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  • 1
    Electronic Resource
    Electronic Resource
    Serum concentrations of local anaesthetics following intraperitoneal administration during laparoscopy (1992)
    Springer
    European journal of clinical pharmacology 42 (1992), S. 223-225 
    Details
    ISSN: 1432-1041
    Keywords: Local anaesthetics ; laparoscopy ; lidocaine ; bupivacaine ; intraperitoneal analgesia ; plasma levels
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The present study is a comparison of the pharmacokinetics of four local anaesthetics injected double blind in the right subdiaphragmatic area during outpatient laparoscopy performed under standard general anaesthesia in 28 young women. 80 ml of one of the following solutions was injected: Group A 0.5% plain lidocaine (n=7), Group B 0.5% lidocaine with 1/320.000 adrenaline (n=8), Group C 0.5% lidocaine with 1/800.000 adrenaline (n=7), and Group D 0.125% bupivacaine with 1/800.000 adrenaline (n=6). Blood samples were collected over 360 min from an iv catheter and serum concentrations were measured by gas chromatography. No adverse effects occurred in the study period. In Group A (plain lidocaine), Cmax was significantly higher and tmax significantly earlier than in Groups B and C (lidocaine with adrenaline). A toxic level was not found after either solution in any patient. The intraperitoneal use of doses of 400 mg lidocaine or 100 mg bupivacaine for perioperative analgesia was safe and solutions of lidocaine containing adrenaline appeared to pose even less risk than plain solutions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00278490
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  • 2
    Electronic Resource
    Electronic Resource
    Analgesic effect of low-dose intrathecal morphine and bupivacaine in laparoscopic cholecystectomy (2000)
    Oxford : Blackwell Science Ltd
    Anaesthesia 55 (2000), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We assessed the peri-operative analgesic efficiency of low-dose intrathecal morphine combined with a low dose of bupivacaine after elective laparoscopic cholecystectomy since postoperative pain in such procedures, although less than after a conventional open technique, may be significant, particularly during the first 12–24 h. After informed consent, 34 ASA I or II patients were randomly allocated to one of two groups to receive either a lumbar intrathecal injection of morphine (75 or 100 μg) combined with 5 mg of isobaric bupivacaine (spinal group) or a subcutaneous injection of a saline solution (control group). Intra-operatively, opioid requirements, blood pressure response and heart rate changes after insufflation were recorded. Postoperatively, morphine requirements, pain scores and opioid-related side-effects were assessed by a physician blinded to the randomisation. Intra-operative opioid requirements did not differ significantly between groups. Mean (SD) postoperative morphine requirements were significantly lower in the spinal group [13 (10) vs. 23 (10) mg; p = 0.04] as were postoperative pain scores (p 〈 0.001). Side-effects were of comparable incidence and severity between groups. Low-dose intrathecal morphine combined with low-dose bupivacaine provided effective postoperative analgesia for elective laparoscopic cholecystectomy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2000.055002118.x
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  • 3
    Electronic Resource
    Electronic Resource
    Evaluation of femoral nerve blockade following inguinal paravascular block of Winnie: are there still lessons to be learnt? (2005)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 60 (2005), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Lower limb peripheral nerve blocks are used to provide surgical anaesthesia or postoperative analgesia. Anatomical texts imply that femoral and saphenous nerve blocks be evaluated by sensory testing of the skin overlying the anterior aspect of the thigh, and the medial aspect of the foot, respectively. We have mapped the distribution of anaesthesia in 25 adults following femoral nerve blockade, performed using the inguinal paravascular technique of Winnie. There was substantial interindividual variation in the area of anaesthesia. Only the skin overlying the middle third of the medial thigh was consistently blocked in 100% of patients. The distribution of anaesthesia conformed to anatomical text descriptions in 24% of cases. We conclude that demonstration of complete quadriceps paralysis confirms femoral nerve blockade. Failing that, sensory evaluation of a femoral nerve block should involve testing the skin of the middle third of the medial aspect of the thigh. The skin overlying the anteromedial aspect of the middle third of the leg should be evaluated for saphenous nerve block.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.2005.04329.x
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  • 4
    Electronic Resource
    Electronic Resource
    Effect of CO2 pneumoperitoneum on early cellular markers of retinal ischemia in rabbits with α-chymotrypsin–induced glaucomarid=""id=""Presented in abstract form at the annual meeting of the Société Française d'Anesthésie-Réanimation, Paris, France, September, 1999, and the annual meeting of the European Society of Anaesthesiologists, Vienna, Austria, 2000 April (2000)
    Springer
    Surgical endoscopy and other interventional techniques 14 (2000), S. 1057 -1061 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Eye — Intraocular pressure — Glaucoma — Müller cells — Laparoscopy — Pneumoperitoneum — Peritoneal pressure — Retinal ischemia — Cytoskeleton — Actin — Vimentin — Rabbits
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Increased intraperitoneal pressure in the head-down position is associated with a significant increase in intraocular pressure (IOP) in rabbits with α-chymotrypsin–induced glaucoma. Also, the retinal cells are weakened by the induction of increased IOP, and/or glaucoma, even when IOP is controlled by adequate therapy; therefore, these cells need to be protected from any additional aggression. Actin and vimentin are proteins of the retinal cell cytoskeleton that react readily in response to retinal injuries, including ischemia and glaucoma. Early changes in these cytoskeleton proteins determine the morphological changes observed after retinal damage. Therefore, we set out to investigate intracytoplasmic changes in vimentin and actin after a 4-h CO2 pneumoperitoneum in the head-down position in rabbits with α-chymotrypsin–induced glaucoma. Methods: Twenty-one rabbits with α-chymotrypsin–induced glaucoma in one eye received general anesthesia for 4 h in the head-down position and were randomly allocated to have (a) no pneumoperitoneum, (b) a 10 mmHg CO2 pneumoperitoneum, or (c) a 20 mmHg CO2 pneumoperitoneum. At the end of the trial, both the right glaucomatous and the left control eyes were enucleated and investigated immunocytochemically for alterations in vimentin and actin, and morphologically for retinal layer disorganization. Results: Except for the preexisting morphological changes induced by glaucoma, both the control and the glaucomatous eyes in all rabbits appeared normal in terms of retinal layer organization and the distribution of intracellular vimentin and actin whatever the intraperitoneal pressure level applied. Conclusion: In rabbits with α-chymotrypsin–induced glaucoma, a 4-h CO2 pneumoperitoneum of ≤20 mmHg in the head-down position did not induce either retinal layer disorganization or alteration of actin or vimentin.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004640000257
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