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An up-down determination of the required seated duration after intrathecal injection of bupivacaine and fentanyl for the prevention of hypotension during Cesarean delivery

AbstractPurposeA prolonged seated time after intrathecal injection of hyperbaric bupivacaine and morphine is related to the incidence of hypotension during Cesarean delivery, but results in a high incidence of pain during peritoneal closure. We conducted this study to determine the effect of the addition of intrathecal fentanyl on the relationship between seated time and hypotension and intraoperative analgesia requirements.MethodsWomen undergoing Cesarean delivery were randomized to receive an intrathecal injection of either 11.25 or 15 mg of hyperbaric bupivacaine with morphine 150 µg and fentanyl 15 µg using a combined spinal-epidural technique. The seated duration following intrathecal injection was assigned using up-down methodology. If the preceding patient was hypo- or normotensive, the next patient sat for 15 sec more or less, respectively. A systolic blood pressure
Source: Canadian Journal of Anesthesia - Category: Anesthesiology Source Type: research

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Publication date: Available online 29 November 2017 Source:Neuroscience Research Author(s): Kaede Kakita, Hirona Tsubouchi, Mayu Adachi, Shiori Takehana, Yoshihito Shimazu, Mamoru Takeda Acute administration of chlorogenic acid (CGA) in vitro was recently shown to modulate potassium channel conductance and acid-sensing ion channels (ASICs) in the primary sensory neurons; however, in vivo peripheral effects of CGA on the nociceptive mechanical stimulation of trigeminal neuronal activity remains to be determined. The present study investigated whether local administration of CGA in vivo attenuates mechanical stimulation-ind...
Source: Neuroscience Research - Category: Neuroscience Source Type: research
View Original Article Here: How Long Does Shingles Last In The Elderly? Shingles is a viral infection that follows a varicella-zoster infection, although it can take decades for symptoms of the secondary disease to emerge. The condition presents as a painful and blistering rash, but it is not life-threatening. According to the Center for Disease Control, there are nearly one million cases in the United States each year, and almost half of those cases are in older adults over age 60. Some people only see one instance of the illness, while others have recurring symptoms, but 30 percent of Americans will develop shingles at s...
Source: Shield My Senior - Category: Geriatrics Authors: Tags: Senior Safety Source Type: blogs
Drs Beckman and Soffin from Hospital for Special Surgery share a spine surgery case that embodies recent shifts in managing pain.
Source: Medscape Anesthesiology Podcast - Category: Anesthesiology Authors: Source Type: podcasts
Drs Beckman and Soffin from Hospital for Special Surgery share a spine surgery case that embodies recent shifts in managing pain.Hospital for Special Surgery
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Anesthesiology Commentary Source Type: news
Conclusion : The treatment by initial traction followed by a cast for childrens ≤ 6 years old gives clinical and radiological results comparable with those reported for immediate casting method. The hospitalization period is longer in the traction method but with less exposure to general anesthesia (GA) and risks of secondary displacements. PMID: 29182129 [PubMed - in process]
Source: Acta Orthopaedica Belgica - Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research
Objectives: Intrathecal morphine is used in the postoperative management of pain after caesarean section (CS), but might not be optimal for intraoperative analgesia. We hypothesized that intrathecal fentanyl could supplement intraoperative analgesia when added to a local anesthetic and morphine without affecting management of postoperative pain. Methods: This prospective, randomized, double-blind, parallel-group study included 60 parturients scheduled for elective CS. Spinal anesthesia consisted of bupivacaine with either morphine 100 μg (M group), or fentanyl 25 μg and morphine 100 μg (FM group). The f...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research
Background: Catheter-related bladder discomfort (CRBD) to an indwelling urinary catheter is defined as a painful urethral discomfort, resistant to conventional opioid therapy, decreasing the quality of postoperative recovery. According to anatomy, the branches of sacral somatic nerves form the afferent nerves of the urethra and bladder triangle, which deriving from the ventral rami of the second to fourth sacral spinal nerves, innervating the urethral muscles and sphincter of the perineum and pelvic floor; as well as providing sensation to the penis and clitoris in males and females, which including the urethra and bladd...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research
ConclusionPeripheral nerve block should be considered, whenever possible, as the first option of anesthesia for lower limb surgery in diabetic patients as it provides hemodynamic stability and superior postoperative pain control compared to SAB.Trial registrationClinical trial registry: ClinicalTrials.gov. ID NCT02727348.
Source: Clinical Autonomic Research - Category: Research Source Type: research
This article offers a brief critical review of integrative medical therapies used to treat chronic pain, including nutritional supplements, yoga, relaxation, tai chi, massage, spinal manipulation, and acupuncture. The goal of this article is to identify those treatments that show evidence of efficacy and to identify gaps in the literature where additional studies and controlled trials are needed. An electronic search of the databases of PubMed, The Cochrane Library, EMBASE, PsycINFO, and Science Citation Index Expanded was conducted. Overall, weak positive evidence was found for yoga, relaxation, tai chi, massage, and mani...
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
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Source: PMandR - Category: Rehabilitation Source Type: research
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