Recent Advances in Epidural Analgesia

Bauer, Maria; George, John E.; Seif, John; Farag, Ehab

doi:10.1155/2012/309219

Cited by 33 publications

(46 citation statements)

References 113 publications

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“…Epidural anesthesia is a versatile technique widely used in anesthetic practice. Its potential to decrease postoperative morbidity and mortality has been demonstrated by numerous studies (3).…”

Section: Introductionmentioning

confidence: 99%

Comparison of the effects of epidural 0.5% bupivacaine and 0.5% levobupivacaine administration on anesthesia quality, side effect incidence, and analgesia requirement times in hip and lower extremity surgery

Kara¹,

Kürşad²,

Çelik³

et al. 2013

Turk J Med Sci

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In conventional two-layer systems various armor units such as tetrapod, dolos, and tribar have been commonly used. Recent developments are accropode and core-loc TM , which can be used in a single layer of armoring. The units for one-layer systems have an interlocking response under waves and hence their stability is high. The structure slope, wave conditions and placement methods are other areas of interest related to the stability of breakwater armor units. This study was intended to investigate the stability of core-loc TM units over a 1:1.5 slope under non-breaking / breaking and regular/random wave conditions and also to compare two different placement methods of core-loc TM as they affect breakwater stability. The results are also reviewed in comparison with previous studies of one-layer breakwater stability. In addition, run-up and run-down on core-loc TM armor layers were also investigated.

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Section: Introductionmentioning

confidence: 99%

Comparison of the effects of epidural 0.5% bupivacaine and 0.5% levobupivacaine administration on anesthesia quality, side effect incidence, and analgesia requirement times in hip and lower extremity surgery

Kara¹,

Kürşad²,

Çelik³

et al. 2013

Turk J Med Sci

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“…Providing adequate postoperative analgesia can attenuate these effects and is an important part of management of these patients. Adequate analgesia may improve the quality of postoperative analgesia in comparison with systemic opioid, and hasten recovery of gut function [11] .…”

Section: Jmscr Vol||06||issue||04||page 1268-1275||april 2018mentioning

confidence: 99%

A Comparative study of epidural Fentanyl with Bupivacaine & epidural Tramadol with Bupivacaine for post operative pain relief after lower abdominal Surgery

Patil¹

2018

jmscr

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“…But epinephrine can lead to hypotension. 1 Bupivacaine or ropivacaine are commonly used a long acting local anesthetic for epidural analgesia. Their doses Assistant Professor, Department of Anesthesiology, S. V. S. Medical College, Mahabubnagar, Telangana, India may vary.…”

Section: Introductionmentioning

confidence: 99%

“…Current studies are not only investigating these agents in the acute pain setting, but are also for use in various chronic pain disorders. 1 Hence present study was undertaken to study the efficacy of bupivacaine plus fentanyl in terms of onset and duration of epidural analgesia.…”

Section: Introductionmentioning

confidence: 99%

Onset and duration of epidural analgesia with bupivacaine and bupivacaine plus fentanyl: a comparative study

Umapathy

Ayathullah

2017

Int J Res Med Sci

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Background: Bupivacaine has got the more cardiac toxicity due to high degree of protein binding. There have been many attempts for improving the duration and onset of epidural block. Fentanyl when administered epidurally was found to reduce the requirement of doses by double in some cases. The objective of the study was to compare the efficacy of bupivacaine plus fentanyl in terms of onset and duration of epidural analgesia. Methods: A clinical study was undertaken to evaluate the onset and duration of analgesia with bupivacaine and mixture of bupivacaine plus fentanyl when given epidurally for patients undergoing lower limb orthopedic surgeries. The study was undertaken in 50 patients who were divided into two groups of 25 each. The patients were undergoing surgery in orthopedic theatre at S. V. S. Medical College and Hospital. Patients studied comprised of both the sexes between the 18-55 years of age. Results: It is seen that the onset of analgesia was equal in both the groups 72% of patients in group II had excellent quality of intra operative analgesia compared to only 36% of patients in group I. This difference was found to be statistically significant (p<0.05). It was seen that none of the patients had analgesia of less than 1 hour 30 minutes. The two-segment regression time was uniformly distributed amongst the two groups. It was found that the incidence of intra operative complications like bradycardia, hypotension, nausea/vomiting were almost equal in both the groups. It was found that the duration of post-operative analgesia in patients of two groups was almost equal. Conclusions: Addition of fentanyl to bupivacaine was found to increase the quality of intra operative analgesia. Otherwise there was no added advantage over bupivacaine alone.Keywords: Analgesia, Bupivacaine, Complications, Fentanyl DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20172995Umapathy P et al. Int J Res Med Sci. 2017 Jul;5(7):3103-3106 International Journal of Research in Medical Sciences | July 2017 | Vol 5 | Issue 7 Page 3104 may vary. It produces motor as well as sensory block. Ropivacaine is an analog of mepivacaine. It has a shorter duration of motor block and also a lower toxicity as compared to bupivacaine. 2Bupivacaine has got the more cardiac toxicity due to high degree of protein binding. There have been many attempts for improving the duration and onset of epidural block. There were attempts of addition of sodium bicarbonate in different concentrations, epinephrine, phenyl epinephrine etc. However ultimately it was clear that opioids can augment the effects of these local anesthetics for use in epidural space. Fentanyl when administered epidurally was found to reduce the requirement of doses by double in some cases. 3Even though opioids were found to be effective, they do have their own side effects. Itching, vomiting, nausea, hypotension and urinary retention are some of them. Alpha adrenergic agonists like clonidine can also be used instead of opioids. 4 When clonidine is added to opioids, it gives an a...

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Recent Advances in Epidural Analgesia

Cited by 33 publications

References 113 publications

Comparison of the effects of epidural 0.5% bupivacaine and 0.5% levobupivacaine administration on anesthesia quality, side effect incidence, and analgesia requirement times in hip and lower extremity surgery

Comparison of the effects of epidural 0.5% bupivacaine and 0.5% levobupivacaine administration on anesthesia quality, side effect incidence, and analgesia requirement times in hip and lower extremity surgery

A Comparative study of epidural Fentanyl with Bupivacaine & epidural Tramadol with Bupivacaine for post operative pain relief after lower abdominal Surgery

Onset and duration of epidural analgesia with bupivacaine and bupivacaine plus fentanyl: a comparative study

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