EpiduralArthroscopic and other surgical proceduresAnalgesiaConcentration of bupivacaineIntrathecalFentanylCesarean deliveryHypotensionEpidurallyIntravenousNeedleEpinephrineCardiac arrestMidazolamAnaesthesiaSubarachnoid spaceCordSafelyNewbornContinuousSurgicalInjectionIntravenouslySolutionLongerSurgery
Epidural12
- 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)
- On completion of this module you will be able to perform spinal, epidural and caudal anaesthesia safely. (developinganaesthesia.com)
- Neuraxial anaesthesia or central neural blockade encompasses spinal, epidural and caudal administration of local anaesthetic and opioid medications. (developinganaesthesia.com)
- The contents of the spinal canal include the spinal cord, nerve roots, the cauda equina (below the conus medullaris of the spinal cord), the meninges (pia, arachnoid and dura mater), epidural space, subdural space and subarachnoid space, blood vessels, fat, lymphatics and ligaments between the vertebrae. (developinganaesthesia.com)
- 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)
- After lumbar epidural catheter placement, 20 ml bupivacaine (n = 35) or bupivacaine with epinephrine 1:300,000 (n = 35) was administered. (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)
- 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)
- Fentanyl is sometimes given intrathecally as part of spinal anesthesia or epidurally for epidural anaesthesia and analgesia. (wikipedia.org)
- 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)
- Possible regional anesthesia techniques include epidural analgesia, spinal analgesia (sometimes referred to as the intrathecal or subarachnoid space), or a combination of epidural and spinal analgesia. (medscape.com)
- Regional anesthesia is contraindicated in the presence of actual or anticipated serious maternal hemorrhage, refractory maternal hypotension, coagulopathy, untreated bacteremia, raised intracranial pressure, skin or soft tissue infection at the site of the epidural or spinal placement, and anticoagulant therapy. (medscape.com)
Arthroscopic and other surgical procedures2
- 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)
- There have been adverse event reports of chondrolysis in patients receiving intra-articular infusions of local anesthetics following arthroscopic and other surgical procedures. (pfizermedicalinformation.com)
Analgesia9
- 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)
- Doses of ≤50 mg bupivacaine equivalents (20 ml 0.25% bupivacaine on each side, for example) are recommended on each side to balance analgesia efficacy with risk of local anesthetic systemic toxicity (LAST). (asra.com)
- 21 The role of liposomal bupivacaine, which provides longer duration of analgesia, shows some promise in the CD setting. (asra.com)
- We conclude that intrathecal midazolam 2.5mg provided moderate prolongation of postoperative analgesia when used as an adjunct to bupivacaine. (ispub.com)
- Spinal anesthesia with bupivacaine is administered routinely for lower limb surgery 1 and provides effective analgesia in the early postoperative period. (ispub.com)
- Various adjuvants have been added to spinal local anesthetic to prolong postoperative analgesia. (ispub.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)
- 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)
- In obstetric patients, regional analgesia refers to partial or complete loss of pain sensation below the T8 to T10 spinal level. (medscape.com)
Concentration of bupivacaine2
- 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)
- 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)
Intrathecal4
- In this prospective, randomized, double- blind study, we investigated the postoperative analgesic efficacy of intrathecal midazolam 2.5mg as an adjunct to bupivacaine for spinal anesthesia in 80 patients undergoing lower limb orthopedic surgery. (ispub.com)
- 3 , 8 , 9 Up to 6 mg per day of midazolam has been used safely as an intrathecal infusion for relief of chronic refractory pain. (ispub.com)
- 10 In this prospective, randomized, double-blind study, we evaluated the analgesic efficacy of a combination of intrathecal midazolam and bupivacaine and compared it with bupivacaine alone in patients undergoing lower limb orthopedic surgery. (ispub.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)
Fentanyl2
- Spinal anesthesia was performed with 0.5% hyperbaric bupivacaine 11 mg mixed with fentanyl 20 μg and morphine 0.1 mg using a 25-gauge Quincke needle at the L3-L4 interspace after gentle aspiration of the clear cerebrospinal fluid in the right decubitus position. (springeropen.com)
- Spinal administration of hyperbaric bupivacaine with fentanyl may be the optimal combination. (wikipedia.org)
Cesarean delivery4
- Post-spinal hypotension has a high occurrence during cesarean delivery, and can lead to adverse maternal or fetal outcomes. (researchsquare.com)
- Maternal hypotension is the most common side effect of spinal anesthesia during cesarean delivery, accounting for 70-83% of all cases. (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)
- He injected hyperbaric bupivacaine 0.5% and the cesarean delivery was carried out uneventfully. (ahrq.gov)
Hypotension5
- Therefore, the 0.9% sodium chloride infusion was increased and 10 mg of ephedrine was given intravenously due to our initial diagnosis of spinal anaesthesia-induced hypotension. (scholars.direct)
- 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)
- the incidence of post-spinal anesthesia hypotension was observed. (researchsquare.com)
Epidurally1
- 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)
Intravenous2
- There have been reports of cardiac arrest and death during the use of bupivacaine for intravenous regional anesthesia (Bier Block). (nih.gov)
- The study series incorporated intravenous tranexamic acid (TXA) infusion in 2 doses of 10-15 mg/kg, 15 minutes before tourniquet release and 3 hours later. (openorthopaedicsjournal.com)
Needle8
- Spinal anaesthesia was performed at the L3-L4 inter space with a 25 gauge spinal needle and 3 ml (15 mg) of 0.5% hyperbaric bupivacaine. (scholars.direct)
- Dural puncture was performed at the lumbar 3-4 inter space in the sitting position using a 25G spinal needle. (ispub.com)
- The anesthesia care provider inserted a spinal needle swiftly and uneventfully. (ahrq.gov)
- However, the short interval between LMWH and spinal needle placement in this case is not in line with national guidelines including those from the Society for Obstetric Anesthesia and Perinatology (SOAP) and the American Society of Regional Anesthesia and Pain Management (ASRA). (ahrq.gov)
- Although this patient did not experience an adverse event attributable to the short interval, placement of a spinal needle was contraindicated given recent dosing of LMWH. (ahrq.gov)
- Use of a 22-gauge or smaller, pencil-point spinal needle (Whitacre, Sprotte, or Gertie Marx) decreases the incidence of PDPH. (brainkart.com)
- 9-cm) spinal needle may not be long enough to reach the subarachnoid space. (brainkart.com)
- 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)
Epinephrine2
- 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)
Cardiac arrest1
- Here, we report a KS case with the development of cardiac arrest during spinal anesthesia in which no lesions were observed in the coronarography. (scholars.direct)
Midazolam1
- group BM received 3.5 ml bupivacaine plus 0.5 ml midazolam (5 mg/ml). (ispub.com)
Anaesthesia4
- Spinal anaesthesia, in adults, should be attempted at the lowest possible level. (developinganaesthesia.com)
- Potent long-acting anaesthetic for spinal anaesthesia in surgery, traumatology and obstetrics. (uf.ua)
- The product is indicated for spinal anaesthesia in urologic surgery, 2-3-hour surgeries on the lower limbs, 45-60-minute abdominal surgery. (uf.ua)
- Longocain ® Heavy is used for hyperbaric spinal anaesthesia, in which the gravity of the solution and the patient's position on the table have an effect on the initial distribution of Longocain ® Heavy in the subarachnoid space. (uf.ua)
Subarachnoid space1
- In the newborn, the spinal cord terminates at the third lumbar vertebra and the subarachnoid space extends to the third (or fourth) sacral space. (developinganaesthesia.com)
Cord9
- The spinal cord starts at the base of the brain at the foramen magnum of the skull and is 45 cm long. (developinganaesthesia.com)
- However there is a variation in the termination of the spinal cord, and it may extend to the level of the third lumbar vertebra. (developinganaesthesia.com)
- The termination of the spinal cord in infants is at L3 and in the foetus it extends along the entire length of the spinal column. (developinganaesthesia.com)
- The inner sheath continues as the covering of the spinal cord and it contains the spinal cord and cerebrospinal fluid. (developinganaesthesia.com)
- The pia mater is the innermost membrane surrounding the brain and spinal cord. (developinganaesthesia.com)
- It is made of vascular connective tissue and projects into the spinal cord fissures and sulci of the brain. (developinganaesthesia.com)
- The level of the termination of the spinal cord changes during development. (developinganaesthesia.com)
- These pain impulses are transmitted by afferent, slow conducting, A-delta and C fibers that accompany the sympathetic nerves and enter the spinal cord at the T10 to L1 level. (medscape.com)
- The nerve fibres from the dorsal root ganglia enter the dorsal root and send branches one to two segments up and down the spinal cord (dorsolateral tract of Lissauer). (postgraduateorthopaedics.co.uk)
Safely1
- These highlights do not include all the information needed to use BUPIVACAINE HYDROCHLORIDE INJECTION safely and effectively. (nih.gov)
Newborn1
- Cesarean section was performed under spinal anesthesia, and a healthy newborn was delivered. (springeropen.com)
Continuous1
- Continuous low dose noradrenaline (0.1 μg/kg/min) infusion was required for the first 2 hours. (scholars.direct)
Surgical1
- Prior to administering the spinal anesthesia, 1 g of ceftriaxone was administered intravenously for the surgical prophylaxis. (scholars.direct)
Injection4
- 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)
Intravenously1
- Both procedures were performed uneventfully under spinal anesthesia, and oxytocin 5 units was intravenously administered as a uterotonic. (springeropen.com)
Solution1
- 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)
Longer1
- In these cases, longer spinal needles of 4.75 in. (brainkart.com)
Surgery1
- Bupivacaine should be chosen if the obstetrician will not likely complete the surgery in minutes. (brainkart.com)