ANESTHESIOLOGIE REANIMATION HAITI (HUEH)

BACKGROUND: Comparing relative potency of new local anesthetics, such as levobupivacaine and ropivacaine, by the minimum local analgesic concentration model has not been described for caudal anesthesia. Therefore, we performed a prospective, randomized, double-blind study to determine the minimum local analgesic concentrations of a caudal single shot of ropivacaine and levobupivacaine in children and to describe the upper dose-response curve. METHODS: We performed a two-stage prospective, randomized, double-blind study comparing the dose-response curves of caudal ropivacaine and levobupivacaine in children. In phase 1, 80 boys were randomized to receive either ropivacaine or levobupivacaine. In the second phase a further 32 patients were randomly allocated to receive caudal anesthesia with doses designed to delineate the upper...

BACKGROUND: Randomized trials comparing air to saline for loss of resistance (LOR) for identification of the epidural space have suggested the superiority of saline. We hypothesized that, in actual clinical practice, anesthesiologists using their preferred technique would produce similar analgesic outcomes with either air or saline. METHODS: The labor analgesia records for 929 parturients requesting neuraxial analgesia were reviewed with respect to technique (epidural or combined spinal-epidural; air or saline for LOR), analgesic outcomes (initial comfort, asymmetry of the block, need for physician top-up during patient-controlled epidural analgesia, and catheter replacement), and complications (paresthesia, IV or intrathecal catheter placement, and unintentional dural puncture). RESULTS: Of 929 labor analgesics analyzed, 52.6% were performed with LOR to air and 47.4% to saline. Among anesthesiologists who performed at least 10 blocks, 82% used 1 medium at least 70% of the time. Ther...

December 22, 2011

  BONNE FETE DR. GUERLINA DOCTEUR (R2)