Recent studies investigating the management of analgesia in childbirth have demonstrated that pain relief can be started early in labor with no negative consequences. Also of particular importance are studies showing that automated delivery of large boluses of diluted local anesthetic with opioids might be more effective than continuous background infusion of these drugs in patient-controlled e...

C ontinuous peripheral nerve blocks offer the potential benefits of extended site-specific postoperative analgesia, few side effects, improved patient satisfaction , and accelerated functional recovery after extremity surgery. 1 Continuous peripheral nerve blocks provide superior analgesia compared with intravenous patient-controlled analgesia and a lower incidence of side effects compared with...

conclusions the addition of 50 mg of magnesium sulfate to a bupivacaine–fentanyl solution for intrathecal anesthesia improved the efficacy and duration of the analgesia without any significant side effects. the addition of 150 µg of neostigmine increased the incidence of hypotension, bradycardia, and nausea and vomiting. moreover, neostigmine failed to prolong analgesia duration. results group ...

It has been more than two decades since neuraxial opioids first underwent rigorous clinical study for use in humans. The intraspinal route of administration is now commonly used to administer anesthetics and analgesics. Addition of opioids to intraspinal administered local anesthetic provides an effective and prolonged analgesia. However, the physiochemical properties of opioids may influence t...

Horner's syndrome is a rare complication of epidural analgesia in labour. Although it is a sign of high sympathetic block, patients are usually haemodynamicaly stable. We report a case of undiagnosed Horner's syndrome complicating epidural analgesia in labour, where a standard dose of local anaesthetic was given for an emergency caesarean section without problems. This may confirm the benign na...

the quality of subarachnoid block can be improved by adding opioids to the local anesthetics. we compared the analgesic effects of different doses of intrathecal sufentanil added to lidocaine %5 for elective cesarean section. this study was a prospective, randomized, double-blind, controlled trial. 90 pregnant women with asa class i-ii, scheduled for elective cesarean section under spinal anest...

OBJECTIVE To quantify benefit and harm of epidural analgesia, compared with systemic opioid analgesia, in adults having surgery under general anesthesia. BACKGROUND It remains controversial whether adding epidural analgesia to general anesthesia decreases postoperative morbidity and mortality. METHODS We searched CENTRAL, EMBASE, PubMed, CINAHL, and BIOSIS till July 2012. We included random...

Studies comparing the efficacy of epidural analgesia for labour have been limited by lack of knowledge about the relative potencies of the involved agents, whether alone or in combination. Recently a clinical model to determine the minimum local analgesic concentration has been developed [1]. This study design estimated the minimum local analgesic concentration or median effective concentration...

BACKGROUND Some anesthesiologists consider combined spinal epidural (CSE) analgesia as superior alternative to continuous labor epidural (CLE) analgesia. However, during CSE, even small doses of intrathecally administered local anesthetics with opioids induce almost instant analgesia that precludes the testing of epidural catheters as well as early appreciation of failed epidural catheters. To ...

Caudal analgesia is a very popular route to provide intraoperative and postoperative analgesia in children because of its simple technique, predictable level of blockade, high success rate and smooth recovery. It can be used mainly for perineal and sub umbilical procedures. Ropivacaine, the S-enantiomer of the amide local anesthetic, produces differential neural blockade, with lesser motor bloc...