Monitoring practices following epidural analgesics for pain management: a follow-up survey.

Indwelling epidural catheters are commonly used in pain management. There is much literature on the risks and benefits of this therapy, but there is no consensus on a standard, cost-effective method of monitoring these patients, nor on the types of analgesics or methods of drug delivery. The purpose of this paper is to examine clinical practices of pain management nurses belonging to the American Society of Pain Management Nurses (ASPMN). A total of 202 members responded to a follow-up survey on their institutions' use of epidural catheters. Although there were numerous variations in practice, certain similarities and themes regarding drug choice, patient monitoring, and health care providers involved with the care of this patient population are evident.

A survey on the clinical use of epidural catheters for acute pain management.

Indwelling epidural catheters are commonly used to provide analgesia in the postoperative setting. In an attempt to determine how epidurals are used in clinical practice, a survey was conducted at the 1992 annual meeting of the American Society of Pain Management Nurses (ASPMN). A total of 42 institutions were surveyed regarding epidural management practices and procedures. Although there were numerous variations in practice, certain similarities and themes regarding drug choice, patient monitoring, and levels of activity are evident. Technology has made possible continuous infusions of drugs on intermediate care floors, with most institutions relying upon nursing personnel for monitoring.

Experience with prazosin in the treatment of patients with severe hypertension.

The efficacy and safety of prazosin, a new vasodilator antihypertensive agent, used mainly in combination with other hypotensive medication, was evaluated in 50 hypertensive patients, 28 of whom had left ventricular hypertrophy and 28 of whom had renal impairment. In 44 cases this agent was introduced because of an inadequate response to, or side effects from other agents. In 38 cases (76%) there was a satisfactory response, the diastolic blood pressure being reduced to 100 mm Hg or less. The blood pressure of the whole group of 50 patients was reduced by an average of 31/20 mm Hg. The mean duration of therapy was 6-6 months. Side effects necessitating withdrawal of prazosin occurred in only three cases. Plasma renin activity was reduced to 25% of the control value in a group treated with prazosin alone.

Differing effects of the vasodilator drugs, prazosin and diazoxide on plasma renin activity in the dog.

1. The effects of intravenous (i.v.) administration of the vasodilator drugs prazosin or diazoxide on blood pressure and plasma renin activity were evaluated in the anaesthetized dog. 2. Prazosin and diazoxide both induced a rapid reduction in the mean arterial pressure to 73% and 75% of control values respectively. 3. Prazosin lowered plasma renin activity to 62% (P less than 0-025) of the control value whereas diazoxide raised plasma renin activity to 178% (P less than 0.05) of the control value. 4. The combination of vasodilatation and low renin activity observed following the administration of prazosin is unique, and may have clinical significance if these factors reduce the vascular complications of hypertension.