Intrathecal ropivacaine for ambulatory surgery.

Background: The rationale of this study was to evaluate intrathecal ropivacaine for ambulatory surgery.

Methods: One hundred fifty patients with American Society of Anesthesiologists physical status 1 scheduled for knee arthroscopy were studied. Patients were randomly assigned to receive 4 ml of one of five isobaric intrathecal solutions: Patients in group 1 (n = 30) received 8 mg of bupivacaine; patients in group 2 (n = 30) received 8 mg ropivacaine; patients in group 3 (n = 30) received 10 mg ropivacaine; patients in group 4 (n = 30) received 12 mg ropivacaine; and patients in group 5 (n = 30) received 14 mg ropivacaine.

A double-blind comparison of 0.125% ropivacaine with sufentanil and 0.125% bupivacaine with sufentanil for epidural labor analgesia.

Background: This study intends to evaluate the benefits of the administration of intermittent bolus doses of ropivacaine (0.125%) compared with bupivacaine (0.125%) after addition of sufentanil for analgesia during labor.

Intrathecal clonidine combined with sufentanil for labor analgesia.

Background: Intrathecal sufentanil provides rapid-onset and complete analgesia for the first stage of labor. The dose required to produce this effect can be associated with maternal respiratory depression, hypotension, nausea, or pruritus. Because clonidine potentiates the analgesic effects of opioids without increasing their side effects, the authors wanted to determine the efficacy of low doses of intrathecal clonidine (15 and 30 microg) combined with sufentanil.

Ambulatory combined spinal-epidural analgesia for labor. Influence of epinephrine on bupivacaine-sufentanil combination.

Background And Objectives: Subarachnoid sufentanil 5 micrograms during labor is known to have variable results. However, subarachnoid sufentanil 5 micrograms plus bupivacaine 1 mg provides good quality labor analgesia of 100 minutes' average duration. The objective of this study was to examine the effects of adding epinephrine 25 micrograms to this mixture.

Intravenous regional anesthesia. Evaluation of 4 different additives to prilocaine.

Intravenous regional anesthesia (IVRA) is an effective method of producing anesthesia of the extremities. Disadvantages are the rapid loss of anesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. This study compared the effect of four different additives to prilocaine with saline on the development of a complete sensory block, on the return of sensory function after deflation of the tourniquet and on the development of postoperative pain after IVRA for minor orthopedic surgery of the arm.

Spinal analgesia during labor with low-dose bupivacaine, sufentanil, and epinephrine. A comparison with epidural analgesia.

Background And Objectives: The purpose of this investigation was to evaluate the effectiveness and side effects of combined spinal-epidural (CSE) injection of a bupiv-acaine-sufentanil-epinephrine mixture during labor as compared with epidural analgesia alone.

Methods: In a randomized trial, 63 parturients presenting for vaginal delivery received either epidural analgesia (10 mL) with 12.5 mg bupivacaine plus 10 micrograms sufentanil and 12.

Hydroxyethylstarch compared with modified gelatin as volume preload before spinal anaesthesia for Caesarean section.

We studied 90 patients undergoing elective Caesarean section under spinal anaesthesia who received lactated Ringer's solution 1000 ml with up to 1000 ml of modified gelatin, lactated Ringer's solution 1000 ml with up to 1000 ml of 6% hydroxyethylstarch or only up to 1000 ml of 6% hydroxyethylstarch. Lumbar puncture was performed as soon as 500 ml of the colloid were infused. The incidence of hypotension, number of patients requiring a vasopressor and doses of ephedrine required to restore arterial pressure were significantly lower in favour of those receiving the crystalloid-hydroxyethylstarch combination.

Sequential spinal epidural analgesia for pain relief in labour: an audit of 620 parturients.

This investigation was designed to evaluate sequential spinal epidural analgesia with a needle through needle technique for pain relief in labour. The spinal injection was made using a Becton Dickinson 29 gauge Quincke point needle. Bupivacaine 1 mg, sufentanil 5 microg and adrenaline 25 microg (2 ml) were injected intrathecally.

Epidural sufentanil for postoperative patient-controlled analgesia (PCA) with or without background infusion: a double-blind comparison.

To evaluate the usefulness of a concurrent infusion in patient-controlled epidural analgesia (PCEA), 40 patients scheduled for elective cesarean section under a combined spinal-epidural technique were assigned randomly in a double-blind fashion to receive sufentanil by PCEA with a concomitant infusion of either sufentanil or saline. The sufentanil 24-h consumption was significantly (P < 0.001) higher in those patients receiving the opioid-containing infusion (212.

Does epidural injection of physiological saline facilitate the advancement of catheters?

Seventy patients (ASA I, ASA II), scheduled for a surgical intervention under epidural or combined spinal-epidural anaesthesia, were randomly allocated to one of two groups. The epidural space was identified by loss of resistance using air, followed by injection in Group A (35 patients) of 10 ml of physiological saline directed cephallad and in Group B (35 patients) by no injection. Thereafter an anaesthetist, different to the one who placed the Tuohy in the epidural space, advanced a catheter up to 10 cm into the epidural space.

Atraucan: a new needle for spinal anesthesia.

Background And Objectives: Atraucan 26-gauge spinal needles have a tip designed to make a small linear cut (as opposed to a V-shaped cut) in the dura mater. The cut is shorter than the outside diameter of the needle and is dilated as the needle passes through the dura. The needle is used with a 20-gauge introducer.

A loss-of-resistance-to-negative-pressure test for subarachnoid puncture with narrow-gauge needles.

Background And Objectives: Approximately 5-10% of attempted myelograms are spoiled by partial subdural injection. Similar spillage of local anesthetics may underlie the wide variability of segmental spread reported for spinal anesthesia. A technique of applied negative pressure to avoid accidental subdural injection and to facilitate subarachnoid puncture with narrow gauge needles is described.

The effects of the addition of sufentanil to 0.125% bupivacaine on the quality of analgesia during labor and on the incidence of instrumental deliveries.

In a double-blinded, randomized, prospective multi-center study of 695 women, we investigated whether epidural injection of sufentanil added to 0.125% bupivacaine with epinephrine (1:800,000) reduces the total amount of local anesthetic required, resulting in less motor blockade and reduced incidence of instrumental deliveries, and improves the quality of analgesia provided by this low concentration of local anesthetic without jeopardizing the safety of the baby. In addition, other potential benefits of sufentanil (such as decrease in the incidence of shivering) and side effects were examined.

Guillain-Barre syndrome after obstetrical epidural analgesia.

Guillain Barre Syndrome (GBS) occurred 24 hours post-partum following an obstetrical epidural anesthetic (OEA) procedure. Clinical diagnosis was confirmed by cerebrospinal fluid (CSF) findings and nerve conduction velocity studies. GBS is an immune mediated process.

Comparison between propofol and midazolam as sedative agents for surgery under regional anaesthesia.

Propofol (25 patients) or midazolam (25 patients) was used to provide sedation in patients who underwent abdominal or orthopaedic surgery under epidural anaesthesia after intravenous premedication with droperidol 1 mg and fentanyl 20 micrograms. The quality of sedation whilst the block was performed, was assessed as good in 19 patients after propofol 1.49 mg/kg but six patients exhibited uncontrolled movement.

Extradural bupivacaine with sufentanil for vaginal delivery. A double-blind trial.

The combination of sufentanil with bupivacaine plus adrenaline given extradurally for pain relief during labour was studied in a double-blind trial. One hundred and twenty patients were randomly divided into three groups and received a 10-ml extradural injection of sufentanil 15 micrograms + bupivacaine 12.5 mg + adrenaline 12.

Sedatives in regional anesthesia.

In regional anesthesia our experience shows that the association of small dose of fentanyl (20 mcg i.v.) and droperidol (1 mg i.

Protein binding of the analgesics alfentanil and sufentanil in maternal and neonatal plasma.

Maternal and umbilical venous plasma was obtained at delivery from 8 mothers and their neonates after an i.v. bolus injection of alfentanil, and from 6 mothers and their neonates after epidural administration of sufentanil.

Bupivacaine, 0.125 per cent, in obstetric epidural analgesia: experience in three thousand cases.

Bupivacaine, 0.125 per cent, with epinephrine, 1:800,000, was administered to 3,000 women in labor. Administration was in the lumbar epidural space for the purpose of achieving satisfactory analgesia with minimal or no motor paralysis.