Abstract:
BACKGROUND:Chloroprocaine has been associated with severe back pain after epidural anesthesia. Factors proposed to contribute to this problem are: 1) the preservative disodium ethylenediaminetetraacetic acid (EDTA), 2) large volumes of chloroprocaine, 3) low pH of chloroprocaine, and 4) local infiltration with chloroprocaine. METHODS:Using a prospective, balanced, randomized study design, 100 patients aged 18-65 yr who were undergoing outpatient knee surgery during continuous epidural anesthesia received one of five local anesthetics (all containing epinephrine 1:200,000). Group I received a bolus of 30 ml 2% lidocaine, followed by 10 ml every 45 min. Group II received 15 ml of 3% chloroprocaine (containing EDTA), plus 5 ml every 45 min. Group III received 30 ml of 3% chloroprocaine plus 10 ml every 45 min. Group IV received 30 ml of 3% chloroprocaine (containing metabisulfite as the preservative but no EDTA) plus 10 ml every 45 min. Group V received 30 ml of 3% chloroprocaine with the pH adjusted to 7.3, plus 10 ml every 45 min. After the anesthesia dissipated and before any analgesic agents were given, the patients were asked to rank maximum knee and back pain on a visual analog scale (0-10) and to give a description of back pain. A telephone interview was conducted 24 h after surgery to determine if back pain returned. Back pain scoring was assessed using a verbal analog scale. RESULTS:After dissipation of anesthesia, the back pain reported by patients fell into two distinct categories. Type 1 pain was described commonly as superficial and localized to the site of needle insertion. There was no difference among groups in incidence of type 1 pain. Type 2 pain was described as deep, aching, burning, and poorly localized in the lumbar region (5% of the patients in group I, 10% in groups II and IV, 50% in group III, and 25% in group V). The incidence of type 2 pain was significantly greater in group III than in groups I, II, or IV. Group III also had a significantly greater mean visual analog scale pain score (types 1 and 2) than all other groups. CONCLUSIONS:Large doses (> or = 40 ml) of chloroprocaine containing EDTA resulted in a greater incidence of deep burning lumbar back pain. Using 25 ml or less of the same solution resulted in an incidence of both types 1 and 2 postepidural anesthesia back pain similar to that in the lidocaine control group.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Stevens RA,Urmey WF,Urquhart BL,Kao TCdoi
10.1097/00000542-199303000-00013subject
Has Abstractpub_date
1993-03-01 00:00:00pages
492-7issue
3eissn
0003-3022issn
1528-1175journal_volume
78pub_type
临床试验,杂志文章,随机对照试验相关文献
ANESTHESIOLOGY文献大全abstract:BACKGROUND:Isoflurane administration is known to increase extracellular dopamine (DA) concentration. Because the dopamine transporter (DAT) is a key regulator of DA, it is likely affected by isoflurane. This study investigates the hypothesis that isoflurane inhibits DA reuptake by causing DAT to be trafficked into the ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200302000-00021
更新日期:2003-02-01 00:00:00
abstract::Liver surgery is often accompanied by hepatic hypoperfusion and hypoxia, and it is controversial whether catecholamines increase hepatic blood flow and oxygen supply. The effects of 3 micrograms.kg-1.min-1 dobutamine on hepatic circulation and oxygen balance were examined in patients anesthetized with enflurane, nitro...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199209000-00005
更新日期:1992-09-01 00:00:00
abstract::The purpose of this study was to evaluate the analgesic contribution of intravenously administered lidocaine and to correlate it with blood levels of the drug. In a double-blind manner, 14 healthy male volunteers received saline solution or lidocaine, 0.2 per cent, at three increasingly greater rates of infusion on tw...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198001000-00005
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:A new endotracheal tube (ETT) was fabricated and tested in sheep. It had no tracheal cuff; airway seal was achieved at the level of the glottis through a no-pressure seal made of "gills"; the laryngeal portion was oval-shaped; and the wall thickness was reduced to 0.2 mm. METHODS:Sheep were tracheally intub...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199601000-00019
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Despite the fact that obesity is a known risk factor for cardiovascular disease, many studies have failed to demonstrate that obesity is independently associated with an increased risk of cardiovascular morbidity and mortality in nondiabetic patients undergoing coronary artery bypass graft surgery. The autho...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200603000-00010
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Neurally adjusted ventilatory assist (NAVA) is a new mode of mechanical ventilation that delivers ventilatory assist in proportion to the electrical activity of the diaphragm. This study aimed to compare the ventilatory and gas exchange effects between NAVA and pressure support ventilation (PSV) during the w...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e3181ee2ef1
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Lamotrigine inhibits glutamate release through the preferential blockade of voltage-dependent Na+ channels. In contrast, morphine reduces release of excitatory amino acids through the activation of opioid receptors and also inhibits tetrodotoxin-resistant Na+ channels on peripheral afferent neurons. The curr...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200204000-00020
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Awake tracheal intubation may evoke reflex bronchoconstriction in asthmatics. Whether this effect is altered by the choice of the local anesthetic used or by pretreatment with a beta2-adrenoceptor agonist is unknown. Therefore, we assessed the effect of awake fiberoptic intubation after lidocaine or dyclonin...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200212000-00016
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Neurocognitive dysfunction is a common complication of cardiac surgery using cardiopulmonary bypass (CPB). Elucidating injury mechanisms and developing neuroprotective strategies have been hampered by the lack of a suitable long-term recovery model of CPB. The purpose of this study was to investigate neurolo...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200112000-00031
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA)-type glutamate receptors mediate fast excitatory synaptic transmission in the central nervous system. Although barbiturates have been shown to suppress the AMPA receptor-mediated responses, it is unclear whether this effect contributes to the a...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199906000-00028
更新日期:1999-06-01 00:00:00
abstract::Anesthetized, prone dogs were intubated with a double-lumen endobronchial tube, and the lungs were ventilated independently. Three methods of recording differential blood flow were compared during unilateral lung hypoxia: electromagnetic flow measurement, flow probes being fitted onto each main pulmonary artery after ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198708000-00015
更新日期:1987-08-01 00:00:00
abstract:BACKGROUND:Patient blood management combines the use of several transfusion alternatives. Integrated use of erythropoietin, cell saver, and/or postoperative drain reinfusion devices on allogeneic erythrocyte use was evaluated using a restrictive transfusion threshold. METHODS:In a factorial design, adult elective hip-...
journal_title:Anesthesiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/ALN.0000000000000134
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Plasminogen activator inhibitor 1 (PAI-1) attenuates the conversion of plasminogen to plasmin. Polymorphisms of the PAI-1 gene are associated with varying PAI-1 levels and risk of prothrombotic events in nonsurgical patients. The purpose of this study, a secondary analysis of a clinical trial, was to investi...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e318167aecc
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:It is increasingly important to evaluate patients' recovery after ambulatory surgery. The authors developed the Functional Recovery Index (FRI) to assess postdischarge functional recovery for ambulatory surgical patients. METHODS:The scale development involved four phases: item generation, item selection, r...
journal_title:Anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/ALN.0b013e318197a16d
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Etomidate is a sedative hypnotic that is often used in critically ill patients because it provides superior hemodynamic stability. However, it also binds with high affinity to 11beta-hydroxylase, potently suppressing the synthesis of steroids by the adrenal gland that are necessary for survival. The authors ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181cf40ed
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Epidural morphine has proven analgesic efficacy in the postoperative period and is widely used. This study evaluated the efficacy of extended-release epidural morphine (EREM; DepoDur; Endo Pharmaceuticals Inc., Chadds Ford, PA; SkyePharma, Inc., San Diego, CA) in providing pain relief for 48 h after surgery....
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000542-200505000-00022
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Vascular spasm is a well-known complication during vascular surgery. Topical lidocaine is frequently used to prevent this spasm. However, the effects of lidocaine on the endothelium-dependent antiaggregation are not clear. METHODS:The aggregation of platelet-rich plasma (PRP) obtained from healthy volunteer...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199508000-00018
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND:Reduction of nocturnal obstructive events during lateral position in patients with obstructive sleep apnea was previously reported. However, little information is available regarding mechanisms of the improvement and the precise pharyngeal site influenced by the lateral position. The authors tested the hypot...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200210000-00006
更新日期:2002-10-01 00:00:00
abstract:WHAT WE ALREADY KNOW ABOUT THIS TOPIC:Acute respiratory distress syndrome is defined according to clinical criteria, but lack of precise characterization may contribute to negative trials and impede personalized care. Polymorphisms of aquaporin-5, a key mediator of inflammation, may impact outcome. WHAT THIS ARTICLE T...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002560
更新日期:2019-03-01 00:00:00
abstract::To assess the effect of a glucose infusion on brain extracellular fluid (ECF) during systemic hypoxia, changes in glucose and lactate concentrations in cerebral ECF during and after moderate hypoxic hypoxia were measured in adult, conscious, unrestrained rats, with a microdialysis probe in the posterior hippocampus. T...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199210000-00017
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:The pharmacology of oxycodone is poorly understood despite its growing clinical use. The discrepancy between its good clinical effectiveness after systemic administration and the loss of potency after spinal administration led the authors to study the pharmacodynamic effects of oxycodone and its metabolites ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200610000-00027
更新日期:2006-10-01 00:00:00
abstract::Continuous lumbar epidural anesthesia was instituted in 49 healthy parturients who were randomly assigned to three treatment groups: 14 patients received chloroprocaine, 3 per cent; 19 received bupivacaine, 0.5 per cent, and 16 received a mixture containing chloroprocaine, 1.5 per cent, and bupivacaine, 0.375 per cent...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-197910000-00002
更新日期:1979-10-01 00:00:00
abstract:INTRODUCTION:The current investigation aimed to study the efficacy of hemostatic therapy guided either by conventional coagulation analyses or point-of-care (POC) testing in coagulopathic cardiac surgery patients. METHODS:Patients undergoing complex cardiac surgery were assessed for eligibility. Those patients in whom...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e318264c644
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:alpha 2 Agonists are powerful analgesics after spinal delivery. The current work characterizes the dose-dependent antinociception and effects upon respiratory function of dexmedetomidine after intrathecal, epidural, intravenous, and intracisternal delivery in chronically prepared dogs. METHODS:Dogs were pre...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199405000-00015
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:Liver damage by ischemia and reperfusion injury is a risk factor for morbidity and mortality after liver surgery. Postoperative oxygen treatment is routinely applied in the postanesthesia and intensive care unit after liver surgery. The risks of aggravating the injury by increasing inspiratory oxygen from 21...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000447
更新日期:2014-12-01 00:00:00
abstract::To determine the correlation between the partial pressures of anesthetics in venous and arterial blood (Pv and Pa), and to assess whether this correlation was better than that between the partial pressure of anesthetic in alveolar gas (PA) and Pa, isoflurane (n = 4) or halothane (n = 4) was administered to eight patie...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198904000-00014
更新日期:1989-04-01 00:00:00
abstract:BACKGROUND:Insufficient data exist on the production of compound A during closed-system sevoflurane administration with newer carbon dioxide absorbents. METHODS:A modified PhysioFlex apparatus (Dräger, Lübeck, Germany) was connected to an artificial test lung (inflow at the top of the bellow approximately/= 160 ml/min...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200109000-00030
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:Age is often the sole criterion for determining the need for preoperative electrocardiograms. However, screening electrocardiograms have not been shown to add value above clinical information. This study was designed to determine whether it is possible to target electrocardiograms ordering to patients most l...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e31819fb139
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Fluid resuscitation in hemorrhagic shock aims to restore hemodynamics and repair altered microcirculation. Hemodynamic coherence is the concordant performance of macro- and microcirculation. The present study on fluid therapy in hemorrhagic shock hypothesized that the choice of fluid (0.9% sodium chloride [s...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002998
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Mechanical ventilation is crucial for patients with respiratory failure. The mechanical takeover of diaphragm function leads to diaphragm dysfunction and atrophy (ventilator-induced diaphragmatic dysfunction), with an increase in oxidative stress as a major contributor. In most patients, a sedative regimen h...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000125
更新日期:2014-03-01 00:00:00