Conventional extradural analgesia during labour with 0.25-0.375% bupivacaine may induce motor weakness and subjective sensory deficit, reducing maternal satisfaction. Even in a regimen for ambulatory extradural analgesia (0.1% bupivacaine-fentanyl 2 micrograms ml-1), a potential for proprioreception impairment exists, which may impair safe ambulation. We have combined fentanyl with clonidine fo...

We have studied the effect of extradural analgesia on postoperative venous thrombosis in patients undergoing knee arthroplasty. Forty-eight patients were allocated randomly to receive either general anaesthesia or extradural analgesia with local anaesthetics for 3 days. All patients wore compressive elastic stockings and no anticoagulant drugs were administered. Bilateral venography was perform...

background: pain in infancy is a developmental process. due to the underdeveloped pain pathways in the spinal cord, the threshold of stimulation and sensation of pain is low at birth and has potential impacts on increasing the central effects of pain. primary trauma during infancy can cause long term changes in structure and function of pain pathways that continue until adulthood. lack of pain ...

The contribution of papavaretum to the incidence of vomiting observed in the 24 hours after paediatric outpatient anaesthesia was assessed in 129 children undergoing circumcision. Postoperative analgesia in all patients was achieved using caudal extradural blockade. The incidence of vomiting in the 24 hours after discharge from hospital was 56 per cent in those receiving papavaretum, compared w...

A multivariate analysis of inadequate extradural analgesia was carried out prospectively on 1051 patients undergoing lumbar extradural anaesthesia for surgery performed on structures innervated by T10-S5. Ninety-six patients (9%) experienced pain during surgery. Age, extradural fentanyl, diazepam sedation and duration of surgery had no significant influence. We found some weak evidence that the...

We have examined postoperative pain in patients allocated randomly to receive extradural bolus diamorphine 3.6 mg, extradural infusion of 0.15% bupivacaine with 0.01% diamorphine or patient-controlled i.v. administration of diamorphine at a maximum rate of 1 mg per 5 min, after total abdominal hysterectomy. Extradural infusion analgesia produced the smallest pain scores from 12 to 24 h after su...

Ninety boys, aged 13-53 months, undergoing repair of hypospadias, were allocated randomly to receive 0.8 ml kg-1 of one of three solutions into the caudal extradural space: group B received bupivacaine 2 mg kg-1, group T received tramadol 2 mg kg-1 in 0.9% saline and group BT a mixture of both. Postoperative pain was assessed hourly for 12 h after injection using a modified TPPPS pain score and...

Catheters were inserted into the extradural space under direct vision at the time of surgery for prolapsed intervertebral disc or lumbar canal stenosis. In the post-operative period, diamorphine (3 mg in 5 ml water) was injected through the catheter when patients requested analgesia. In only four of 49 patients was significant pain relief not achieved after extradural diamorphine injection. In ...

We have investigated the hormonal and metabolic effects of thoracic extradural analgesia with bupivacaine in addition to sufentanil 20 micrograms kg-1 in nine patients undergoing coronary artery bypass surgery. A control group received general anaesthesia alone. The catecholamine response was inhibited for 24 h after surgery in patients who had received extradural analgesia, and the cortisol re...