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At least 73 records · Page 4Linked to original sources
PubMed1995

[Arguments against conduction anesthesia in children].

Regional anaesthesia has been increasingly popular in paediatric patients of all ages, especially because some techniques afford excellent per and post-operative pain relief. However, side effects may occur. Particularly, systemic toxicity from bupivacaine administration is associated with intravascular injection or overdosage. Then, we focused anaesthesiologist's attention on some inconvenients related with these practices. Regional blockade is most of the time performed in conjunction with general anaesthesia. Consequently, these procedures need additional time, material and nurses. There are relatively few absolute indications for regional anaesthesia in children. The decision for using these techniques is influenced by several factors as incidence of complications, local technical expertise. Alternative methods to provide per and post-operative analgesia being available, advantages and side effects of loco-regional anaesthesia have to be opposited. Management of the best method of block, doses and local anaesthetics or adjuvants according age, requires likely specific teaching in training team. An effort to provide appropriate guidelines and training to ward nurses is necessary to improve security when regional blockade is used for postoperative analgesia. In every cases, physician's experience is the best argument of choice.

Age Factors↗
PubMed1995

[Conduction anesthesia and the newborn infant].

The placental transfer of local anaesthetics (LA) depends on maternal, placental and fetal factors. The assessment of effects of LA and epidural anaesthesia (EA) on the fetus is based on the monitoring of fetal heart rate (FHR) and the measurement of the fetal pH. Apgar score and neurobehavioral tests allow an evaluation of the neonatal effects of the drugs used. Direct effects of LA: a diminution of variability of FHR was observed shortly after the beginning of an EA using lidocaine but there was no modification of FHR after EA using bupivacaine or lidocaine with epinephrine. Fetal neurological toxicity is rare and there are very few alterations of neurobehavioral scores after EA. Indirect effects on uteroplacental blood flow (UBF): in high concentration, LA can induce vasoconstriction of uterine arteries but maternal arterial hypotension that impedes directly uteroplacental blood flow is the main effect. Prevention of aortocaval compression is essential because it allows better Apgar scores and arterial pH at birth. Use of colloids has not a better preventive efficacy than an equal volume of cristalloids while dextrans are formally contra-indicated because of serious fetal accidents. Large iv infusion of dextrose solutions are responsible for maternal and fetal hyperglycemia and hyperinsulinemia leading to neonatal hypoglycemia. The utilization of IM prophylactic ephedrine is not useful while the therapeutic administration of ephedrine to treat maternal arterial hypotension is efficient. Phenylephrine used in case of maternal arterial hypotension seems as efficient as is ephedrine. Epidural narcotics: the use of morphine by epidural route can induce neonatal respiratory depression and low neurobehavioral scores. The epidural administration of fentanyl does not alter the variability of the FHR and does not modify neither Apgar or neurobehavioral scores, nor respiratory adaptation of the newborn. Use of epidural alfentanil or sufentanil does not lead to low neurobehavioral scores unless very high doses are used. For elective caesarean section, newborns present a lower Apgar score at 1 min and necessitate respiratory assistance more frequently after general anaesthesia (GA) than after EA. Neurobehavioral scores are better after EA than after GA. For emergency caesarean section, the percentage of newborns with an Apgar score < 4 or necessitating a respiratory assistance is more important after GA than after EA. However, the perinatal mortality is not more important after GA than after EA.

Adult↗
PubMedDate not supplied

[Use of transcutaneous electroneurostimulation for enhancing the effectiveness of conduction anesthesia in dental polyclinic practice].

The efficiency of mandibular conduction anesthesia was assessed in patients with inflammatory disorders in the area innervated by the mandibular nerve. In patients with conduction anesthesia induced after an electroneurostimulation session, the efficiency of anesthesia was considerably higher than in those operated on under mandibular anesthesia only.

Adolescent↗
PubMed1995

Major conduction anesthesia in a patient with Klippel-Trenaunay Syndrome.

The successful management of major conduction anesthesia in a patient with Klippel-Trenaunay syndrome is discussed. This case illustrates that major conduction anesthesia can be safely used if proper imaging studies are obtained, if one is aware of the underlying disease process, and if there is no port wine lesion in the dermatomal area corresponding to the spinal segment where the needle is to be inserted.

Adult↗
PubMedDate not supplied

[Tactical aspects of the use of conduction anesthesia in anesthesiology].

Based on the experience gained in surgery for varicose veins of the lower limbs, the authors discuss the strategy of conduction anesthesia and the necessity of replacing it with the alternative analgetic methods. Conduction anesthesia implies that variants of anesthesiologic provision are specified, based on the results of conduction anesthesia and the patient's status; if a physician doubts whether the nerve block or patient's behavior controllability are full-value, he should resort to combined anesthesia; the surgeon's manipulations in nerve blocking should not increase the risk or limit the use of alternative methods of analgesia.

Adult↗
PubMed1980

Conduction anesthesia in obstetrics and its effects upon fetus and newborn.

The use of conduction anesthesia has made childbearing a vastly more pleasant experience for the mother and certainly made the practice of obstetrics safer and easier. However, its safety to the fetus and newborn, once unquestioned, has become the subject of much study and concern in recent years. It is the purpose of this article to examine the fetal effects of local anesthetic agents and review some of these agents as well as the regional techniques most commonly employed in the perinatal period with respect to their fetal and maternal safety.

Anesthesia, Conduction↗
PubMed2005

A method for evaluation of conduction anesthesia.

We propose a new method for evaluation of conduction anesthesia in animals: by the degree of prolongation of cardiac cycle during vagus nerve stimulation by solitary electric discharges synchronous to the dominant ECG wave, proximally from the site of anesthetic application on the nerve.

Anesthesia, Conduction↗