12: Comparison of spinal, low dose spinal and epidural anesthesia with ropivacaine plus fentanyl for transurethral surgical procedures

2007 ◽  
Vol 32 (5) ◽  
pp. 8-8
Author(s):  
B ULKER ◽  
R ERBAY ◽  
S SERIN ◽  
H SUNGURTEKIN
Keyword(s):  
Surgical Procedures ◽  
Epidural Anesthesia ◽  
Low Dose

The Hemodynamic and Fibrinolytic Response to Low Dose Epinephrine and Phenylephrine Infusions During Total Hip Replacement Under Epidural Anesthesia

1992 ◽  
Vol 68 (04) ◽  
pp. 436-441 ◽  
Author(s):  
Nigel E Sharrock ◽  
George Go ◽  
Robert Mineo ◽  
Peter C Harpel
Keyword(s):  
Heart Rate ◽  
Deep Vein Thrombosis ◽  
Cardiac Index ◽  
Total Hip Replacement ◽  
Epidural Anesthesia ◽  
Hip Replacement ◽  
Low Dose ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryLower rates of deep vein thrombosis have been noted following total hip replacement under epidural anesthesia in patients receiving exogenous epinephrine throughout surgery. To determine whether this is due to enhanced fibrinolysis or to circulatory effects of epinephrine, 30 patients scheduled for primary total hip replacement under epidural anesthesia were randomly assigned to receive intravenous infusions of either low dose epinephrine or phenylephrine intraoperatively. All patients received lumbar epidural anesthesia with induced hypotension and were monitored with radial artery and pulmonary artery catheters.Patients receiving low dose epinephrine infusion had maintenance of heart rate and cardiac index whereas both heart rate and cardiac index declined significantly throughout surgery in patients receiving phenylephrine (p = 0.0001 and p = 0.0001, respectively). Tissue plasminogen activator (t-PA) activity increased significantly during surgery (p <0.0005) and declined below baseline postoperatively (p <0.005) in both groups. Low dose epinephrine was not associated with any additional augmentation of fibrinolytic activity perioperatively. There were no significant differences in changes in D-Dimer, t-PA antigen, α2-plasmin inhibitor-plasmin complexes or thrombin-antithrombin III complexes perioperatively between groups receiving low dose epinephrine or phenylephrine. The reduction in deep vein thrombosis rate with low dose epinephrine is more likely mediated by a circulatory mechanism than by augmentation of fibrinolysis.

Could Emesis from Epidural Anesthesia for a Cesarean Section be Controlled by Prophylactic Low-Dose Granisetron?

2002 ◽  
Vol 43 (6) ◽  
pp. s13
Author(s):  
Youn Woo Lee ◽  
Jeong Yeon Hong ◽  
Hea Jo Yoon ◽  
Soo Mie Kim
Keyword(s):  
Cesarean Section ◽  
Epidural Anesthesia ◽  
Low Dose

scholarly journals Low-dose combined spinal-epidural anesthesia for a patient with a giant hiatal hernia who underwent urological surgery

2018 ◽  
Vol 46 (10) ◽  
pp. 4354-4359 ◽  
Author(s):  
Mi Kyeong Kim ◽  
Junoik Shin ◽  
Jeong-Hyun Choi ◽  
Hee Yong Kang
Keyword(s):  
Hiatal Hernia ◽  
Epidural Catheter ◽  
Epidural Anesthesia ◽  
Low Dose ◽  
Intrathecal Injection ◽  
Vital Signs ◽  
Esophageal Hiatus ◽  
Urological Surgery ◽  
Gastrointestinal Problems ◽  
Giant Hiatal Hernia

A hiatal hernia refers to herniation of the abdominal organs through the esophageal hiatus of the diaphragm. A giant hiatal hernia affects digestive and cardiopulmonary function by compressing the organs. We report a patient who had low-dose combined spinal and epidural anesthesia (CSEA) for safe and effective anesthesia for conservative treatment of a giant hiatal hernia. An 84-year-old woman who had a giant hiatal hernia was scheduled for ureteroscopic removal of a ureteral stone. CSEA was performed at the L4 to L5 lumbar interspace and an epidural catheter tip was placed 5 cm cephalad from the inserted level. The T12 block was checked after 10 minutes of intrathecal injection of 6 mg of 0.5% bupivacaine. The T10 block was checked after additional injection of 80 mg of 2% lidocaine through the epidural catheter. During anesthesia and surgery, the patient's vital signs remained stable and the operation was completed within 1 hour without any problems. In conclusion, low-dose CSEA may be safely used without any cardiopulmonary and gastrointestinal problems in patients with a giant hiatal hernia undergoing urological surgery.

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