Spinal hyperbaric ropivacaine-fentanyl for day-surgery

Kallio, H.; Snäll, Eljas-Veli T.; Suvanto, Sami; Tuomas, Carl A.; Iivonen, Mauri; Pokki, Juha-Pekka; Rosenberg, P. H.

doi:10.1016/j.rapm.2004.11.002

Cited by 21 publications

(25 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Trials were published between 1992 and 2012 and included data on 1393 patients, 733 of whom received intrathecal opioids (Table 1) [1,[3][4][5][6][7][8][11][12][13][14]22,[24][25][26][27]29,30,32,34,35,38,39,[42][43][44][45][46]. The median group size was 20 patients (range, 10-60 patients).…”

Section: Trial Characteristicsmentioning

confidence: 99%

“…In 11 reports (39%), the principal aim of the study was to test whether equal analgesic efficacy but fewer adverse effects could be achieved with the combination of a small dose of an opioid with a reduced dose of an LA [4,5,7,12,24,34,38,39,42,43,46]. In the other 17 reports, there was a large variety of working hypotheses: different analgesic efficacy and different risks of adverse effects with experimental interventions [1,3,8,11,14,26,32,44]; improved analgesia and fewer adverse effects [13,25]; improved analgesia and equal risk of adverse effects [30]; equal analgesia and equal risk of adverse effects [22]; fewer adverse effects with no statement about analgesic efficacy [6,29,45]; and improved analgesia and potentially increased risk of adverse effects [27,35].…”

Section: Trial Characteristicsmentioning

confidence: 99%

“…In the other 17 reports, there was a large variety of working hypotheses: different analgesic efficacy and different risks of adverse effects with experimental interventions [1,3,8,11,14,26,32,44]; improved analgesia and fewer adverse effects [13,25]; improved analgesia and equal risk of adverse effects [30]; equal analgesia and equal risk of adverse effects [22]; fewer adverse effects with no statement about analgesic efficacy [6,29,45]; and improved analgesia and potentially increased risk of adverse effects [27,35]. Selection of the LA dose in controls was based on literature findings in 6 reports [7,12,26,38,43,45], on previous personal findings in 2 [24,29], but unclear in the remaining 18 (64%).…”

Section: Trial Characteristicsmentioning

confidence: 99%

“…Seven trials (274 patients) reported the duration of postoperative analgesia, defined as the time from the end of surgery until the first request for rescue analgesia [3,4,7,12,24,25,38]. In controls, the median of all mean durations of analgesia was 127 minutes (range, 98-498 minutes).…”

Section: Duration Of Postoperative Analgesiamentioning

confidence: 99%

See 3 more Smart Citations

Combination of a reduced dose of an intrathecal local anesthetic with a small dose of an opioid: A meta-analysis of randomized trials

Pöpping

Elia

Wenk

et al. 2013

Pain

View full text Add to dashboard Cite

a b s t r a c tWe tested whether the combination of a reduced dose of a local anesthetic (LA) with an opioid compared with a standard dose of the same LA alone guaranteed adequate intraoperative anesthesia and postoperative analgesia and decreased LA-related adverse effects. We systematically searched (to November 2012) for randomized comparisons of combinations of a reduced dose of an LA with a concomitant opioid (experimental) with a standard dose of the LA alone (control) in adults undergoing surgery with singleinjection intrathecal anesthesia without general anesthesia. We included 28 trials (1393 patients). In experimental groups, the median decrease in LA doses was 40% (range, 12%-70%). There was no difference between experimental and control groups in the need for intraoperative opioids or general anesthesia for failed block or in the duration of postoperative analgesia. With experimental interventions, there was evidence of a reduction in the duration of motor blockade postoperatively (average, À50 minutes), time to discharge from hospital or PACU (À33 minutes), time to ambulation (À28 minutes), and time to urination (À14 minutes). There was also evidence of a decrease in the risk of shivering (risk ratio [RR]: 0.26; 95% confidence interval [CI]: 0.12-0.56), nausea (RR: 0.45; 95% CI: 0.31-0.66), and arterial hypotension (RR: 0.52; 95% CI: 0.35-0.78). The risk of pruritus was increased (RR: 11.7; 95% CI: 6.2-21.9). Adding an opioid to a reduced dose of an intrathecal LA can decrease LA-related adverse effects and improve recovery from the spinal block without compromising intraoperative anesthesia or duration of postoperative analgesia. Ó

show abstract

Section: Trial Characteristicsmentioning

confidence: 99%

Section: Trial Characteristicsmentioning

confidence: 99%

Section: Trial Characteristicsmentioning

confidence: 99%

Section: Duration Of Postoperative Analgesiamentioning

confidence: 99%

See 2 more Smart Citations

Combination of a reduced dose of an intrathecal local anesthetic with a small dose of an opioid: A meta-analysis of randomized trials

Pöpping

Elia

Wenk

et al. 2013

Pain

View full text Add to dashboard Cite

show abstract

“…Spinal anesthesia is extensively used for both intraoperative anesthesia and postoperative analgesia management in IHR with the adverse effect concerns. The combination of intrathecal (IT) opioid and local anesthetic has been studied in these cases [2][3][4][5] . IT morphine can produce a long-lasting postoperative pain relief 6 .…”

Section: Introductionmentioning

confidence: 99%