Abstract:
BACKGROUND AND OBJECTIVES:Patients treated with regional anesthesia often require concomitant medication for comfort and sedation. Propofol is widely used for this purpose. Remifentanil, a new ultra-short-acting opioid, exhibits at low doses distinct sedative properties that may be useful for supplementation of regional anesthesia. This study compared the effectiveness of remifentanil and propofol infusions for providing sedation during regional block placement and surgery. METHODS:In an open, prospective trial, 28 patients were randomly allocated to receive continuous infusions of remifentanil (6 microg/kg/h) or propofol (3 mg/kg/h) for sedation during spinal or axillary regional anesthesia. Infusion rates were titrated to maintain a sedation level > or = 2 as assessed with the Observer's Assessment of Alertness Scale. Vital signs were measured continuously, during and for 2 hours after ending study drug infusion. RESULTS:Similar scores for comfort and sedation were obtained in both groups during placement of the regional block and during surgery. Degree of sedation correlated with drug infusion rate of remifentanil (P < .002) but not for propofol. Respiratory rate decreased in the remifentanil group in absence of surgery (P < .05). Mean arterial pressure and heart rate were 20% lower in the propofol group (P < .05). Return to alertness occurred after 10 +/- 6 minutes in the remifentanil group and after 16 +/- 15 minutes in the propofol group. Similar incidences of hypotension, bradycardia, and nausea and vomiting were found in both groups, but intraoperative respiratory depression and nausea were more prominent in the remifentanil group. CONCLUSIONS:When titrated to the same sedation level, remifentanil provided a smoother hemodynamic profile than propofol during regional anesthesia. The frequent occurrence of remifentanil-induced respiratory depression requires cautious administration of this agent. The incidence of adverse reactions seen with both agents during and after their administration makes the management of such sedative infusion techniques difficult.
journal_name
Reg Anesth Pain Medjournal_title
Regional anesthesia and pain medicineauthors
Lauwers MH,Vanlersberghe C,Camu Fdoi
10.1016/s1098-7339(98)90112-2subject
Has Abstractpub_date
1998-01-01 00:00:00pages
64-70issue
1eissn
1098-7339issn
1532-8651pii
S1098-7339(98)90112-2journal_volume
23pub_type
临床试验,杂志文章,随机对照试验abstract:BACKGROUND AND OBJECTIVES:Pregabalin is often used as a perioperative analgesic adjunct; some studies show benefit, but others do not. Adverse effects, such as confusion and sedation, have been attributed to perioperative use of pregabalin. We tested the hypothesis that pregabalin, when used as part of a multimodal ana...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e31824c6846
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Radiofrequency (RF) lesions are safe and effective in the treatment of spine pain; however, models developed to study factors affecting lesion dimensions have been performed in homogeneous media that may not accurately simulate human anatomy and electrophysiology. We present a novel ex vivo po...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000221
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:For pain relief after total knee arthroplasty (TKA), an injection at the midthigh level may produce analgesia inferior to that of a femoral nerve block as the anterior femoral cutaneous nerves (intermediate femoral cutaneous nerve (IFCN) and medial femoral cutaneous nerve (MFCN)) are not anest...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-100904
更新日期:2019-12-10 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Meperidine is frequently used in general anesthesia and perioperative analgesia. In addition to its opioid action, meperidine possesses some local anesthetic properties. A preliminary study using the tourniquet venous retention technique found meperidine to be more effective in reducing propof...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00115550-199823020-00014
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The typical blind insertion of a catheter into the epidural space risks catheter misplacement into the intrathecal space. The epidural stimulation test is designed to confirm the correct epidural location of a catheter but may also detect unintended intrathecal catheter placement by evaluating...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/aap.0b013e3181bfbe1e
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Practitioners mix faster-onset, intermediate-duration local anesthetics (LAs) with slower-onset, long-duration LAs to get fast peripheral nerve block (PNB) onset and long duration. We hypothesized that 1.5% mepivacaine (with epinephrine) (mepivacaine) or 1.5% mepivacaine (with epinephrine) mix...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e318236bc30
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Peripherally administered opioids, e.g., intra-articular morphine, exert their analgesic action on local opioid receptors. The present study investigated the safety and efficacy of intrabursal oxycodone and bupivacaine in comparison with bupivacaine infiltration and interscalene brachial plexu...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1098-7339(98)90030-x
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:Postdural puncture headache (PDPH) is an uncommon sequel of lumbar puncture in children. When conservative treatment with bed rest, hydration, and caffeine are ineffective, epidural blood patches are recommended and are generally effective. The purpose of this report was to highlight that when lumbar epidural...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000562
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Many patients experience moderate to severe postoperative pain. Nitrous oxide (N₂O) exerts analgesia by inhibition of N-methyl-D-aspartate receptors. Ketamine, another N-methyl-D-aspartate receptor antagonist, reduces postoperative opioid consumption and pain. A similar effect of N₂O is plausi...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000039
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Dorsal root ganglion stimulation is an emerging therapy in the treatment of chronic pain. Compared with traditional spinal cord stimulation, it allows a discretely targeted stimulation profile and may act via differing mechanisms of action. Despite these advantages, little is known about the c...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-000007
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Several studies have evaluated the effect of pectoral nerve blocks to improve postoperative analgesia following breast cancer surgery resulting in contradictory findings. The aim of this study was to examine the effect of Pecs blocks on postoperative analgesia in women following mastectomies. ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-100658
更新日期:2019-08-09 00:00:00
abstract:BACKGROUND AND OBJECTIVES:In this study, we examined the consistency, rapidity, and reproducibility of the ABCDE technique for diaphragm identification. Operators using this method place the probe at the Anterior axillary line, watch for Breathing (lung sliding), and then move the probe Caudally to identify the Diaphra...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000718
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Bupivacaine is a racemic mixture of S(-)- and R(+)-enantiomers. Both isomers have similar potency as local anesthetics, but the S(-)-enantiomer produces less central nervous system and cardiovascular toxicity. Local anesthetic-induced convulsion is likely to be associated with not only sodium ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2005.09.004
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Anesthesiologists are increasingly utilizing the Internet for personal and professional purposes. Without guidance, the task of searching the Internet for information may be time-consuming and frustrating. This article includes a basic introduction to the Internet with suggestions and guidelin...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1016/s1098-7339(99)90115-3
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Poorly controlled postoperative pain is strongly associated with the development of chronic pain. We aimed to investigate the effect of topical morphine (in 1 of 3 doses: 5, 10, or 15 mg) on acute and chronic neuropathic pain after modified radical mastectomy for cancer breast. METHODS:In thi...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000496
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Paresthesia occasionally occurs during dural puncture or injection of local anesthetic for spinal anesthesia. Although the incidence of neurologic complications after spinal anesthesia is extremely low, the significance of paresthesia is unknown. The influence of known lumbar spine pathology o...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/s1098-7339(98)90081-5
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Epidural anesthesia (EA) is known to reduce postoperative thromboembolic complications, but mechanisms are incompletely understood. In this study, we tested the hypothesis that local anesthetics (LA) prevent postoperative hypercoagulability without affecting physiologic aggregation and coagula...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1053/rapm.2001.23209
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The aim of this study was to compare the potency of bupivacaine, ropivacaine, and levobupivacaine in an equal dose and concentration for sympathetic block. METHODS:We measured mean arterial pressure, heart rate (HR), and right and left brachial artery blood flow (BABF) before and after cervic...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0b013e3181e6acf1
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Peripheral nerve and spinal cord stimulation techniques have been used for many years. However, electrical stimulation methods rarely have been used to confirm epidural catheter placement. This study examines the practicality of this technique to confirm epidural catheter placement in obstetri...
journal_title:Regional anesthesia and pain medicine
pub_type: 临床试验,杂志文章
doi:10.1016/s1098-7339(99)90160-8
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The study goal was to compare the effect of epinephrine in different doses on pulmonary gas exchange in a rat model of bupivacaine-induced cardiac depression. METHODS:Twenty-four adult male Sprague-Dawley rats were divided into 4 groups (n = 6), and each group received a bupivacaine infusion (...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1097/AAP.0000000000000541
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The current intensity at which a motor response is elicited with an intraneural needle placement has been inadequately studied. We hypothesized that electrical current delivered through an intraneurally placed needle does not always result in an evoked motor response. Our secondary objective w...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2007.12.010
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:A sublingual sufentanil tablet is being developed as a potential alternative to intravenous (IV) opioids for the management of postoperative pain. The objective of these studies was to evaluate the pharmacokinetics, efficacy, and safety of sublingual sufentanil tablets for postoperative pain m...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e3182791157
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Success in performing ultrasound-guided peripheral nerve blockade (PNB) demands sound knowledge of sonoanatomy, good scanning techniques, and proper hand-eye coordination. The objectives of our study were to evaluate whether simulator training aids success of novice operators in ultrasound-gui...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e31823dc340
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Ultrasound-guided infiltration of the interspace between the popliteal artery and capsule of the knee (iPACK) block, a new regional analgesic technique, is believed to relieve posterior knee pain, after total knee arthroplasty, by targeting the articular branches innervating posterior aspect o...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2018-100355
更新日期:2019-05-06 00:00:00
abstract:BACKGROUND:Cervical erector spinae plane (ESP) block has been described to anesthetize the brachial plexus (BP), however, the mechanism of its clinical effect remains unknown. As the prevertebral fascia encloses the phrenic nerves, BP and erector spinae muscles to form a prevertebral compartment, a local anesthetic inj...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1136/rapm-2019-101154
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Epidural anesthesia is a technically challenging regional anesthetic technique that can be difficult to teach to novices. Epidural simulators are now available to allow realistic training within a safe and controlled environment before attempting the procedure on patients. Potentially, this ma...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0b013e3181a34345
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Despite ultrasound (US) guidance, sciatic nerve block (SNB) remains among the least performed peripheral blocks. By targeting the tissue plane between the gluteus maximus and quadratus femoris muscles, the US-guided subgluteal space technique may facilitate the performance of US-guided SNB. We...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/AAP.0000000000000016
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND/IMPORTANCE:Ultrasound (US)-guided cervical selective nerve root injections (CSNRI) have been proposed as an alternative to fluoroscopic (FL) -guided injections. When choosing US guidance, the proceduralist should be aware of potential issues confirming vertebral level, be clear regarding terminology, and up ...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章,评审
doi:10.1136/rapm-2020-102325
更新日期:2021-01-13 00:00:00
abstract:BACKGROUND AND OBJECTIVES:In addition to their blockade of voltage-dependent sodium channels, the action of local anesthetics at 5-hydroxytryptamine-3 (5-HT3) receptors may be clinically relevant. Because local anesthetics have different clinical properties, we have tested the hypothesis that differences in interaction...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/j.rapm.2007.06.391
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The incidence of postdural puncture headache (PDPH) after epidural wet tap for obstetric patients may be as high as 75%. We have studied how subsequent placement of a subarachnoid catheter immediately after confirmation of a wet tap, and leaving the catheter in place for 24 hours affects the i...
journal_title:Regional anesthesia and pain medicine
pub_type: 杂志文章
doi:10.1016/s1098-7339(03)00393-6
更新日期:2003-11-01 00:00:00