A double-blind comparison of the abdominal wall relaxation produced by epidural 0.75% ropivacaine and 0.75% bupivacaine in gynecologic surgery.

Background And Objectives: Ropivacaine is a long-acting local anesthetic agent with similar potency to that of bupivacaine when administered for epidural anesthesia. Ropivacaine, however, may be less cardiotoxic than bupivacaine. Epidural bupivacaine and ropivacaine have been shown to be equally effective in providing sensory block for lower extremity surgery, but they have not been compared for their ability to produce abdominal wall relaxation.

Future of regional anaesthesia and pain management.

Consideration of the future practice of regional anaesthesia and pain management must include more than scientific advances. With advances in technology, the practice of medicine will increasingly become international in scope. Socio-economic issues will also have increasing impact on the practice of regional anaesthesia and pain management.

Pharmacokinetics of intravenous and epidural ropivacaine in the rhesus monkey.

Ropivacaine is a new long-acting amide local anesthetic which is possibly less cardiotoxic than bupivacaine. The absorption and disposition of ropivacaine were characterized in six rhesus monkeys in an open two-way crossover study following intravenous and epidural administration. For these studies, animals were anesthetized for placement of intravenous and intraarterial catheters.

Tourniquet pain: the response to the maintenance of tourniquet inflation on the upper extremity of volunteers.

This investigation examined the effect of three factors--tourniquet width, tourniquet inflation pressure, and application of the tourniquet to the left or right extremity--on the intensity of tourniquet pain and duration of tourniquet inflation, as well as the circulatory effects associated with maintenance of inflation of a pneumatic tourniquet on an upper extremity of 12 healthy, unmedicated volunteers. All subjects manifested a time-dependent circulatory response to maintenance of tourniquet inflation, characterized by increases in heart rate and systolic and diastolic blood pressure. The mean duration of tourniquet inflation was 34 +/- 13 minutes (mean +/- SD).

A double-blind comparison of 0.5% bupivacaine and 0.75% ropivacaine administered epidurally in humans.

In an attempt to compare equipotent doses of epidurally administered bupivacaine and ropivacaine, 44 healthy patients, aged 18-70 years, undergoing lower extremity orthopedic procedures were studied in a randomized, double-blind manner. Twenty-one patients received a single epidural injection of 20 ml 0.5% bupivacaine at the L23 or L34 interspace and 23 patients received 20 ml 0.

Pharmacodynamics and pharmacokinetics of epidural ropivacaine in humans.

The purpose of this study was to characterize the pharmacodynamics and pharmacokinetics of three concentrations of the new long-acting amide local anesthetic, ropivacaine, given epidurally in 15 physical status ASA I or II patients for elective lower-extremity orthopedic procedures using a nonrandomized open-label design. Three groups of five patients each received either 0.5%, 0.

Optical and photorefractive properties of InP:Ti: a new photorefractive semiconductor.

The optical and photorefractive properties of Ti-doped InP are investigated. Four-wave mixing at wavelengths of 1.06 and 1.

Postoperative analgesia.

In recent years hospitals have begun to institute special postoperative pain services staffed by anesthesia department personnel. The charter for such services is to provide the best and most appropriate postoperative analgesia for surgical patients, in particular for the increasing numbers of patients who, released from hospital soon after surgery, still require pain relief on an outpatient basis. This review focuses on the relative benefits and risks of the currently available options for postoperative pain relief: intramuscular (i.

Hypotension in spinal anesthesia: a comparison of isobaric tetracaine with epinephrine and isobaric bupivacaine without epinephrine.

Two isobaric spinal anesthetic solutions (bupivacaine 0.5%/20 mg without epinephrine and tetracaine 0.5%/15 mg with 0.

Addition of glucose to bupivacaine in spinal anesthesia increases incidence of tourniquet pain.

The effect of baricity of 0.5% bupivacaine on the incidence of tourniquet pain when used for spinal anesthesia was evaluated in 60 patients undergoing orthopedic surgery. Three ml of either hyperbaric (8% glucose) or isobaric (glucose-free) solution was used.

Tourniquet pain: a volunteer study.

The effect of inflation pressure (300 and 400 mm Hg) and method of exsanguination (gravity and Esmarch bandage) on the time of onset and the severity of tourniquet-induced pain in the lower extremity was investigated in 11 unmedicated adult volunteers. Each volunteer underwent eight experiments in a random order. A visual analog scale was used to assess pain and discomfort.

The influence of diazepam on the pharmacokinetics of intravenous and epidural bupivacaine in the rhesus monkey.

Pretreatment of patients with diazepam has been reported to reduce the plasma half-life of epidurally administered bupivacaine. The concentrations of bupivacaine used to estimate its plasma half-life may be influenced by input into the vascular system (rate and extent of absorption from the epidural space) and disposition (distribution and elimination). We conducted a study in Rhesus monkeys in which the input function was known and the influence of intravenous diazepam on the disposition of intravenous bupivacaine could be delineated.

The influence of lactic acid on the serum protein binding of bupivacaine: species differences.

Various animal models have been used for studies of bupivacaine cardiovascular toxicity. These studies are difficult to relate to the clinical situation, since the disposition of bupivacaine in the various species is unknown. The serum protein binding of bupivacaine, therefore, was determined in human, sheep, monkey, dog, and rat at physiologic pH using ultrafiltration.

Pharmacokinetics and neural blockade after subarachnoid lidocaine in the rhesus monkey. III. Effects of phenylephrine.

Using a rhesus monkey model, lidocaine (30 mg) in 7.5% dextrose was compared with lidocaine (30 mg) in 7.5% dextrose containing 1.

Comparison of neural blockade and pharmacokinetics after subarachnoid lidocaine in the rhesus monkey. II: Effects of volume, osmolality, and baricity.

The effects of volume, osmolality, and baricity on lidocaine spinal anesthesia in the rhesus monkey were studied. Changes in neural blockade, physical properties of cerebrospinal fluid, and arterial pharmacokinetics associated with variations in injectate composition were assessed. Wide ranges of volume, baricity, and osmolality were studied using 1, 2, and 5% lidocaine prepared in either sterile water or 7.