Anesthesia, Epidural

Publication Title: 
Obstetrics and Gynecology

Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor.

Publication Title: 
Obstetrics and Gynecology

Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor.

Author(s): 
Committee on Practice Bulletins—Obstetrics
Publication Title: 
Minerva Anestesiologica

Regional - mostly spinal and epidural - anaesthesia associated with pharmacological hypnosis in approximately fifty general surgery and orthopaedic patients is described. The advantage of this type of management is that patients are sedated during the operation and in the post-operative period, coupled, in the latter situation, with a good antalgic effect.

Author(s): 
Mellano, C.
Cattaneo, P.
Publication Title: 
Journal of Clinical Pharmacy and Therapeutics

Midazolam concentration curves versus time were analysed in 10 otherwise healthy patients (ASA I-II) with inferior limb pathologies. The benzodiazepine was used as an adjuvant agent to epidural anaesthesia in view of its lower residual effect compared with other intravenous benzodiazepines. Midazolam pharmacokinetics in these patients fitted an open two-compartment model. The plasma levels versus time corresponded to a biexponential process with a very rapid distribution phase (t1/2a = 5.7 +/- 2.4 min) and an elimination phase (t1/2 beta = 66 +/- 37 min).

Author(s): 
Sánchez-Alcaraz, A.
Sangrador, G.
Laguarda, M.
Quintana, B.
Publication Title: 
Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie

Spinal and epidural anaesthesia were compared in 65 patients undergoing hip arthroplasty, with regard to the degree of sensory and motor blockade, cardiovascular effects, operating conditions, the dose of propofol required to produce satisfactory hypnosis, and complications. Epidural anaesthesia was successful in 30 patients using an initial dose of 15 ml of 0.5% bupivacaine, and spinal anaesthesia in 32 patients, using 4 ml 0.5% isobaric bupivacaine. The two techniques were similar with regard to the level of sensory blockade (T8), degree of hypotension and perioperative haemorrhage.

Author(s): 
Davis, S.
Erskine, R.
James, M. F.
Publication Title: 
Anesthesia and Analgesia

To evaluate the concentration-effect relationships of propofol during recovery after total intravenous anesthesia, 20 female patients undergoing lower abdominal surgery were studied. In 10 patients (Group B) the propofol infusion was supplemented with an epidural block with bupivacaine to evaluate the relation between the blood concentration of propofol and various pharmacodynamic end-points. The remaining 10 patients (Group A) received an alfentanil infusion intravenously instead of the epidural block to assess the dynamic interactions of alfentanil and propofol.

Author(s): 
Wessén, A.
Persson, P. M.
Nilsson, A.
Hartvig, P.
Publication Title: 
Journal of Clinical Anesthesia

STUDY OBJECTIVES: To investigate the pharmacokinetics of propofol in combination with epidural anesthesia or with intravenous (i.v.) alfentanil infusion, and to investigate the clinical feasibility of this anesthetic technique in lower abdominal surgery. DESIGN: Randomized, open clinical study. SETTING: Operating theaters and postanesthesia recovery unit at the department of gynecology of a university medical center. PATIENTS: 20 healthy, consenting ASA physical status I and II adult female patients undergoing lower abdominal surgery. INTERVENTIONS: A total i.v.

Author(s): 
Wessén, A.
Persson, P. M.
Nilsson, A.
Hartvig, P.
Publication Title: 
Saudi Medical Journal

OBJECTIVE: To compare spinal versus epidural anesthesia for transurethral resection of the prostate. METHODS: A total of 65 patients undergoing transurethral resection of the prostate between September 1996 and March 1997, from the King Hussein Medical Centre, Amman, Jordan, were enrolled in this study. RESULTS: Epidural anesthesia was successful in 30 patients using an initial dose of 15 ml of 0.5% bupivicaine; whereas spinal anesthesia was successful in 32, using 2.5 ml of 0.5% bupivicaine.

Author(s): 
Jayousi, N. A.
Publication Title: 
European Journal of Anaesthesiology

BACKGROUND AND OBJECTIVE: Combined (local and general) anaesthesia or Balanced (intravenous analgesics and inhalational hypnotics) anaesthesia are commonly used in paediatrics. The authors have investigated the influence of both types of anaesthesia on the requirements of sevoflurane to maintain an adequate level of hypnosis as measured by Bispectral index (at around 50) monitoring in paediatric orthopaedic patients.

Author(s): 
Reinoso-Barbero, F.
Martínez-García, E.
Hernández-Gancedo, M. C.
Simon, A. M.
Publication Title: 
Anesthesia and Analgesia

The bispectral index (BIS) has been used as a measure of the degree of sedation and level of hypnosis for IV hypnotics and sedatives, potent volatile anesthetics. We evaluated the effect of increasing concentrations of nitrous oxide (N2O) on BIS and compared it with the Observer's Assessment of Alertness and Sedation (OAA/S) scale in patients undergoing regional anesthesia. We studied 48 unpremedicated, ASA physical status I-II adult patients scheduled for lower extremity surgery under lumbar epidural anesthesia.

Author(s): 
Park, Kyung Soo
Hur, Eun Jin
Han, Kyung Woo
Kil, Ho Yeong
Han, Tae Hyung

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