operation for creation of arteriovenous fistula included into the study. Patients randomized into two groups. In group A (n 11) Stimuplex® A needle and in group D (n 12) Stimuplex® D needle used to perform vertical infraclavicular brachial plexus blockade described by Kilka et al (2). 40 ml 1% prilocaine and 10 ml 0.5% bupivacaine with epinephrin administered for blockade. Time needed to achieve motor blockade and anesthesia for radial, median, ulnar and musculocutaneous nerves were recorded with 5 minute intervals. Results: Similar mA levels obtained in both groups. The difference in the overall success and time needed for brachial plexus anesthesia did not reach statistical significance between the two groups. However number of attempts to achieve minimum required mA was significantly lower in group D (2.36 1.56 vs 1.25 1.27, p 0.05). Conclusion: Needles which is more insulated (Stimuplex® D), may be more appropriate to achieve minimum required electrical current with minimum effort. References: 1 Ford DJ, Pither CE, Raj PP: Comparison of insulated and uninsulated needles for locating peripheral nerves with a peripheral nerve stimulator. Anesth. Analg. 63:925, 1984. 2 Kilka HG, Geiger P, Mehrkens HH: Infraclavicular vertical brachial plexus blockade. A new method for anesthesia of the upper extremity. An anatomical and clinical study. Anaesthesist 44(5):339–44, 1995.

Patients 18 or older, ASA I or II were randomly selected for the study. Patients were submitted to SAB using 0,04–0,06 mg bupivacaine/cm of height and 2,5 microgram Sufentanil. We evaluated and recorded the development of pruritus every 20 min after the block until 120 min, as well as nausea, vomiting, deep sedation and hypoxia. Pruritus was classified into 4 categories: none, light, moderate, severe. Data was analysed using ANOVA. Results and Discussions: Women have an increased susceptibility to the development of pruritus, which appeared earlier and more frequently than in men. Pregnant and pre-menopausal women have increased susceptibility although it did not reach statistical significance. Conclusion(s): Our data shows that women are more prone to the development of pruritus after SAB with sufentanil. We propose that the mechanism underpinning this fact might be the hormonal milieu of sexual steroids in particular progesterone. References: 1 Debon R, Allaouchiche B, Duflo F et al. Anesth Analg. 2001; 92(1): 180–3. 2 Dahl J, Jeppesen IS, Jørgensen H, et al Anesthesiology 1999; 91: 1919–27.

ethods: After standard premedication and femoral nerve block ere given, 60 patients undergoing knee arthroscopy were ranomly allocated to receive a sciatic nerve block with mepivacaine .5% using either nerve stimulation (NS n 30) or ultrasound (US 30) guidance. In the US group, with a semiconvex 2-5 mHz robe (logiq E GE), after localizing ischiatic tuberosity and great rocanter, the local anesthetic (LA) was injected while in the NS roup the neurostimulator was set at 1 mA (2 Hz) and a proper uscular twitch (tibial nerve) was evocated at an output 0.5mA. he volume of the injected solution was varied for consecutive atients based on an up-and-down staircase method according to he response of the previous patient. The initial volume was 12 ml. single-blind observer evaluated the occurrence of complete loss f pinprick sensation (Tibial and Common Peroneal Nerve) and otor block (plantar and dorsiflexion): positive or negative reponses within 20 min after the injection determined a 2 ml derease or increase for the next patient, respectively.

Wiessner, D.; Groessle, R.; Heller, A. R.; Hakenberg, O.; Wirth, M. P.; Koch, T.; Litz, R. J.Author Information

You have accessJournal of UrologyDiscussed Poster, Wednesday, May 24, 2006, 1:00 - 4:00 pm1 Apr 20061612: Perioperative Thoracic Epidural Analgesia Reduces the Incidence and Severity of Cardiopulmonary Complications in Radical Prostatectomy Patients Diana Wiessner, Rainer J. Litz, Alexandra Zurawski, Michael Frohner, Thea Koch, Oliver W. Hakenberg, and Manfred P. Wirth Diana WiessnerDiana Wiessner More articles by this author , Rainer J. LitzRainer J. Litz More articles by this author , Alexandra ZurawskiAlexandra Zurawski More articles by this author , Michael FrohnerMichael Frohner More articles by this author , Thea KochThea Koch More articles by this author , Oliver W. HakenbergOliver W. Hakenberg More articles by this author , and Manfred P. WirthManfred P. Wirth More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)33804-7AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1612: Perioperative Thoracic Epidural Analgesia Reduces the Incidence and Severity of Cardiopulmonary Complications in Radical Prostatectomy Patients." The Journal of Urology, 175(4S), pp. 519–520 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 175Issue 4SApril 2006Page: 519-520 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Diana Wiessner More articles by this author Rainer J. Litz More articles by this author Alexandra Zurawski More articles by this author Michael Frohner More articles by this author Thea Koch More articles by this author Oliver W. Hakenberg More articles by this author Manfred P. Wirth More articles by this author Expand All Advertisement PDF DownloadLoading ...

Introduction. Using the surgical procedure OPS 5 - 604.0 (radical retropubic prostatecto my) as an example, our study identifies revenue-relevant patient characteristics and de scribes the impact of the perioperative application of thoracic epidural analgesia ( TEA).Methods. Factors affecting duration of stay were determined in 460 patients undergoing OPS 5 - 604.0 in the year 2001 and 2002 using multifactorial regression analysis. Preoperative parameters served as factors for matched-pair analysis of the effects of TEA.Results. Characteristics significantly affecting length of postoperative hospital stay were ASA status, age, preoperative haemoglobin concentration, post operative tachycardia, number of transfused packed red cells, wound infection and surgical revision. Based on identical matching criteria 27 pairs (with/with out TEA) could be formed. While the induction time in the TEA group was 8 +/- 18 min longer (p = 0.04), emergence was briefer by 3 +/- 9 min ( p= 0.045). Neither anaesthesia presence time nor anaesthesia costs or total costs of surgery differed significantly between the pairs. However, duration of epidural post operative pain therapy was longer with TEA but in con trast, the postoperative length of hospital stay after TEA was reduced. Assuming a continuous demand for OPS 5 - 604.0 procedures, TEA enables 32 more procedures to be carried out per year with an in creased yield on turn over of 2.7%.Conclusion. At first sight combined anaesthesia procedures require more human resources and material, however, as a result of shortened hospital stay and optimized pain therapy patient satisfaction increases and a substantial potential for increased revenue is gained.

Ziele dieser Arbeit sind die Identifikation erlösrelevanter Patientenmerkmale am Beispiel der OP-Prozedur OPS 5–604.0 (radikale retropubische Prostatektomie) und die Beschreibung des Prozessmehrwerts durch den perioperativen Einsatz von thorakaler Epiduralanalgesie (TEA).

analgesia and sometimes block insufficiency especially in bone surgery(2). We conducted this study to evaluate the effects of ketamine, when added to lidocaine for IVRA, on tourniquet pain and postoperative analgesia. Materials and Methods: Thirty patients undergoing elective hand surgery during IVRA were randomly assigned to three groups: 1– Case: Ketamine (0.1 mg/Kg) Lidocaine (40 ml 0.5%) for IVRA. 2– Control: Lidocaine placebo (normal saline) for IVRA and ketamine (0.1 mg/Kg) IV at the end of operation. 3– Placebo: Lidocaine placebo for IVRA and placebo IV at the end of operation. The measures of tourniquet and postoperative pain via visual analog scale (VAS), use of fentanyl (25 g q20 min), and patient and surgeon satisfaction from block quality were obtained. Results and Discussions: Data are shown in table:

Wiessner, D.; Litz, R. J.; Seifert, S.; Roessel, T.; Heller, A. R.; Gastmeier, J.; Koch, T. Author Information