgesia requirements, volume of levobupivacaine administered, demands for levobupivacaine, levobupivacaine boluses received, and patient satisfaction. RESULTS:Resting and dynamic pain scores were comparable in the groups. Two 15-min lockout patients and five 30-min lockout patients required rescue analgesia (P = 0.23). Patients received 400 +/- 95 mL and 330 +/- 130 mL levobupivacaine in 15-min and 30-min lockout groups, respectively (P = 0.012). The 15-min lockout group requested a bolus 75 +/- 16 times; the 30-min lockout group requested it 69 +/- 14 times (P = 0.40). However, the 15-min lockout group received 39 +/- 22 boluses and the 30-min lockout group only 24 +/- 16 (P = 0.02). Systolic pressure, heart rate, respiratory rate, sedation scores, nausea, antiemetic requirement, and satisfaction scores were similar in each group. CONCLUSIONS:Patient-controlled paravertebral analgesia for breast cancer surgery, with either regimen, provided satisfactory analgesia and was well tolerated.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
McElwain J,Freir NM,Burlacu CL,Moriarty DC,Sessler DI,Buggy DJdoi
10.1213/ane.0b013e31817b7f01subject
Has Abstractpub_date
2008-08-01 00:00:00pages
665-8issue
2eissn
0003-2999issn
1526-7598pii
107/2/665journal_volume
107pub_type
杂志文章,随机对照试验abstract::The anesthetic effect of lidocaine was evaluated in rats by determining the change in anesthetic requirement of cyclopropane MAC that was produced by blood concentrations of lidocaine in the clinically useful range. A linear reduction in anesthetic requirement was produced with concentrations up to 1 mug/ml. Further i...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197611000-00016
更新日期:1976-11-01 00:00:00
abstract::Perioperative lung-protective ventilation (LPV) can reduce perioperative pulmonary morbidity. We hypothesized that modifying default anesthesia machine ventilator settings would increase the use of intraoperative LPV. Default tidal volume settings on our anesthesia machines were decreased from 600 to 400 mL, and defau...
journal_title:Anesthesia and analgesia
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pub_type: 杂志文章,随机对照试验
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journal_title:Anesthesia and analgesia
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pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e318288416d
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pub_type: 杂志文章
doi:10.1213/ANE.0000000000000229
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abstract:BACKGROUND:Preoperative flushing of an anesthesia workstation is an alternative for preparation of the anesthesia workstation before use in malignant hyperthermia-susceptible patients (MHS). We studied in vitro, using a test lung, the washout profile of sevoflurane in 7 recent workstations during adult and, for the fir...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000208
更新日期:2014-07-01 00:00:00
abstract::To determine the pharmacokinetics of local anesthetics after lumbar sympathetic blocks, total and free (unbound) plasma concentrations of bupivacaine in venous blood samples were measured in 12 patients using a high-performance liquid chromatography (HPLC) technique. Administration of 30 mL of plain bupivacaine 0.175%...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199411000-00017
更新日期:1994-11-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1981-05-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章,meta分析,评审
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/00000539-199003000-00013
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abstract::Although there have been several anecdotal reports of the use of buccal pulse oximeter monitoring (Spo2) when digital Spo2 monitoring cannot be used, there have been no objective evaluations of the accuracy of buccal Spo2 monitoring. The purpose of this study was to systematically compare buccal Spo2 monitoring to bot...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1992-10-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000002635
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abstract::The sensitivity, specificity, and accuracy of the cobalt blue and ninhydrin sweat tests were compared with the sympathogalvanic response (SGR) in assessment of complete sympathetic blockade. Patients were randomly assigned to receive epidural administration of either preservative-free physiologic saline solution and 8...
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:1985-04-01 00:00:00
abstract::Evaluation of a new inhaled anesthetic requires determination of the anesthetic's potential to predispose to ventricular (and other) arrhythmias in an animal model. This need poses logistic and economic burdens if the effects of large numbers of new anesthetics are to be surveyed. We have devised a technique for deter...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199006000-00013
更新日期:1990-06-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2001-12-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,多中心研究
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pub_type: 杂志文章,评审
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更新日期:2007-03-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1982-12-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1992-06-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181fe4841
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
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journal_title:Anesthesia and analgesia
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
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更新日期:2009-03-01 00:00:00
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