Adrenaline markedly improves thoracic epidural analgesia produced by a low-dose infusion of bupivacaine, fentanyl and adrenaline after major surgery: A randomised, double-blind, cross-over study with and without adrenaline

1998 ◽  
Vol 42 (8) ◽  
pp. 897-909 ◽  
Author(s):  
G. Niemi ◽  
H. Breivik
Keyword(s):  
Epidural Analgesia ◽  
Low Dose ◽  
Thoracic Epidural Analgesia ◽  
Major Surgery ◽  
Double Blind ◽  
Thoracic Epidural ◽  
Dose Infusion

The additive analgesia of adrenaline in epidural blockade

2018 ◽  
Author(s):  
Paul Farquhar-Smith
Keyword(s):  
Epidural Analgesia ◽  
Clinical Application ◽  
Low Dose ◽  
Receptor Expression ◽  
Major Surgery ◽  
Antinociceptive Action ◽  
Neuraxial Blockade ◽  
Thoracic Epidural ◽  
Pain Pathways ◽  
Dose Infusion

The landmark paper discussed in this chapter is ‘Adrenaline markedly improves thoracic epidural analgesia produced by a low-dose infusion of bupivacaine, fentanyl and adrenaline after major surgery’, published by Niemi and Breivik in 1998. The analgesic potential of neuraxial blockade has long been recognized. The extensive opioid receptor expression in areas germane to pain pathways gave credence to the effective clinical application of lower doses of neuraxial opioids compared with systemic administration. Preclinical data also proposed a potential spinal action of α‎2 agonists in achieving analgesia by a number of mechanisms, including a direct antinociceptive action and by reducing elution of other epidural drugs from the spinal effector site. Early clinical data failed to show a clear benefit from the addition of adrenaline to epidural infusions. Niemi and Breivik’s experiment addressed the methodological flaws of previous studies by using combinations of relatively sub-analgesic doses of each of the combined elements.

Interpleural or thoracic epidural analgesia for pain after thoracotomy. A double blind study

1994 ◽  
Vol 38 (4) ◽  
pp. 317-321 ◽  
Author(s):  
V. BROCKMEIER ◽  
H. MOEN ◽  
B. R. KARLSSON ◽  
N. B. FJELD ◽  
F. REIESTAD ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Thoracic Epidural Analgesia ◽  
Blind Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Thoracic Epidural

A PROSPECTIVE DOUBLE-BLIND STUDY OF CONTINUOUS THORACIC EPIDURAL ANALGESIA FOR THORACOTOMY PATIENTS

1984 ◽  
Vol 61 (3) ◽  
pp. A222-A222 ◽  
Author(s):  
W. G. Logas ◽  
L. P. Faber ◽  
A. El-Ganzouri ◽  
A. D. Ivankovich
Keyword(s):  
Epidural Analgesia ◽  
Thoracic Epidural Analgesia ◽  
Blind Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Thoracic Epidural
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