Comparison of hypobaric, hyperbaric, and isobaric solutions of bupivacaine during continuous spinal anesthesia.

Abstract:

:This study was designed to compare the anesthetic properties of hypobaric bupivacaine with those of isobaric and hyperbaric solutions when administered in the supine position in an elderly population undergoing hip surgery using continuous spinal anesthesia. Plain bupivacaine (0.5%) was mixed with equal volumes of 10% dextrose (hyperbaric), 0.9% NaCl (isobaric), or distilled water (hypobaric) to obtain 0.25% solutions. In a double-blind fashion, all patients received 3 mL (7.5 mg) of their particular solution injected through the spinal catheter in the horizontal supine position. The sensory level obtained in the hyperbaric group (median, T4; range, T3-L3) was significantly higher than in both the isobaric (median, T11; range, T6-L1) and hypobaric (median, L1; range, T4-L3) groups. A motor blockade of grade 2 or 3 was obtained in 14 of 15 and 12 of 15 patients in, respectively, the hyperbaric and isobaric groups, but only in 8 of 15 patients in the hypobaric group. After the initial injection of 3 mL (7.5 mg), a sensory level of T10 and a motor blockade of grade 2 or 3 was obtained in 14 of 15, 5 of 15, and 3 of 15 patients in the hyperbaric, isobaric, and hypobaric groups, respectively. All remaining patients received 1 or 2 additional milliliters (2.5-5 mg) and achieved these required anesthetic conditions, except for one patient in the hyperbaric group and eight patients in the hypobaric group in whom anesthesia was achieved with hyperbaric tetracaine. The decrease in mean arterial pressure was significantly more severe in the hyperbaric (30%) than in either the isobaric (18%) or hypobaric (14%) groups.(ABSTRACT TRUNCATED AT 250 WORDS)

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Van Gessel EF,Forster A,Schweizer A,Gamulin Z

doi

10.1213/00000539-199106000-00011

subject

Has Abstract

pub_date

1991-06-01 00:00:00

pages

779-84

issue

6

eissn

0003-2999

issn

1526-7598

journal_volume

72

pub_type

临床试验,杂志文章
  • Effect on postoperative sore throat of spraying the endotracheal tube cuff with benzydamine hydrochloride, 10% lidocaine, and 2% lidocaine.

    abstract:BACKGROUND:Postoperative sore throat (POST) is a common complication after endotracheal intubation. We compared the effectiveness on POST of spraying the endotracheal tube (ETT) cuff with benzydamine hydrochloride, 10% lidocaine, and 2% lidocaine. METHODS:Three hundred seventy-two patients were randomly allocated into...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e3181d4854e

    authors: Hung NK,Wu CT,Chan SM,Lu CH,Huang YS,Yeh CC,Lee MS,Cherng CH

    更新日期:2010-10-01 00:00:00

  • Long-term pain vulnerability after surgery in rats: prevention by nefopam, an analgesic with antihyperalgesic properties.

    abstract:BACKGROUND:Tissue damage associated with surgery often produces peripheral and central sensitization that may outlast the stimuli, leading to exaggerated postoperative pain. Paradoxically, the use of opioid analgesia, which is essential for surgical pain management may induce pain sensitization leading to enhanced post...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e3181aa956b

    authors: Laboureyras E,Chateauraynaud J,Richebé P,Simonnet G

    更新日期:2009-08-01 00:00:00

  • Cost-Effectiveness Research in Anesthesiology.

    abstract::Perioperative interventions aimed at decreasing costs and improving outcomes have become increasingly popular in recent years. Anesthesiologists are often faced with a choice among different treatment strategies with little data available on the comparative cost-effectiveness. We performed a systematic review of the E...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000003334

    authors: Teja BJ,Sutherland TN,Barnett SR,Talmor DS

    更新日期:2018-11-01 00:00:00

  • Droperidol causes a dose-dependent prolongation of the QT interval.

    abstract::To further investigate possible prolongation of the frequency-corrected QT interval (QTc interval) after administration of droperidol (DRO), we studied 40 surgical patients who were randomly assigned to one of three groups, receiving an intravenous (IV) injection of either 0.1 mg/kg (Group 1, n = 10), 0.175 mg/kg (Gro...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/00000539-199411000-00028

    authors: Lischke V,Behne M,Doelken P,Schledt U,Probst S,Vettermann J

    更新日期:1994-11-01 00:00:00

  • Does pregnancy protect against intrathecal lidocaine-induced transient neurologic symptoms?

    abstract::We investigated the incidence of transient neurologic symptoms (TNS) after the use of hyperbaric lidocaine as compared with hyperbaric bupivacaine in patients undergoing cesarean delivery under spinal anesthesia. Two hundred women scheduled for cesarean delivery were randomly allocated to receive spinal anesthesia wit...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200102000-00023

    authors: Aouad MT,Siddik SS,Jalbout MI,Baraka AS

    更新日期:2001-02-01 00:00:00

  • Muscle weakness and paresthesia associated with epidural analgesia in a patient with an intrathecal neurofibrolipoma as part of a tethered cord syndrome.

    abstract::We report a case of a 75-yr-old female patient in whom motor deficits and paresthesias occurred after lumbar epidural analgesia. These symptoms were eventually found to be due to a tethered cord syndrome. An epidural catheter was inserted for analgesia after colon surgery. The postoperative course was characterized by...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000120387.09339.d1

    authors: Jetzek-Zader M,Peterschulte G,Ludwig U,Lipfert P

    更新日期:2004-07-01 00:00:00

  • Anesthesia by n-alkanes not consistent with the Meyer-Overton hypothesis: determinations of the solubilities of alkanes in saline and various lipids.

    abstract::Because deviations from the Meyer-Overton rule may provide insights into the attributes of the anesthetic site of action, we characterized the solubility of the n-alkanes in various hydrophobic solvents (n-tetradecane, olive oil, n-octanol, and lecithin) as well as saline using variations on standard techniques. Incre...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199307000-00003

    authors: Taheri S,Laster MJ,Liu J,Eger EI 2nd,Halsey MJ,Koblin DD

    更新日期:1993-07-01 00:00:00

  • Intravenous dexmedetomidine inhibits cerebrovascular dilation induced by isoflurane and sevoflurane in dogs.

    abstract:UNLABELLED:Our aim in this study, performed using a closed cranial window preparation, was to investigate the effect of systemic pretreatment with dexmedetomidine on cerebrovascular response to isoflurane or sevoflurane. After instrumentation under pentobarbital anesthesia, 48 dogs were assigned to one of two groups: t...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199908000-00023

    authors: Ohata H,Iida H,Dohi S,Watanabe Y

    更新日期:1999-08-01 00:00:00

  • Butorphanol and morphine: a double-blind comparison of their parenteral analgesic activity.

    abstract::The analgesic effects of butorphanol tartrate and morphine sulfate were compared in 127 patients judged to have moderate to severe pain following major operations. The study was double-blind, and the drugs were given IM at several dosage levels. Scores for pain intensity and relief, as well as pain-intensity differenc...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/00000539-197605000-00025

    authors: Tavakoli M,Corssen G,Caruso FS

    更新日期:1976-05-01 00:00:00

  • 2,6 di-tert-butylphenol, a nonanesthetic propofol analog, modulates alpha1beta glycine receptor function in a manner distinct from propofol.

    abstract::The anesthetic propofol (2,6 diisopropylphenol) mediates some of its effects by activating inhibitory chloride currents in the lower brainstem and spinal cord. The effects comprise direct activation of gamma-aminobutyric acid-A and glycine receptors in the absence of the natural agonist, as well as potentiation of the...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000120083.10269.54

    authors: Ahrens J,Haeseler G,Leuwer M,Mohammadi B,Krampfl K,Dengler R,Bufler J

    更新日期:2004-07-01 00:00:00

  • Sugammadex reversal of rocuronium-induced neuromuscular blockade: a comparison with neostigmine-glycopyrrolate and edrophonium-atropine.

    abstract:BACKGROUND:Sugammadex is a modified [gamma] cyclodextrin compound, which encapsulates rocuronium to provide for a rapid reversal of residual neuromuscular blockade. We tested the hypothesis that sugammadex would provide for a more rapid reversal of a moderately profound residual rocuronium-induced blockade than the com...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/01.ane.0000248224.42707.48

    authors: Sacan O,White PF,Tufanogullari B,Klein K

    更新日期:2007-03-01 00:00:00

  • Nitrous oxide minimum alveolar anesthetic concentration in rats is greater than previously reported.

    abstract::Recent determinations of the minimum alveolar anesthetic concentration (MAC) for nitrous oxide in rats yield values of 1.51-1.55 atm. When combined with results from other reports, these results suggest a deviation from linear additivity, and call into question the unitary theory of narcosis. The present report provid...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199410000-00016

    authors: Gonsowski CT,Eger EI 2nd

    更新日期:1994-10-01 00:00:00

  • The pain visual analog scale: is it linear or nonlinear?

    abstract:UNLABELLED:The visual analog scale (VAS) is a tool widely used to measure pain, yet controversy surrounds whether the VAS score is ratio or ordinal data. We studied 52 postoperative patients and measured their pain intensity using the VAS. We then asked them to consider different amounts of pain (conceptually twice as ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000539-199912000-00038

    authors: Myles PS,Troedel S,Boquest M,Reeves M

    更新日期:1999-12-01 00:00:00

  • Effects of Obesity and Leptin Deficiency on Morphine Pharmacokinetics in a Mouse Model.

    abstract:BACKGROUND:Obesity causes multiorgan dysfunction, specifically metabolic abnormalities in the liver. Obese patients are opioid-sensitive and have high rates of respiratory complications after surgery. Obesity also has been shown to cause resistance to leptin, an adipose-derived hormone that is key in regulating hunger,...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000001578

    authors: Dalesio NM,Hendrix CW,McMichael DH,Thompson CB,Lee CK,Pho H,Arias RS,Lynn RR,Galinkin J,Yaster M,Brown RH,Schwartz AR

    更新日期:2016-12-01 00:00:00

  • Somatosensory evoked potential quantification of ulnar nerve blockade.

    abstract::We investigated the appropriateness of the somatosensory evoked potentials (SSEPs) as an objective monitor of sensory blockade of the ulnar nerve by comparing the effects of saline and lidocaine infiltration of the ulnar nerve at the elbow, with and without epinephrine. The four treatments were administered in random ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Benzon HT,Toleikis JR,Shanks C,Ramseur A,Sloan T

    更新日期:1986-08-01 00:00:00

  • Synergy between pairs of competitive antagonists at adult human muscle acetylcholine receptors.

    abstract:BACKGROUND:Synergistic neuromuscular blocking effects have been observed clinically with certain pairs of nicotinic acetylcholine receptor (nAChR) competitive antagonists. The mechanism for synergy has not been elucidated. We tested the hypothesis that synergy arises from a differential selectivity of antagonists for t...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e31817b4469

    authors: Liu M,Dilger JP

    更新日期:2008-08-01 00:00:00

  • The effect of fresh gas flow and anesthetic technique on the ability to control acute hemodynamic responses during surgery.

    abstract:UNLABELLED:We evaluated the effect of the fresh gas flow (FGF) rate and the anesthetic technique on the ability to control the acute hyperdynamic response to a specific surgical stimulus during surgery in 90 consenting ASA physical status I-III patients undergoing lower abdominal procedures. After the administration of...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199809000-00033

    authors: Avramov MN,Griffin JD,White PF

    更新日期:1998-09-01 00:00:00

  • A multicenter randomized controlled trial comparing patient-controlled epidural with intravenous analgesia for pain relief in labor.

    abstract::In this multicenter, randomized, controlled trial, we sought to determine whether patient-controlled epidural analgesia (PCEA) for labor affected the incidence of cesarean delivery when compared with patient-controlled IV opioid analgesia (PCIA). Healthy, term nulliparous patients in 4 Canadian institutions were rando...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1213/01.ANE.0000136850.08972.07

    authors: Halpern SH,Muir H,Breen TW,Campbell DC,Barrett J,Liston R,Blanchard JW

    更新日期:2004-11-01 00:00:00

  • Point-of-Care Fibrinogen Testing in Pregnancy.

    abstract::Agreement between estimated fibrinogen concentration via thromboelastography and traditional assays is not established in the parturient. We therefore recruited 56 parturients and performed Clauss and functional fibrinogen level (FLEV) tests. Mean difference of measurements was 36.8 mg/dL (95% CI, 21.8-51.9) with a st...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000003301

    authors: Katz D,Hamburger J,Batt D,Zahn J,Beilin Y

    更新日期:2019-09-01 00:00:00

  • The interaction of FK409, a novel nitric oxide releaser, and peripherally administered morphine during experimental inflammation.

    abstract:UNLABELLED:Nitric oxide (NO) may play an important role in central and peripheral nociceptive processes. However, its contribution to peripheral antinociception is still not clear. In the present study, we investigated the effect of peripherally administered FK409, a spontaneous NO releaser, and its interaction with pe...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199802000-00028

    authors: Nozaki-Taguchi N,Yamamoto T

    更新日期:1998-02-01 00:00:00

  • A new highly reliable instrument for the assessment of pre- and postoperative gynecological pain.

    abstract:UNLABELLED:In this study, we evaluated the reliability of a newly developed method for pain assessment, which is based on perceptual matching by Pain Matcher, Cefar Medical AB, Lund, Sweden, during minor gynecological surgery. In addition, the responsiveness to two different anesthetic methods-electro-acupuncture or a ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-200207000-00027

    authors: Stener-Victorin E,Kowalski J,Lundeberg T

    更新日期:2002-07-01 00:00:00

  • The use of metoprolol and glycopyrrolate to prevent hypotensive/bradycardic events during shoulder arthroscopy in the sitting position under interscalene block.

    abstract:UNLABELLED:Sudden profound hypotensive and/or bradycardic events (HBE) have been reported in >20% of patients undergoing shoulder arthroscopy in the sitting position under interscalene block anesthesia. Retrospective studies suggest that the administration of beta-blockers is safe and may decrease the incidence of thes...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000539-199812000-00020

    authors: Liguori GA,Kahn RL,Gordon J,Gordon MA,Urban MK

    更新日期:1998-12-01 00:00:00

  • High-Sensitivity Cardiac Troponin T Improves the Diagnosis of Perioperative MI.

    abstract:BACKGROUND:The diagnosis of myocardial infarction (MI) after noncardiac surgery has traditionally relied on using relatively insensitive contemporary cardiac troponin (cTn) assays. We hypothesized that using a recently introduced novel high-sensitivity cTnT (hscTnT) assay would increase the detection rate of perioperat...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0000000000002240

    authors: Brown JC,Samaha E,Rao S,Helwani MA,Duma A,Brown F,Gage BF,Miller JP,Jaffe AS,Apple FS,Scott MG,Nagele P

    更新日期:2017-11-01 00:00:00

  • Cardiovascular effects of morphine in patients with coronary arterial disease.

    abstract::Large doses of morphine sulfate have been reported to cause myocardial lactate production and reduction in coronary blood flow in animals. Similar effects with clinical doses in man would significantly alter the management of cardiac patients. Eleven adult patients with significant coronary arterial disease and normal...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Sethna DH,Moffitt EA,Gray RJ,Bussell J,Raymond M,Conklin C,Shell WE,Matloff JM

    更新日期:1982-02-01 00:00:00

  • Three-dimensional computed tomography for difficult thoracic epidural needle placement.

    abstract:BACKGROUND:Thoracic epidural anesthesia is often used as a postoperative analgesic technique in thoracic surgery. However, the structure of the overlapping spinous processes, resulting in interlaminar space occlusion, often makes thoracic epidural needle placement difficult. With the development of multi-detector row s...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ane.0b013e31815efa06

    authors: Murata H,Sakai T,Goto S,Sumikawa K

    更新日期:2008-02-01 00:00:00

  • Cardiac sympathovagal balance and peripheral sympathetic vasoconstriction: epidural versus general anesthesia.

    abstract::Both epidural and general anesthetics alter autonomic balance. However, the relative differences between epidural (EA) and general anesthetics (GA) with regard to cardiac and peripheral sympathovagal balance have not been described. Twenty consecutive patients scheduled for radical retropubic prostatectomy were random...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/00000539-199407000-00031

    authors: Fleisher LA,Frank SM,Shir Y,Estafanous M,Kelly S,Raja SN

    更新日期:1994-07-01 00:00:00

  • The intrathecally administered kappa-2 opioid agonist GR89696 and interleukin-10 attenuate bone cancer-induced pain through synergistic interaction.

    abstract:BACKGROUND:Although bone cancer-related pain is one of the most disruptive symptoms in patients with advanced cancer, patients are often refractory to pharmacological treatments; thus, more effective treatments for bone cancer pain are needed. We evaluated the analgesic efficacy of and interaction between intrathecal G...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e318227824e

    authors: Kim WM,Jeong CW,Lee SH,Kim YO,Cui JH,Yoon MH

    更新日期:2011-10-01 00:00:00

  • The effects of heparin, protamine, and heparinase 1 on platelets in vitro using whole blood flow cytometry.

    abstract:UNLABELLED:The effects of heparinization and the reversal of heparin activity on platelet function after cardiopulmonary bypass have not been well defined. Flow cytometry has become a convenient and powerful technique for characterizing platelets. We examined the expression of a secretion marker (P-selectin) and an agg...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200004000-00007

    authors: Kozek-Langenecker SA,Mohammad SF,Masaki T,Kamerath C,Cheung AK

    更新日期:2000-04-01 00:00:00

  • Safety and efficacy of drug-induced sleep endoscopy using a probability ramp propofol infusion system in patients with severe obstructive sleep apnea.

    abstract:BACKGROUND:Drug-induced sleep endoscopy (DISE) uses sedative-hypnotics to induce moderate obstruction in sleep apnea patients, thereby facilitating anatomic assessment of obstructive physiology. Implementation of DISE with propofol requires a dosing strategy that reliably and efficiently produces obstruction while mini...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000000229

    authors: Atkins JH,Mandel JE,Rosanova G

    更新日期:2014-10-01 00:00:00

  • The incidence of intraoperative awareness in children: childhood awareness and recall evaluation.

    abstract:BACKGROUND:There is a considerable discrepancy between the reported incidences of awareness under anesthesia in children (0.2%-2.7%). In this prospective, observational, cohort study we evaluated 1) the incidence of awareness during general anesthesia in children across three settings, 2) factors contributing to awaren...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,多中心研究

    doi:10.1213/ANE.0b013e3181b620b0

    authors: Malviya S,Galinkin JL,Bannister CF,Burke C,Zuk J,Popenhagen M,Brown S,Voepel-Lewis T

    更新日期:2009-11-01 00:00:00