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PubMed1995

[Arguments for conduction anesthesia in children].

Regional anaesthesia is more and more popular in pediatrics. Many arguments plead for its use. The efficient diffusion of local anaesthetics through the nerve roots sheet and the epidural space improves success in children. The lack of deleterious haemodynamic effect of sympathetic block following spinal and epidural blocks is a factor for their use. So is the quality of intra- and postoperative analgesia. In addition, the few number of complications is also an advantage of regional blocks in children.

Age Factors↗
PubMed1995

[Conduction anesthesia in patients with heart diseases].

The effect of epidural/spinal anaesthesia on cardiovascular function results from blockade of the sympathetic nervous system and secondly from plasma absorption of local anaesthetic agents. Patients suffering from preexisting heart diseases may have different responses to epidural or spinal anaesthesia. In patients with myocardial ischemia, the decrease in myocardial work and the reduction in heart rate induced by cervical or thoracic epidural anaesthesia improve the myocardial oxygen balance. Changes in the inotropic state induced by thoracic epidural anaesthesia may worsen the haemodynamic condition of patients with heart failure. When the spread of the epidural blockade is limited to the lower segments (< T12), changes are limited. In high risk patients, the haemodynamic advantages of a combined technique (general plus epidural anaesthesia) and the protective effect on the occurrence of myocardial ischemia and related complications are a matter of interest. Part of the beneficial effect of epidural anaesthesia could be related to postoperative analgesia and its effects on stress response and haemostasis.

Anesthesia, Conduction↗
PubMed1995

[Conduction anesthesia and analgesia in emergency cases. From pain to its treatment].

The study of pathophysiological and symptomatological characteristics of pain in emergency situations, and of its harmful consequences, shows that, in spite of a difficult context, analgesia is an essential part of the care to patients during the prehospital stage. Its prescription implies a good knowledge of analgesia techniques, including precise rules such as titration. The choice of analgesia must be the outcome of a rigorous step giving priority to the vital functions and associating several techniques. Regional anaesthesia is not very often used in prehospital emergency but rather in emergency units and in the surgical ward. Analgesia must be adapted, mainly to specific situations in emergency: children, old people, burned people with pain.

Analgesia↗
PubMed1995

[Conduction anesthesia on an outpatient basis].

Regional anaesthesia in the setting of pre-hospital trauma care implies adverse conditions. Therefore some practical advices may be useful; avoid spinal or epidural anaesthesia, prefer safer lidocaine. Aspiration test, test dose and slow injection are mandatory; so is a large experience in regional anaesthesia. Main usable blocks are: brachial plexus block (axillary or interscalenic approach), radial, medial and ulnar nerve blocks, intercostal and interpleural nerve blocks, sciatic and femoral nerve blocks, superior laryngeal nerve block. Using a nerve stimulator is strongly advised in most cases.

Ambulatory Care↗
PubMed1990

[Conduction anesthesia in orthopedic operations in injuries of the extremities].

An analysis of results of using conduction anesthesia for various operations on extremities of 274 patients of different age groups has been made. Complete effects were achieved in 91% of the patients, 5% of the patients were potentiated with neuroleptanalgesia drugs because of insufficient anesthesia, in 2% of the patients general anesthesia was used. The method of conduction anesthesia makes it possible to use a conveyer method of bringing patients to the operating room. It is more economical as compared with narcosis, easy in use. It may be recommended for wider use.

Adjuvants, Anesthesia↗
PubMed1983

[Conduction anesthesia in operations on the limbs].

Conduction anesthesia with 1-2% solution of trimekain or novokain with a vasoconstrictor was used in 142 operations on the upper and lower extremities. The technique of blockade of nerve trunks of the upper and lower extremities is described. Good results of the anesthesia were obtained. There were only two complications, no lethal outcomes.

Amputation, Surgical↗
PubMed1985

[Electroacupuncture combined with conduction anesthesia in operations on varicose veins of the lower limbs].

A combination of conduction anesthesia and electroacupuncture was used for obtaining an adequate adaptive effect in 22 patients with varicose dilatation of veins. Good sedative effect was obtained in 12 patients, satisfactory--in 6 patients. In 4 patients minimum doses of droperidol were additionally injected. Antinociceptive therapy in corporal and auricle points in the postoperative period permitted exclusion of narcotics in 14 patients, in 8 patients their doses were considerably lower.

Acupuncture Therapy↗
PubMed1991

[Necroses and hematomas--two local complications in intraoral conduction anesthesia. Case report].

According to the literature vascular lesions are reported in 6% of intraoral conduction anesthesia. A possible consequence is the intraarterial injection of catecholamin added local anesthetic. Due to a long lasting angiospasm necrosis of local mucosae and extraoral skin are possible. In a young female patient extraoral necrosis of parts of the skin of the lower lip and intraoral mucosa appeared, following intraoral conduction anesthesia. Subsequently a scar persisted needing a plastic cicatricotomy. Moreover sensitivity in the area of distribution of the mental nerve was deranged.

Adult↗
PubMedDate not supplied

[A failure of conduction anesthesia in a patient with latent pathology of the peripheral nervous system].

Patients who have been long exposed to ultrasound and high-frequency currents at work are likely to develop diseases of the peripheral nervous system and thus the risk of nerve damage during conduction anesthesia. Profound examination of the peripheral nervous system before surgery is necessary in such patients. In patients with this pathology general anesthesia will be the technique of choice during surgery on the lower extremities.

Adult↗
PubMedDate not supplied

[Central hemodynamics during conduction anesthesia in patients with pyonecrotic forms of the diabetic foot].

Conduction anesthesia-induced central hemodynamic changes were studied in 20 patients with pyonecrotic forms of the diabetic foot and coronary heart disease (CHD). There was a 19% reduction in cardiac output and a 25% increase in total peripheral vascular resistance, as compared with the baseline values, the level of blood pressure being unchanged. The authors proposed to include droperidole into premedication and intraoperative perlinganite infusion for postload reduction, which stabilized central hemodynamics during conduction anesthesia in patients with diabetes mellitus and CHD.

Aged↗
PubMed1992

Intraoral conduction anesthesia with epinephrine-containing local anesthetics and arterial epinephrine plasma concentration.

Following conduction anesthesia using either lidocaine 2% with epinephrine 1:80,000, articaine 4% with epinephrine 1:100,000, or articaine 4% with epinephrine 1:200,000, the arterial plasma epinephrine concentration was measured. Eighteen healthy young patients scheduled for osteotomy of a mandibular third molar were studied. Each local anesthetic-epinephrine combination was tested in six patients. There was no significant difference in the arterial plasma epinephrine concentration after injection of 2 mL of the studied anesthetic-epinephrine combinations. The result was explained by the concentration difference in the local anesthetics. Although the vasodilating action of lidocaine and articaine is almost identical, there will be enhanced vasodilation by the doubled concentration in the case of articaine (4%) and the local resorption of epinephrine may be facilitated. There were no significant changes in the measured cardiovascular parameters.

Analysis of Variance↗
PubMedDate not supplied

[Regional (conduction) anesthesia: new solutions of old problems].

Despite the constant improvements, local and total anesthesia are often regarded as alternative methods while selecting anesthesia. Modern anesthesiology aiming at the maximal regulation and safety of anesthesiological care, by no means confined to mere analgesia, clearly demonstrated the disagreement between the traditional approach to local anesthesia and the practical requirements. It is obvious that today we can speak about a revision of our attitude to local anesthesia. Use of novel technologies helps solve all problems involved in the attaining and maintaining the regional blocking. A great variety of local anesthetics, appreciably differing from the traditional agents by their physicochemical and clinical characteristics, creates objective prerequisites for solving numerous practical problems requiring stable many-hour analgesia, reliable regional immobilization, or selective effects of sympathetic blocking in individual regions. That is why the traditional limitations connected with the local and total-system toxicity, similarly as the regional and total-system hemodynamic effects, should not be regarded as contraindications, but taken into consideration when choosing not only the method of conduction blocking, but the local anesthetic as well. The authors consider that at present the strategic problem of regional anesthesia-regulation and safety of its pharmacological effects-is solved. Such anesthesia is as readily regulated as different variants of total anesthesia, and it may be even safer. This permitted not only extending the indications to regional anesthesia, but using the selective effects of regional blocking as the main or special component of anesthesiology.

Anesthesia, Conduction↗
PubMed1993

[The circulatory effect of conduction anesthesia near the spinal cord. Pathogenesis, prophylaxis and therapy of heart circulation complications].

Major conduction anaesthesia is not harmless. Based on new findings about sympathetic blockade, it was analysed whether circulatory side effects after spinal or epidural anaesthesia, in particular cardiocirculatory arrest, correlate with the level of segmental spread and whether prophylactic or therapeutic measures are effective. With spinal or epidural anaesthesia in healthy, unpremedicated patients, blood pressure, heart rate, and cardiac output remain within +/- 20% of normal independent of the height of segmental spread. However, in patients with circulatory diseases and/or premedication blood pressure often drops more than 20%, especially when cranial spread exceeds T4. Cardiocirculatory arrest during major conduction anaesthesia: (1) is preceded by an interval of 10-20 min recognisable by narrowing of the pulse pressure and continuous decreases in blood pressure and heart rate; (2) does not correlate with the level of segmental spread; and (3) is possibly caused by reduced filling of the heart and/or vagal activity. Infusion of crystalloid or colloid solutions may diminish the drop in blood pressure, whereas vasopressors reduce the frequency and extent of cardiocirculatory side effects. As yet, however, there is no safe prophylaxis to prevent cardiocirculatory arrest. Cardiopulmonary resuscitation after circulatory arrest must be combined with early administration of catecholamines.

Anesthesia, Epidural↗