AnatomyOrganismsDiseasesChemicals and DrugsAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPsychiatry and PsychologyPhenomena and ProcessesHealth Care
BupivacaineInfusions, IntravenousAnalgesia, EpiduralAnalgesia, ObstetricalAnesthetics, LocalAnesthesia, EpiduralDrug Administration ScheduleInjections, EpiduralSpinal CordCordotomyMeperidineDose-Response Relationship, DrugFentanylPain, PostoperativePain MeasurementLabor, ObstetricAnesthesia, SpinalAnalgesics, OpioidSpinal Cord InjuriesDouble-Blind MethodMorphineInjections, SpinalInfusions, ParenteralPregnancyAmidesAnesthesia, ObstetricalNerve BlockLidocaineInfusion PumpsAnesthesia, CaudalSufentanilEtidocaineSpinal NervesAnesthesia, LocalSpinal Nerve RootsAnesthetics, CombinedAdjuvants, AnesthesiaSpinal Cord DiseasesSpinal CanalCesarean SectionMepivacaineSpinal Cord NeoplasmsInfusions, Intra-ArterialSpinal DiseasesSpinal Cord CompressionSpinal NeoplasmsAnalgesiaCarticaineRats, Sprague-DawleySpinal StenosisTime FactorsSpinal FusionSubarachnoid SpaceInjections, IntravenousSensationStereoisomerismAnalgesia, Patient-ControlledSpinal InjuriesHemodynamicsMuscular Atrophy, SpinalGanglia, SpinalEpinephrineBlood PressureBrachial PlexusLumbosacral RegionSpinal Cord IschemiaSciatic NerveEpidural Space
AnalgesiaAnesthesiaThreaded into the epidural spaceCatheterLumbar epidural0.25CordIntrathecalIntravenous BolusAnalgesicBlockadeHypotensionPostoperative painFentanyl infusionLidocaineOpioidsAmide local anestheticCaudalHydrochlorideIncidenceDoseHematomaConcentrationAnestheticEpinephrineThoracicDosesAnaesthesiaMLACMaternalSubarachnoidPencil-point spinal needleNeedlePatientsSignificantlyDura materComplicationsMorphineTotal knee arthroplastyOpioidLocalCommonlyPainPlacementMicrogContinuous infusion
Analgesia44
  • The advantages of IT opioids for analgesia, especially if spinal anesthesia is already planned, include its simplicity, lack of need for catheter care or pumps, low cost, and easy supplementation with low-dose patient-controlled analgesia (PCA) opioids as needed. (medscape.com)
  • A nationwide data analysis from 2016 reviewed more than 3.7 million instances of epidural analgesia over a period of 12 years and found the rate of spinal hematoma to be 0.6 per 100,000 in obstetric patients and 18.5 per 100,000 in nonobstetric patients. (medscape.com)
  • We have previously demonstrated that continuous epidural infusions of fentanyl without local anesthetics elicit analgesia by a systemic mechanism. (stanford.edu)
  • In this study, we examined the hypothesis that, in the presence of epidural bupivacaine, continuous infusions of epidural fentanyl elicit analgesia by a spinal mechanism. (stanford.edu)
  • Women received lumbar epidural analgesia with 20-30 mL bupivacaine 0.125% until pain free. (stanford.edu)
  • Unlike previous studies that assessed the minimum local analgesic concentration (MLAC) for bolus administration at the initiation of analgesia, this study assessed MLAC(infusion) for the maintenance of analgesia throughout the first stage of labor. (stanford.edu)
  • This marked increase in potency for the epidural route is highly suggestive for a predominantly spinal mechanism of action for infused epidural fentanyl under the conditions of this study.This study determined the median effective concentration for epidural infusions of bupivacaine during labor analgesia. (stanford.edu)
  • The minimum local analgesic concentration (MLAC) has been defined as the median effective local analgesic concentration in a 20-ml volume for epidural analgesia in the first stage of labor. (silverchair.com)
  • In this double-blind, randomized, prospective study, 70 parturients who were at 7 cm or less cervical dilation and who requested epidural analgesia were allocated to one of two groups. (silverchair.com)
  • WHETHER the addition of epinephrine to local anesthetic solutions used for epidural labor analgesia is advantageous is subject to debate. (silverchair.com)
  • single-shot epidural or intrathecal opioids may serve as an indicator to the future success of continuous infusions or patient-controlled analgesia using opioids. (slideserve.com)
  • Al-Zahrani T, Doais KS, Aljassir F, Alshaygy I, Albishi W, Terkawi AS (2015) Randomized clinical trial of continuous femoral nerve block combined with sciatic nerve block versus epidural analgesia for unilateral total knee arthroplasty. (springer.com)
  • Effects of Postoperative Patient Controlled Epidural Analgesia in Pediatric Patients Undergoing Lower Extremity Surgery. (ekja.org)
  • A limited number of studies have been conducted on postoperative epidural analgesia in pediatric patients. (ekja.org)
  • This study evaluated the safety and efficacy of postoperative continuous patient controlled epidural analgesia (PCEA) in children undergoing lower extremity surgery using a bupivacaine and fentanyl via lumbar approach. (ekja.org)
  • Delivery occurred 16 min after intrathecal injection with excellent analgesia, after which the unused epidural catheter was removed. (silverchair.com)
  • In a 20-yr-old nulliparous woman, with 4 cm cervical dilatation, 35 min after intrathecal injection, an epidural test dose was administered with the intent to follow with a continuous epidural infusion to maintain uninterrupted analgesia. (silverchair.com)
  • A sustained-release DepoFoam injection formulation of bupivacaine (EXPAREL, 15 mg/mL) is currently being investigated for postsurgical analgesia via peripheral nerve block (PNB). (hindawi.com)
  • Care for a patient with an epidural for post operative or obstetric analgesia. (developinganaesthesia.com)
  • it achieves sedation, analgesia, and sympathetic activation 12 with a relatively low risk of side effects to mothers or infants, 13 making it an optimum choice as an IV adjuvant for spinal anesthesia during cesarean delivery. (researchsquare.com)
  • Epidural analgesia during childbirth may also impact the mother's ability to move during labor. (wikipedia.org)
  • Epidural injections are commonly used to provide pain relief (analgesia) during childbirth. (wikipedia.org)
  • Epidural clonidine is rarely used but has been extensively studied for management of analgesia during labor. (wikipedia.org)
  • Epidural analgesia is considered a safer and more effective method of relieving pain in labor as compared to intravenous or oral analgesia. (wikipedia.org)
  • In a 2018 Cochrane review of studies which compared epidural analgesia with oral opioids, some advantages of epidural analgesia versus opioids included fewer instances of naloxone use in newborns, and decreased risk of maternal hyperventilation. (wikipedia.org)
  • Some disadvantages of epidural analgesia versus opioids included longer labor durations, an increased need for oxytocin to stimulate uterine contractions, and an increased risk of fever, low blood pressure, and muscle weakness. (wikipedia.org)
  • However, the review found no difference in overall Caesarean delivery rates between epidural analgesia versus no analgesia. (wikipedia.org)
  • Additionally, there was no difference found on the immediate neonatal health of the child between epidural analgesia versus no analgesia. (wikipedia.org)
  • Complications of epidural analgesia are rare, but may include headaches, dizziness, difficulty breathing and seizures for the mother. (wikipedia.org)
  • Research in newborn animals has revealed that failure to provide analgesia for pain results in "rewiring" of the nerve path-ways responsible for pain transmission in the dorsal horn of the spinal cord, resulting in increased pain perception of future painful insults. (nysora.com)
  • Bupivacaine hydrochloride injection contains bupivacaine hydrochloride, an amide local anesthetic indicated in adults for the production of local or regional anesthesia or analgesia for surgery, oral surgery procedures, diagnostic and therapeutic procedures, and for obstetrical procedures. (nih.gov)
  • An epidural catheter was placed, and analgesia was reported only at high doses of local anesthetic. (openanesthesiajournal.com)
  • The last delivery was performed at another institution, and according to the provided records, sufficient analgesia was never reached with a customary dose and concentration of local anesthetic (bupivacaine 0.125% epidural block analgesia combined with fentanyl 100mcg). (openanesthesiajournal.com)
  • The aim of this study was to compare the effect of dexmedetomidine versus ketamine when added to caudal bupivacaine on the incidence of emergence delerium (ED), postoperative sedation, and analgesia in pediatric patients undergoing inguinal hernia repair under sevoflurane anesthesia. (springeropen.com)
  • Spinal anaesthesia is advantageous in that it uses a small dose of anaesthesia, simple to perform and offer a rapid onset of action, reliable surgical analgesia and good muscle relaxation. (panafrican-med-journal.com)
  • Patients were assigned to ESPB with 30 ml 0.25% bupivacaine (Group-1) or ESPB with 20 ml 0.25% bupivacaine (Group-2) groups according to the analgesia protocol. (biomedcentral.com)
  • 1 More than a century later, epidurals have become the most popular method of analgesia, or pain relief, in US birth rooms. (sarahbuckley.com)
  • Spinal analgesia has also been increasingly used in labor to reduce the motor block. (sarahbuckley.com)
  • Spinals involve drugs injected right through the dura and into the spinal (intrathecal) space, and produce only short-term analgesia. (sarahbuckley.com)
  • 6 As the World Health Organization comments, "epidural analgesia is one of the most striking examples of the medicalization of normal birth, transforming a physiological event into a medical procedure. (sarahbuckley.com)
  • Lumbar epidural injection Analgesia of a local anesthetic is the most commonly used method. (msdmanuals.com)
  • Epidural analgesia is being increasingly used for delivery, including cesarean delivery, and has essentially replaced pudendal and paracervical blocks. (msdmanuals.com)
  • When epidural analgesia is used, drugs can be titrated as needed during the course of labor. (msdmanuals.com)
  • Sixty-two patients undergoing TKA with simple spinal analgesia and ACB were randomized to receive either LIA (group A+L) or placebo LIA (group A). Postoperative visual analog scale (VAS) score for pain, Timed Up and Go (TUG) test and quadriceps strength, total dosage of rescue analgesia, time to first rescue analgesia, and adverse events were serially evaluated from postoperative day 1 to 3 months. (jksrr.org)
Anesthesia20
  • Intrathecal (IT), often referred to as "spinal," anesthesia refers to the delivery of anesthetic agents to the subarachnoid layer of the spinal column into cerebrospinal fluid (CSF) surrounding the spinal cord. (medscape.com)
  • IT opioids can be administered as an adjunct to general anesthesia (e.g., for scoliosis surgery) or combined with local anesthetics and administered during spinal anesthesia (e.g., for total hip arthroplasty). (medscape.com)
  • Spinal epidural hematoma after neuraxial anesthesia is exceedingly rare. (medscape.com)
  • Although parturients, a cohort of patients that often receives neuraxial anesthesia, are generally in a hypercoagulable state, certain conditions of pregnancy (eg, gestational thrombocytopenia, HELLP [hemolysis, elevated liver enzymes, low platelets] syndrome, and complications of preeclampsia) can increase the incidence of epidural hematoma. (medscape.com)
  • All patients underwent regional anesthesia with plain bupivacaine (0.5%, given epidurally) or hyperbaric bupivacaine (0.5%, given spinally) without any other additives. (asahq.org)
  • Reduces blood loss: In total hip arthroplasty (THA), studies have demonstrated that both spinal and epidural anesthesia tend to have approximately a 30% reduction in intraoperative blood loss compared with general anesthesia , owing to lower arterial and venous pressures. (medscape.com)
  • Prospective randomized double-blinded study in patients who underwent a TKA for knee osteoarthritis under spinal anesthesia and treated with femoral and sciatic nerve blocks. (springer.com)
  • Maternal hypotension is the most common side effect of spinal anesthesia during cesarean delivery, accounting for 70-83% of all cases. (researchsquare.com)
  • Methods such as intrathecal adjuvant opioid use to reduce the total dose of anaesthetics delivered, 8 prophylactic use of vasopressors, 4,9 and the use of intravenous (IV) pre-load colloid liquid 10 have been proposed to reduce the incidence or extent of maternal hypotension after spinal anesthesia during cesarean delivery. (researchsquare.com)
  • We hypothesized that a single ultra-low IV bolus of S-ketamine may reduce the total need for spinal ropivacaine and thus reduce the incidence of post-spinal anesthesia hypotension during cesarean delivery. (researchsquare.com)
  • the incidence of post-spinal anesthesia hypotension was observed. (researchsquare.com)
  • There have been reports of cardiac arrest with difficult resuscitation or death during use of bupivacaine hydrochloride for epidural anesthesia in obstetrical patients. (nih.gov)
  • The 0.75% (7.5 mg/mL) concentration of bupivacaine hydrochloride is not recommended for obstetrical anesthesia and should be reserved for surgical procedures where a high degree of muscle relaxation and prolonged effect are necessary ( 5.1 ). (nih.gov)
  • There have been reports of cardiac arrest and death during the use of bupivacaine for intravenous regional anesthesia (Bier Block). (nih.gov)
  • On admission, the patient reported failure of epidural anesthesia during the previous delivery. (openanesthesiajournal.com)
  • Hypotension following epidural anesthesia typically has a slower onset. (brainkart.com)
  • Continuous spinal anesthesia is also a reason-able option, especially for obese patients, follow-ing unintentional dural puncture sustained while attempting to place an epidural catheter for cesar-ean section. (brainkart.com)
  • Epidural anesthesia for cesarean section is typically performed using a catheter, which allows supplemen-tation of anesthesia if necessary and provides an excellent route for postoperative opioid admin-istration. (brainkart.com)
  • Some practitioners also add sodium bicarbon-ate (7.5% or 8.4% solution) to local anesthetic solutions (1 mEq/10 mL of lidocaine) to increase the concentration of the nonionized free base and pro-duce a faster onset and more rapid spread of epidural anesthesia. (brainkart.com)
  • A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth. (lookformedical.com)
Threaded into the epidural space1
Catheter9
  • Hematoma can occur as a consequence of trauma to the epidural venous plexus during placement of a needle or catheter. (medscape.com)
  • After lumbar epidural catheter placement, 20 ml bupivacaine (n = 35) or bupivacaine with epinephrine 1:300,000 (n = 35) was administered. (silverchair.com)
  • There have been primarily dealt with spinal or abdominal surgeries where multiple dermatomal segments needed to be blocked and morphine was given either through the caudal approach or by direct catheter placement. (ekja.org)
  • the control group received an intramuscular injection of ketorolac 1 mg/kg t.i.d. and meperidine 0.5 mg/kg p.r.n., and the epidural group received PCEA (0.1% bupivacaine + fentanyl 2 microgram/ml) through an epidural catheter positioned at the surgical dermatomal level of the spinal cord. (ekja.org)
  • Facial sensory changes began to recede at 45 min and were gone at 100 min when the unused epidural catheter was removed after delivery. (silverchair.com)
  • Epidural administration involves the placement of a catheter into the epidural space, which may remain in place for the duration of the treatment. (wikipedia.org)
  • Insertion of an epidural catheter consists of threading a needle between bones and ligaments to reach the epidural space without going so far as to puncture the dura mater. (wikipedia.org)
  • When placed properly, an epidural catheter may remain inserted for several days, but is usually removed when the use of less invasive administration methods (such as taking medication by mouth) is a viable alternative. (wikipedia.org)
  • An epidural catheter was successfully placed on the first attempt. (openanesthesiajournal.com)
Lumbar epidural2
0.255
  • When contractions again became painful 2.5 h after the intrathecal injection, an epidural bolus of 10 ml 0.25% bupivacaine was given, and a continuous epidural infusion of 0.125% bupivacaine was started at 10 ml/h. (silverchair.com)
  • Patients of group B received caudal injectate of 1 ml/kg bupivacaine 0.25%, while group BK patients received caudal injectate of 1 ml/kg bupivacaine 0.25% mixed with ketamine 0.5 mg/kg, and group BD patients received caudal injectate of 1 ml/kg bupivacaine 0.25% mixed with dexmedetomidine 1 μg/kg. (springeropen.com)
  • The intervention consists of an intra-operative local anaesthetic wound infiltration, consisting of 60 mls of 0.25% bupivacaine with 1 in 200,000 adrenaline. (biomedcentral.com)
  • The aim of this study is to compare the analgesic efficacy of 0.25% bupivacaine in different volumes for ESPB in patients undergoing thoracotomy. (biomedcentral.com)
  • 0.25mg ( 20 ml vial ) , injection solution for 1.48 bupivacaine hydrochloride inj. (tendersinmadhyapradesh.com)
Cord21
Intrathecal4
  • In each case, intrathecal sufentanil was administered as part of a combined spinal-epidural technique. (silverchair.com)
  • Intrathecal injection was performed via a 120-mm (Sprotte) or 127-mm (Gertie Marx) 24-G pencil-point spinal needle (cases 1-5) or a 120-mm 25-G Quincke needle (case 6) introduced via the 18-G needle. (silverchair.com)
  • In cases 4-6, epidural test doses of 1.5% lidocaine with 1:200,000 epinephrine 3 ml were administered at varying times after intrathecal injection. (silverchair.com)
  • CONCLUSION: The use of intrathecal meperidine for caesarean section during spinal anaesthesia for the prevention of shivering cannot be recommended as its use is associated with increased incidence of nausea and vomiting. (druglib.com)
Intravenous Bolus1
  • Because of the associ-ated sympathetic blockade, patients should receive an appropriate intravenous bolus of crystalloid such as lactated Ringer's (typically 1000-1500 mL) or col-loid (typically 250-500 mL) solution at the time of neural blockade. (brainkart.com)
Analgesic3
  • All women received an epidural infusion of bupivacaine at a rate of 20 mL/h, the concentration of which was determined by the response of the previous woman in the same group to the analgesic regimen used. (stanford.edu)
  • Bupivacaine is a local anesthetic/analgesic widely used in the perioperative and postsurgical settings. (hindawi.com)
  • It was aimed to compare the analgesic efficacy of bupivacaine in different volumes for ESPB in patients undergoing thoracotomy. (biomedcentral.com)
Blockade4
  • Brachial plexus blockade may require dispersion of a relatively large volume of bupivacaine in solution to accomplish blockade of the entire plexus. (hindawi.com)
  • Neuraxial anaesthesia or central neural blockade encompasses spinal, epidural and caudal administration of local anaesthetic and opioid medications. (developinganaesthesia.com)
  • Five minutes after premedication, subarachnoid block (SAB) was given with 3 ml of 0.5% hyperbaric bupivacaine following which sensory and motor blockade, hemodynamic changes, sedation, and complications of the surgery were recorded and this data was analyzed statistically using χ 2 test, corrected χ 2 test, Fisher´s exact test, and test of proportion (Z-test). (panafrican-med-journal.com)
  • IV infusion of dexmedetomidine 1 g/kg body weight prior to SAB can be recommended to achieve better sensory blockade and adequate hemodynamic stability and sedation. (panafrican-med-journal.com)
Hypotension6
  • Post-spinal hypotension has a high occurrence during cesarean delivery, and can lead to adverse maternal or fetal outcomes. (researchsquare.com)
  • The purpose of the study was to determine the optimal dose of spinal ropivacaine for cesarean section with or without intravenous single bolus of S-ketamine and to observe the incidences of hypotension of both methods. (researchsquare.com)
  • The primary outcome was the successful use of spinal ropivacaine to maintain VAS of patients below 3 before delivery and the incidence of post-spinal hypotension of both groups. (researchsquare.com)
  • A spinal dose of ropivacaine 12 mg with single intravenous 0.15 mg/kg bolus dose of S-ketamine may significantly reduce the risk of hypotension and provide sedative status before delivery, thus the method could be cautiously used in parturients with high risks of hypotension or extreme nervousness. (researchsquare.com)
  • Such boluses will not consistently prevent hypotension but can virtually eliminate preexisting hypovolemia. (brainkart.com)
  • When spinal injection is used, patients must be constantly attended, and vital signs must be checked every 5 minutes to detect and treat possible hypotension. (msdmanuals.com)
Postoperative pain3
  • OBJECTIVE: Patients undergoing spinal fusion surgery suffer from severe postoperative pain. (bvsalud.org)
  • Bupivacaine solutions have been used for many years by multiple routes for the relief of postoperative pain [ 1 ]. (hindawi.com)
  • Intra-articular bupivacaine reduces postoperative pain and meperidine use after total hip arthroplasty: a randomized, double-blind study. (druglib.com)
Fentanyl infusion2
  • Subjects were then randomized to either IV or epidural (EPI) fentanyl infusion groups. (stanford.edu)
  • Continuous epidural fentanyl infusion (0.5 µg/kg/hr) started 60 min after the bolus dose had no effect on end tidal CO2 concentration or respiratory rate for up to 18 hours. (anesthesiaexam.com)
Lidocaine3
  • The patient is usually placed in the lateral decubi-tus or sitting position, and a hyperbaric solution of lidocaine (50-60 mg) or bupivacaine (10-15 mg) is injected. (brainkart.com)
  • een anesthetische pleister voor lokale toepassing, die per pleister 70 mg lidocaine en 70 mg tetracaine bevat, verwerkt in een warmteproducerende patch. (richtlijnendatabase.nl)
  • In een dubbelblinde gerandomiseerde studie werden bij het inbrengen van een 16 Gauge katheter bij volwassenen het analgetisch van een lidocaine 70mg/ tetracaine 70 mg zonder en met warmteproducerend effect vergeleken. (richtlijnendatabase.nl)
Opioids1
  • To evaluate the pharmacodynamic contributions of the various epidural analgesics, we previously described a clinical model to determine the relative potencies of local anesthetic agents in the first stage of labor 13-15 and to estimate the local anesthetic-sparing potential of epidural opioids. (silverchair.com)
Amide local anesthetic1
Caudal2
Hydrochloride8
  • These highlights do not include all the information needed to use BUPIVACAINE HYDROCHLORIDE INJECTION safely and effectively. (nih.gov)
  • Recommended concentrations and dosages of bupivacaine hydrochloride injection according to type of block. (nih.gov)
  • Bupivacaine hydrochloride injection is available in multiple concentrations. (nih.gov)
  • Known hypersensitivity to bupivacaine or to any local anesthetic agent of the amide-type or to other components of bupivacaine hydrochloride injection. (nih.gov)
  • Monitor cardiovascular and respiratory vital signs and patient's state of consciousness after injection of bupivacaine hydrochloride. (nih.gov)
  • Intra-articular infusions of local anesthetics including bupivacaine hydrochloride following arthroscopic and other surgical procedures is an unapproved use, and there have been post-marketing reports of chondrolysis in patients receiving such infusions. (nih.gov)
  • Bupivacaine Hydrochloride Injection, USP and Bupivacaine Hydrochloride and Epinephrine Injection, USP are available in multiple concentrations. (pfizermedicalinformation.com)
  • Bupivacaine Hydrochloride and Epinephrine Injection contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. (pfizermedicalinformation.com)
Incidence3
  • [ 3 ] The incidence is also increased in patients who are taking anticoagulants, those who have coagulation disorders, and those who require multiple attempts for epidural placement. (medscape.com)
  • A significant correlation was observed between the bolus number and the incidence of nausea/vomiting in the epidural group. (ekja.org)
  • Use of a 22-gauge or smaller, pencil-point spinal needle (Whitacre, Sprotte, or Gertie Marx) decreases the incidence of PDPH. (brainkart.com)
Dose2
  • Single-dose toxicology studies of EXPAREL (9, 18, and 30 mg/kg), bupivacaine solution (Bsol, 9 mg/kg), and saline injected around the brachial plexus nerve bundle were performed in rabbits and dogs. (hindawi.com)
  • If the patient had VAS scores above 2 or needed an extra epidural rescue bolus before delivery, a higher dose was used for the next patient. (researchsquare.com)
Hematoma1
  • However, serious complications such as dural puncture, sympathetic block, spinal hematoma, and epidural abscess can also be seen due to epidural application [ 5 ]. (biomedcentral.com)
Concentration2
  • The concentration of bupivacaine was determined by the response of the previous patient in that group to a higher or lower concentration using up-down sequential allocation. (silverchair.com)
  • It has been shown that after a single bolus of propofol it exhibits an immediate plasma concentration peak, followed by a rapid decline [ 11 , 13 ]. (biomedcentral.com)
Anesthetic8
  • The aim of this study was to determine the local anesthetic-sparing efficacy of epidural epinephrine by its effect on the MLAC of bupivacaine. (silverchair.com)
  • The epidural route is used by physicians and nurse anesthetists to administer local anesthetic agents, analgesics, diagnostic medicines such as radiocontrast agents, and other medicines such as glucocorticoids. (wikipedia.org)
  • Two different anesthetic protocols were used: inhalation using isoflurane (ISO) and combined-inhalation and epidural (EPI) with propofol being the induction agent. (biomedcentral.com)
  • Split P waves on electrocardiogram have been reported previously but not in a perioperative setting.CASE PRESENTATION: A 69-year-old Caucasian male patient with widely split P waves on his preoperative electrocardiogram was scheduled for a reimplantation right total hip replacement under a combined spinal-general anesthetic technique. (stanford.edu)
  • In the last five to ten years, epidurals have been developed with lower concentrations of local anesthetic drugs, and with combinations of local anesthetics and opiate pain killers (drugs similar to morphine and meperidine) to reduce the motor block, and to produce a so-called "walking" epidural. (sarahbuckley.com)
  • Pudendal block, rarely used because epidural injections are typically used instead, involves injecting a local anesthetic through the vaginal wall so that the anesthetic bathes the pudendal nerve as it crosses the ischial spine. (msdmanuals.com)
  • Procedure in which an anesthetic is injected into the epidural space. (lookformedical.com)
  • Prior to the surgery, the anesthesiologist is performing an ultrasound-guided interscalene nerve block when the patient suddenly loses consciousness and then develops cardiovascular collapse following the injection of the local anesthetic bupivacaine. (theanesthesiaconsultant.com)
Epinephrine3
  • The lowest maternal blood pressure was significantly lower in the bupivacaine-epinephrine group (P = 0.03). (silverchair.com)
  • There were statistically significant reductions in fetal heart rate (P = 0.011) in the bupivacaine-epinephrine group that were not clinically significant. (silverchair.com)
  • The addition of epidural epinephrine 1:300,000 (66 microg) resulted in a significant 29% reduction in the MLAC of bupivacaine. (silverchair.com)
Thoracic1
  • Oncological breast surgeries have commonly been performed under General Anaesthesia (GA). Thoracic Epidural Anaesthesia (TEA) is a safe and advantageous technique associated with fewer post surgical recovery complications, shorter hospital stay and consequently, decreased health care costs. (oaji.net)
Doses2
  • From a systemic standpoint, high doses of bupivacaine may be associated with a wide range of systemic complications, such as central nervous and cardiovascular effects [ 6 ]. (hindawi.com)
  • Respiratory rate decreases significantly and end tidal CO2 showeda non significant increase following single doses of epidural fentanyl (1.5 µg/kg). (anesthesiaexam.com)
Anaesthesia4
  • Spinal anaesthesia, in adults, should be attempted at the lowest possible level. (developinganaesthesia.com)
  • to evaluate the effects of intravenous (IV) dexmedetomidine as a pre-medication on clinical profile of bupivacaine spinal anaesthesia in lower abdominal surgeries. (panafrican-med-journal.com)
  • this prospective randomized double blind study was done on 60 patients with ASA grade I/II undergoing lower abdominal surgeries under bupivacaine spinal anaesthesia. (panafrican-med-journal.com)
  • Spinal anaesthesia remains one of the basic techniques in modern anaesthesia which is a commonly used technique in anaesthesia practice for gynaecological, lower abdominal, pelvic, and lower limb surgeries. (panafrican-med-journal.com)
MLAC4
  • MLAC(infusion) was determined using the up-down sequential analysis described by Dixon and Massey. (stanford.edu)
  • The MLAC(infusion) of epidural bupivacaine was 0.063% (95% confidence interval, 0.058-0.068) and 0.019% (95% confidence interval, 0.000-0.038) in the IV and EPI groups respectively. (stanford.edu)
  • The MLAC of bupivacaine alone was 0.091% wt/vol (95% confidence interval, 0.081-0.102). (silverchair.com)
  • 0.01) in the MLAC of bupivacaine to 0.065% wt/vol (95% confidence interval, 0.047-0.083). (silverchair.com)
Maternal1
  • 10 Epidurals also obliterate the maternal oxytocin peak that occurs at birth 11 -the highest of a mother's lifetime-which catalyses the final powerful contractions of labor and helps mother and baby to fall in love at first meeting. (sarahbuckley.com)
Subarachnoid2
  • 9-cm) spinal needle may not be long enough to reach the subarachnoid space. (brainkart.com)
  • Spinal injection (into the paraspinal subarachnoid space) may be used for cesarean delivery, but it is used less often for vaginal deliveries because it is short-lasting (preventing its use during labor) and has a small risk of spinal headache afterward. (msdmanuals.com)
Pencil-point spinal needle1
  • 6.3-cm) 20-gauge Quincke type spinal needle can be used as a long introducer and guide for a 25-gauge pencil-point spinal needle. (brainkart.com)
Needle1
  • Sufentanil, 10 micro gram, diluted to 1 or 2 ml with preservative-free saline, was injected and the spinal needle withdrawn. (silverchair.com)
Patients4
  • A case study investigating opioid medication utilization in patients with complex regional pain syndrome before and after ketamine infusion therapy. (uclahealth.org)
  • MRI prediction of therapeutic response to epidural steroid injection in patients with cervical radiculopathy. (uclahealth.org)
  • PATIENTS AND METHODS: Forty-two patients, who were in classes I-II-III according to the American Society of Anesthesiologists (ASA) classification and were scheduled for lumbar spinal fusion surgery, were randomly divided at a ratio of 1:1 into the erector spinae plane block (ESPB) group and the control group. (bvsalud.org)
  • One hundred patients receiving unilateral total hip arthroplasty (THA) were randomized to receive an intra-articular injection of 300mg bupivacaine or normal saline after completion of surgery. (druglib.com)
Significantly2
  • The epidural group had significantly lower pain scores and minimal side effects. (ekja.org)
  • Epidurals significantly interfere with some of the major hormones of labor and birth, which may explain their negative effect on the processes of labor. (sarahbuckley.com)
Dura mater1
Complications2
  • Severe complications from epidural administration are rare, but can include problems resulting from improper administration, as well as side effects of the medicines administered. (wikipedia.org)
  • The most common complications of epidural injections include bleeding problems, headaches, and inadequate pain control. (wikipedia.org)
Morphine1
  • 4 on a visual analog scale, on which 0 represents no pruritus and 10 represents worst pruritus imaginable) after spinal or epidural administration of morphine, received either 8 mg ondansetron intravenously (ondansetron group) in 100 ml NaCl 0.9% or vehicle (placebo group). (asahq.org)
Total knee arthroplasty1
  • Browne C, Copp S, Reden L, Pulido P, Colwell C Jr (2004) Bupivacaine bolus injection versus placebo for pain management following total knee arthroplasty. (springer.com)
Opioid1
  • Coadministered epidural fentanyl infusions were more than three times more potent than IV fentanyl infusions, suggesting a predominantly spinal mechanism of opioid action under these study conditions. (stanford.edu)
Local2
  • A formulation of bupivacaine that provides prolonged release of the active ingredient after a single administration would simplify pain management in the postoperative period and eliminate the undesired peak plasma concentrations as a result of excessively high concentrations and reduce the risk of local and systemic reactions [ 7 ]. (hindawi.com)
  • Our goal was to evaluate the potential local and systemic toxicity of EXPAREL after a bolus injection into the brachial plexus (i.e., a large, complex bundle of nerves in the shoulder). (hindawi.com)
Commonly1
  • For this reason, epidurals are commonly used for pain control during childbirth and surgery. (wikipedia.org)
Pain7
  • Adequate relief of pain with trial spinal oipoids is mandatory before proceeding to more permanent procedures for long-term treatment. (slideserve.com)
  • Alleviating Thoracotomy Pain With Intercostal Liposomal Bupivacaine: A Case Report. (uclahealth.org)
  • The study aims to investigate the effectiveness of ultrasound-guided erector spinae plane block in alleviating pain following multilevel spinal fusion with instrumentation. (bvsalud.org)
  • After an epidural is administered, a woman may not feel pain, but may still feel pressure. (wikipedia.org)
  • To prolong the pain-relieving effect for labor, epidurals are now being co-administered with spinals, as a combined spinal epidural (CSE). (sarahbuckley.com)
  • Epidurals and spinals offer laboring women the most effective form of pain relief available, and women who have used these analgesics rate their satisfaction with pain relief as very high. (sarahbuckley.com)
  • However, satisfaction with pain relief does not equate with overall satisfaction with birth, 5 and epidurals are associated with major disruptions to the processes of birth. (sarahbuckley.com)
Placement1
Microg1
Continuous infusion1
  • A continuous infusion of fentanyl was more than three times as potent when administered by the epidural than by the IV route. (stanford.edu)