Optimal regional anaesthesia for abdominal hysterectomy: combined subarachnoid and epidural block compared with other regional techniques.

Abstract:

:Regional anaesthesia for abdominal hysterectomy is commonly combined with heavy sedation or light general anaesthesia in order to avoid the occurrence of visceral pain. Our clinical experience has indicated that this pain can be controlled using regional anaesthesia techniques alone. In an effort to find the optimal technique, we randomly assigned 200 ASA and I and II patients who requested regional anaesthesia for abdominal hysterectomy (with or without elective appendicectomy) to one of five groups: 1) subarachnoid bupivacaine; 2) subarachnoid bupivacaine plus intravenous midazolam and buprenorphine; 3) epidural bipivacaine; 4) epidural bupivacaine plus epidural morphine; 5) subarachnoid bupivacaine plus epidural morphine and bupivacaine. The last combination provided by far the best analgesia. Only two of 40 patients complained of slight discomfort, and this was easily controlled. Success rates correlated also with the height of the blockade. It was concluded that the combination of subarachnoid bupivacaine plus epidural morphine and bupivacaine represents an effective and reliable technique for abdominal hysterectomy with or without elective appendicectomy.

journal_name

Eur J Anaesthesiol

authors

Mihic DN,Abram SE

subject

Has Abstract

pub_date

1993-07-01 00:00:00

pages

297-301

issue

4

eissn

0265-0215

issn

1365-2346

journal_volume

10

pub_type

临床试验,杂志文章,随机对照试验
  • Anaesthesia for Sturge-Weber syndrome.

    abstract::A 6-month-old boy with Sturge-Weber syndrome was scheduled for congenital glaucoma and left buphthalmus surgery. Physical examination revealed haemangioma throughout the right trigeminal nerve, congenital glaucoma, left megalocornea and bilateral buphthalmus. Examination of the eye was performed under general anaesthe...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1046/j.1365-2346.1999.00472.x

    authors: Ceyhan A,Cakan T,Başar H,Bababalim M,Unal N

    更新日期:1999-05-01 00:00:00

  • Alfentanil infusions: relationship between pharmacokinetics and pharmacodynamics in man.

    abstract::Fourteen fit young patients undergoing body surface surgery received an infusion of alfentanil at either 50 or 100 micrograms kg-1 hr-1 to supplement nitrous oxide anaesthesia. The alfentanil infusion was continued for two hours post-operatively at the lower rate of 20 micrograms kg-1 hr-1. Resting ventilation, carbon...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章

    doi:

    authors: O'Connor M,Prys-Roberts C,Sear JW

    更新日期:1987-05-01 00:00:00

  • The effect of paracetamol on postoperative nausea and vomiting during the first 24 h after strabismus surgery: a prospective, randomised, double-blind study.

    abstract:CONTEXT:Strabismus surgery is one of the most common ophthalmic surgical procedures in children and is associated with significant postoperative nausea and vomiting (PONV). OBJECTIVE:We evaluated the effect of intravenous paracetamol on PONV in children after strabismus surgery. DESIGN:Prospective, placebo-controlled...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/EJA.0b013e32834c580b

    authors: Cok OY,Eker HE,Pelit A,Canturk S,Akin S,Aribogan A,Arslan G

    更新日期:2011-12-01 00:00:00

  • Double- vs. single-injection infraclavicular plexus block in the emergency setting: higher success rate with lower volume of local anaesthetic.

    abstract:BACKGROUND AND OBJECTIVES:Infraclavicular plexus block has many advantages of particular interest in the emergency setting. However, the number of nerve stimulations needed to optimize the technique remains unclear. We evaluated both the local anaesthetic requirement and the success rate of Sim's derived infraclavicula...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1017/S0265021506000329

    authors: Fuzier R,Fourcade O,Fuzier V,Albert N,Samii K,Olivier M

    更新日期:2006-04-01 00:00:00

  • Platelet function assessed by whole-blood aggregometry in patients undergoing non-cardiac surgery.

    abstract:BACKGROUND:The risk/benefit of continuing low-dose acetylsalicylic acid (aspirin) for secondary prevention in the perioperative period is still debated. The primary aim of this study was to determine the effect of acetylsalicylic acid compared with placebo on platelet function in the perioperative period. METHODS:This...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/EJA.0b013e32834448ed

    authors: Oscarsson A,Öster S,Fredrikson M,Lindahl TL,Eintrei C

    更新日期:2011-05-01 00:00:00

  • Laparoscopically assisted vaginal and abdominal hysterectomy: comparison of postoperative pain, fatigue and systemic response. A case-control study.

    abstract:BACKGROUND AND OBJECTIVE:Laparoscopic and open surgery have been compared with conflicting results regarding their systemic responses. The sensitivity of biochemical markers that are used to discriminate between the stress responses to different types of surgery varies from study to study. We wanted to evaluate the str...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1046/j.1365-2346.2001.00889.x

    authors: Rorarius MG,Kujansuu E,Baer GA,Suominen P,Teisala K,Miettinen A,Ylitalo P,Laippala P

    更新日期:2001-08-01 00:00:00

  • Flurbiprofen does not change the bispectral index and 95% spectral edge frequency during total intravenous anaesthesia with propofol and fentanyl.

    abstract:BACKGROUND AND OBJECTIVE:Previous studies have shown that general anaesthetic agents modulate the production of hypothalamic prostaglandins (PG) D2 and E2, which are mediators of sleep and wakefulness respectively. Although flurbiprofen, a cyclo-oxygenase inhibitor, is used clinically as a non-steroidal anti-inflammato...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/s0265021502000790

    authors: Hirota K,Fukushi S,Baba S,Matsuki A

    更新日期:2002-07-01 00:00:00

  • Duration of fluid fasting and choice of analgesic are modifiable factors for early postoperative delirium.

    abstract:BACKGROUND AND OBJECTIVE:Most therapeutic options for postoperative delirium are only symptom oriented; therefore, the best approach remains prevention. The aim of this study was to identify predisposing and precipitating factors for early postoperative delirium. METHODS:A total of 1002 patients were screened for deli...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0b013e3283335cee

    authors: Radtke FM,Franck M,MacGuill M,Seeling M,Lütz A,Westhoff S,Neumann U,Wernecke KD,Spies CD

    更新日期:2010-05-01 00:00:00

  • Thrombogenicity of central venous catheters: prospective study of polyethylene, silicone and polyurethane catheters with phlebography or post-mortem examination.

    abstract::The thrombogenicity of polyethylene, silicone and polyurethane central venous catheters was compared in a prospective clinical, phlebographic and post-mortem study in 52 patients. The incidence of central venous thrombosis was high with polyethylene catheters (70%), but much lower with silicone (20%) and with polyuret...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Pottecher T,Forrler M,Picardat P,Krause D,Bellocq JP,Otteni JC

    更新日期:1984-12-01 00:00:00

  • CobraPLUS and Cookgas air-Q versus Fastrach for blind endotracheal intubation: a randomised controlled trial.

    abstract:BACKGROUND AND OBJECTIVE:CobraPLUS and Cookgas air-Q are supraglottic airways expected to allow safe ventilation as well as reliable blind intubation. In a prospective, controlled trial, we hypothesised that quality of ventilation and success rate of blind endotracheal intubation of these new devices would be superior ...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/EJA.0b013e328340c352

    authors: Erlacher W,Tiefenbrunner H,Kästenbauer T,Schwarz S,Fitzgerald RD

    更新日期:2011-03-01 00:00:00

  • Intrathecal hydromorphone added to hyperbaric bupivacaine for postoperative pain relief after knee arthroscopic surgery: a prospective, randomised, controlled trial.

    abstract:BACKGROUND AND OBJECTIVE:Adding opioid to spinal anaesthetic provides additional analgesia during the postoperative period. The purpose of this study was to determine the dose of intrathecal hydromorphone necessary to achieve postoperative pain relief after arthroscopic knee surgery. METHODS:In a prospective, double-b...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/EJA.0b013e3283476055

    authors: Lee YS,Park YC,Kim JH,Kim WY,Yoon SZ,Moon MG,Min TJ

    更新日期:2012-01-01 00:00:00

  • Impact of intra-operative fluid and noradrenaline administration on early postoperative renal function after cystectomy and urinary diversion: A retrospective observational cohort study.

    abstract:BACKGROUND:The use of noradrenaline to enable a restrictive approach to intra-operative fluid therapy to avoid salt and water overload has gained increasing acceptance. However, concerns have been raised about the impact of this approach on renal function. OBJECTIVES:To identify risk factors for acute kidney injury (A...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0000000000000808

    authors: Furrer MA,Schneider MP,Löffel LM,Burkhard FC,Wuethrich PY

    更新日期:2018-09-01 00:00:00

  • Effect of injection speed on anaesthetic spread during axillary block using the orthogonal two-needle technique.

    abstract::One hundred patients undergoing scheduled upper limb orthopaedic surgery were studied to determine if the speed of injection of the local anaesthetic solution could modify the extent and depth of anaesthesia with the axillary approach to the brachial plexus. The blocks were performed using the 'orthogonal two-needle t...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Rucci FS,Pippa P,Boccaccini A,Barbagli R

    更新日期:1995-09-01 00:00:00

  • Changes in resistances of endotracheal tubes with reductions in the cross-sectional area.

    abstract:BACKGROUND AND OBJECTIVES:Partial obstruction of endotracheal tubes due to accumulation of secretions and mucus plugs can increase the tube resistance and subsequently impose increased resistive load on the patient. This study was performed to determine the changes in the resistance of endotracheal tubes of sizes 7.5, ...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/S0265021507003134

    authors: El-Khatib MF,Husari A,Jamaleddine GW,Ayoub CM,Bou-Khalil P

    更新日期:2008-04-01 00:00:00

  • Emergency intubation with the Combitube in two cases of difficult airway management.

    abstract::The airway was managed successfully in two cases of difficult intubation using the Combitube, a new device for emergency intubation, which combines the functions of an oesophageal obturator airway and a conventional endotracheal airway. One patient could not be intubated due to lockjaw; in the other patient, the vocal...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:

    authors: Staudinger T,Tesinsky P,Klappacher G,Brugger S,Rintelen C,Locker G,Weiss K,Frass M

    更新日期:1995-03-01 00:00:00

  • Genetics and postsurgical neuropathic pain: An ancillary study of a multicentre survey.

    abstract:BACKGROUND:Neuropathic pain following surgery could be a useful model for the study of the genetic mechanisms of peripheral neuropathic pain. OBJECTIVE:The aim of this study was to identify genetic predictors of persistent postsurgical neuropathic pain. DESIGN:An ancillary study from a prospective cohort. SETTING:Ei...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,多中心研究

    doi:10.1097/EJA.0000000000000986

    authors: Blanc P,Génin E,Jesson B,Dubray C,Dualé C,EDONIS-gene Investigating group.

    更新日期:2019-05-01 00:00:00

  • Diastolic function: the influence of pneumoperitoneum and Trendelenburg positioning during laparoscopic hysterectomy.

    abstract:BACKGROUND AND OBJECTIVE:Several reports concerning the haemodynamic changes during gynaecologic laparoscopy have been published so far, and the effects of head-down tilt and pneumoperitoneum have not been clearly separated. However, its main effect seems to be an increase in systemic vascular resistance. We investigat...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0b013e32832cb3c9

    authors: Russo A,Marana E,Viviani D,Polidori L,Colicci S,Mettimano M,Proietti R,Di Stasio E

    更新日期:2009-11-01 00:00:00

  • Pre-operative anaemia and myocardial injury after noncardiac surgery: A retrospective study.

    abstract:BACKGROUND:Pre-operative anaemia is associated with adverse outcomes of noncardiac surgery, but its association with myocardial injury after noncardiac surgery (MINS) has not been fully investigated. OBJECTIVE:The association between pre-operative anaemia and MINS. DESIGN:A single-centre retrospective cohort study. ...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0000000000001421

    authors: Kwon JH,Park J,Lee SH,Lee JH,Min JJ,Kim J,Oh AR,Seo W,Hyeon CW,Yang K,Choi JH,Lee SC,Kim K,Ahn J,Gwon HC

    更新日期:2021-01-04 00:00:00

  • Ketamine does not affect suxamethonium-induced neuromuscular blockade in man.

    abstract::The effect of ketamine on the onset time, the duration of action and the recovery characteristics of suxamethonium-induced neuromuscular blockade was examined in a double-blind randomized study comprising 30 patients anaesthetized with thiopentone, fentanyl, midazolam and nitrous oxide. The ulnar nerve was stimulated ...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Helbo-Hansen HS,Toft P,Nielsen HK

    更新日期:1989-11-01 00:00:00

  • Monitoring of respiratory function before and after cardiopulmonary bypass using side-stream spirometry.

    abstract::Pulmonary impairment is more frequent after cardiac surgery than after other major surgical procedures. The present study investigates whether, by using standard respiratory monitoring, i.e. side-stream spirometry and blood gas analysis, it is possible to detect changes in pulmonary function secondary to cardiopulmona...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1017/s026502159800009x

    authors: Bund M,Seitz W,Uthoff K,Krieg P,Strüber M,Piepenbrock S

    更新日期:1998-01-01 00:00:00

  • Biphasic cardiac output changes during onset of spinal anaesthesia in elderly patients.

    abstract:BACKGROUND AND OBJECTIVE:In most studies of cardiac output changes after spinal anaesthesia, the time-resolution is limited. The aim of this study was to demonstrate cardiac output changes with high time-resolution during onset of spinal anaesthesia in elderly patients. METHODS:We investigated 32 patients aged 60 yr s...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/S0265021507000427

    authors: Meyhoff CS,Hesselbjerg L,Koscielniak-Nielsen Z,Rasmussen LS

    更新日期:2007-09-01 00:00:00

  • Comparison of the effects of two intrathecal anaesthetic techniques for transurethral prostatectomy on haemodynamic and pulmonary function.

    abstract:BACKGROUND AND OBJECTIVE:Transurethral prostatectomy is routinely performed under spinal anaesthesia. This technique can cause hypotension, which is particularly undesirable in the elderly. The objective was to compare spinal anaesthesia for transurethral prostatectomy using hyperbaric bupivacaine 15 mg (control group)...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1017/s0265021503000899

    authors: Walsh KH,Murphy C,Iohom G,Cooney C,McAdoo J

    更新日期:2003-07-01 00:00:00

  • The influence of etomidate upon cerebral metabolites after complete brain ischaemia in the rat.

    abstract::The influence of etomidate on post-ischaemic cerebral metabolism was examined in 1-year-old male Wistar rats. Ten rats were randomly allocated to each of three groups. Group 1 animals received etomidate for 60 min without undergoing cerebral ischaemia. In Group 2, there was a 60-min recovery period following 15 min of...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:

    authors: Böhrer H,Hoyer S,Krier C

    更新日期:1991-05-01 00:00:00

  • Drotrecogin alfa (activated): diffusion from clinical trials to clinical practice.

    abstract:BACKGROUND AND OBJECTIVE:Although the PROWESS trial demonstrated a mortality benefit, subsequent studies in different patient populations have not reproduced the effect. As a result, concerns have been expressed about the clinical effectiveness of drotrecogin alfa (activated). Therefore the aim of this audit was to rev...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1017/S0265021507002992

    authors: Ridley S,Lwin A,Wyncoll D,Lippett S,Watson D,Gunning K,Higgins D

    更新日期:2008-03-01 00:00:00

  • Preconditioning and protection against ischaemia-reperfusion in non-cardiac organs: a place for volatile anaesthetics?

    abstract::There is an increasing body of evidence that volatile anaesthetics protect myocardium against ischaemic insult by a mechanism termed 'anaesthetic preconditioning'. Anaesthetic preconditioning and ischaemic preconditioning share several common mechanisms of action. Since ischaemic preconditioning has been demonstrated ...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,评审

    doi:10.1017/S0265021507000531

    authors: Minguet G,Joris J,Lamy M

    更新日期:2007-09-01 00:00:00

  • Effects of hyperventilation on cerebral oxygen saturation estimated using near-infrared spectroscopy: A randomised comparison between propofol and sevoflurane anaesthesia.

    abstract:BACKGROUND:Near-infrared spectroscopy estimates cerebral regional tissue oxygen saturation (rSO2), which may decrease under hyperventilation. Propofol and sevoflurane act differently on cerebral blood vessels. Consequently, cerebral blood flow during hyperventilation with propofol and sevoflurane anaesthesia may differ...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/EJA.0000000000000507

    authors: Ishiyama T,Kotoda M,Asano N,Ikemoto K,Shintani N,Matsuoka T,Matsukawa T

    更新日期:2016-12-01 00:00:00

  • Comparison of a simplified nasal continuous positive airways pressure device with nasal cannula in obese patients undergoing colonoscopy during deep sedation: A randomised clinical trial.

    abstract:BACKGROUND:Continuous positive airways pressure (CPAP) with a CPAP machine and mask has been shown to be more effective at minimising hypoxaemia than other devices under deep sedation. However, the efficacy of a new and simple CPAP device for spontaneously breathing obese patients during colonoscopy is unknown. OBJECT...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/EJA.0000000000001052

    authors: Bai Y,Xu Z,Chandrashekar M,St Jacques PJ,Liang Y,Jiang Y,Kla K

    更新日期:2019-09-01 00:00:00

  • Antagonism of midazolam sedation by flumazenil: a placebo-controlled study in patients recovering from intravenous anaesthesia with high doses of midazolam.

    abstract::Twenty adult surgical patients were anaesthetized with high-dose midazolam and alfentanil by infusion, vecuronium, and intubated and ventilated with 50% N2O in O2. The midazolam and alfentanil infusions were stopped at the end of surgery. Residual neuromuscular blockade and ventilatory depression were antagonized and ...

    journal_title:European journal of anaesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Hennis PJ,van Haastert FA,Mulder AJ,Spierdijk J

    更新日期:1988-11-01 00:00:00

  • What is the optimal remifentanil dosage for providing excellent intubating conditions when coadministered with thiopental? A prospective randomized dose-response study.

    abstract:BACKGROUND AND OBJECTIVE:The aim of the present study was to determine the dosage of remifentanil that must be added to thiopental 5 mg kg(-1) to provide excellent intubating conditions in 95% of patients. METHODS:Sixty-eight premedicated female American Society of Anesthesiologists class 1 and 2 patients were randoml...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/EJA.0b013e3283396341

    authors: Bouvet L,Stoian A,Rousson D,Allaouchiche B,Chassard D,Boselli E

    更新日期:2010-07-01 00:00:00

  • Prevention of atelectasis by continuous positive airway pressure in anaesthetised children: A randomised controlled study.

    abstract:BACKGROUND:Continuous positive airway pressure (CPAP) prevents peri-operative atelectasis in adults, but its effect in children has not been quantified. OBJECTIVE:The aim of this study was to evaluate the role of CPAP in preventing postinduction and postoperative atelectasis in children under general anaesthesia. DES...

    journal_title:European journal of anaesthesiology

    pub_type: 杂志文章

    doi:10.1097/EJA.0000000000001351

    authors: Acosta CM,Lopez Vargas MP,Oropel F,Valente L,Ricci L,Natal M,Suarez Sipmann F,Tusman G

    更新日期:2021-01-01 00:00:00