No abstract

No abstract

Sufficient and rapid motor and sensory block was achieved in all the patients in the present study; however, motor and sensory block had faster onset, lasted longer, and was of a higher level in groups 2 and 3; these effects were more pronounced in the group 3.

The use of intrathecal midazolam combined with intrathecal bupivacaine produces a more effective and longer analgesia with a mild sedative effect in perianal surgery.

No abstract

Objectives: To compare two intrathecal anaesthetics, bupivacaine and levobupivacaine, for their effects on motor and sensory blockade and haemodynamics in patients aged !65 years undergoing transurethral resection of the prostate (TUR-P) or transurethral resection of the urinary bladder (TUR-M). Methods: Patients scheduled to undergo TUR-P or TUR-M were randomized to receive either 3 ml (15 mg) 0.5% isobaric levobupivacaine (group L) or 3 ml (15 mg) of 0.5% hyperbaric bupivacaine (group B) for spinal anaesthesia. The onset time, maximum level and time to reach the maximum level of sensory and motor blockade were recorded. Changes to haemodynamic parameters were also recorded. Results: The study randomized 100 patients: 57 to group L and 43 to group B. Levobupivacaine did not cause any significant changes in haemodynamic parameters, including systolic blood pressure, and showed a similar sensory block onset time compared with bupivacaine, but it had a significantly longer motor block onset time compared with bupivacaine. Conclusion: These current findings suggest that levobupivacaine can be used as a substitute for bupivacaine for spinal anaesthesia in elderly patients !65 years of age undergoing elective TUR-P or TUR-M operations.

Objective  Patients undergoing laparoscopic procedures may experience postoperative pain. We evaluated the effectiveness of intraperitoneal local anaesthetic instillation after laparoscopic gynaecological procedures. Design  Randomized, double‐blinded, placebo‐controlled trial. Methods  Patients were randomly assigned to one of three groups of 20 patients each. Those in group A received ropivacaine, 20 ml 0.75%, and those in group B received bupivacaine, 20 ml 0.5% intraperitoneally. Those in group C (the control group) received 20 ml 0.9% saline. Pain was assessed, using a visual analogue scale (VAS) and a verbal rating scale (VRS), at 30 min, 60 min, 2 h and 4 h after surgery. Total analgesic consumption and the time to first need for analgesia were also noted. Results  VAS and VRS pain scores were significantly lower in the ropivacaine and bupivacaine groups compared with the placebo group. Patients in group A (ropivacaine) experienced less pain than those in group B (bupivacaine) for all measurements. The time to first need for analgesia was significantly later for the ropivacaine and bupivacaine groups compared with the placebo group. The total analgesic consumption was also significantly lower in those groups than in the placebo group. Conclusion  The results indicated that both ropivacaine and bupivacaine were effective at preventing pain and the need for postoperative analgesic when intraperitoneally instilled. However, ropivacaine is the better choice because of its higher efficacy.

Sufficient and rapid motor and sensory block was achieved in all the patients in the present study; however, motor and sensory block had faster onset, lasted longer, and was of a higher level in groups 2 and 3; these effects were more pronounced in the group 3.