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subarachnoid block

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https://www.readbyqxmd.com/read/28096582/comparison-of-different-regimens-of-intravenous-dexmedetomidine-on-duration-of-subarachnoid-block
#1
Anil Thomas, M V S Satyaprakash, Lenin Babu Elakkumanan, Prasanna Udupi Bidkar, Sandeep Kumar Mishra
BACKGROUND AND AIMS: Many studies have studied the effect of intravenous dexmedetomidine on the prolongation of the duration of the subarachnoid block (SAB). These studies had administered dexmedetomidine using different regimens. This study was designed to find out the suitable regimen with maximum advantages and minimum disadvantages. MATERIAL AND METHODS: Ninety-three ASA 1 and 2 patients scheduled to undergo surgeries under SAB were randomly allocated into three groups namely B, M, and BM...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28096579/intrathecal-ropivacaine-with-or-without-tramadol-for-lower-limb-orthopedic-surgeries
#2
Rashmi Salhotra, Medha Mohta, Deepti Agarwal, Ashok K Sethi
BACKGROUND AND AIM: Preservative free tramadol has been used as an adjuvant to intrathecal bupivacaine. However, the effect of the addition of tramadol on intrathecal isobaric ropivacaine has never been studied. MATERIAL AND METHODS: This prospective, randomized, double-blind study was conducted in 50 adult male American Society of Anesthesiologists grade I or II patients, aged 18-60 years, being operated for unilateral femur fractures. An epidural catheter was inserted in L2-L3 interspace and subarachnoid block was given in L3-L4 space...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28051832/fast-glycorrhachia-and-cerebrospinal-fluid-protein-as-predictors-of-sensory-block-in-anesthesia-with-subarachnoid-ropivacaine
#3
S Collini, F Troisi, F Pacella, P Merlin, S De Sio, E Pacella
BACKGROUND: Identify if glycorrhachia and cerebrospinal fluid protein could influence the time of sensory block to T10, the duration and the metameric block's level, after a standard dose of Ropivacaine. METHODS: 80 patients, ASA I - III undergoing to transurethral prostate resection with spinal anesthesia in a prospected open study were recruited. A 0.2 ml liquor's sample was taken; glycorrhachia, by glycemic stix and CSF protein, by urinary stix, were got, before Ropivacaine 0...
November 2016: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28040125/preoperative-measurement-of-maternal-abdominal-circumference-relates-the-initial-sensory-block-level-of-spinal-anesthesia-for-cesarean-section-an-observational-study
#4
Chi-Hang Kuok, Chung-Hsin Huang, Pei-Shan Tsai, Yuan-Pi Ko, Wei-Shih Lee, Yung-Wei Hsu, Fang-Yu Hung
OBJECTIVE: Lumbosacral cerebrospinal fluid volume is decreased as the enlarging uterus compresses the inferior vena cava during pregnancy. A subsequent greater cephalad spread of sensory blockade is observed. Gravid uterus plays a crucial role in affecting the spinal anesthesia level. We hypothesized that maternal abdominal circumference can reflect compressive effect of the uterus and investigated the relationship between abdominal circumference and the level of sensory blockade, and incidence of hypotension following spinal anesthesia with hyperbaric bupivacaine in term parturients...
December 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28026887/combined-spinal-epidural-anesthesia-with-hypobaric-ropivacaine-in-sitting-position-significantly-increases-the-incidence-of-hypotension-in-parturients-undergoing-cesarean-section
#5
Zhendong Xu, Fuyi Shen, Yueqi Zhang, Yiyi Tao, Xiubing Chen, Zhiqiang Liu
AIM: Maternal position during induction of combined spinal-epidural anesthesia (CSEA) may affect hemodynamics and block characteristics. This study aimed to assess whether the sitting position is more likely to induce hypotension and higher block level than the lateral position in CSEA with hypobaric ropivacaine. METHODS: Ninety American Society of Anesthesiologists physical status I and II parturients undergoing elective cesarean section were randomized into three groups: the sitting, left-lateral, and right-lateral position groups...
December 27, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28010836/acupuncture-in-the-management-of-intraoperative-nausea-and-vomiting
#6
Francisco Gouveia, Carmen Oliveira, Nuno Losa
Intraoperative and postoperative nausea and vomiting (IONV and PONV, respectively) are common complications of anesthesia with significant associated morbidity. Strategies for their prevention and treatment have been organized in pharmacological and nonpharmacological measures. Acupuncture at PC6 has demonstrated efficacy in randomized trials, although evidence regarding its efficacy in treating IONV and PONV has not yet been fully established. We present the case of a patient who underwent peripheral vascular surgery on a limb under a subarachnoid block and who developed IONV refractory to conventional pharmacological therapy...
December 2016: Journal of Acupuncture and Meridian Studies
https://www.readbyqxmd.com/read/28003695/anaesthesia-for-foetoscopic-laser-ablation-a-retrospective-study
#7
Vaishali Kumbhar, M Radhika, Parameswara Gundappa, Jayashree Simha, Prathima Radhakrishnan
BACKGROUND AND AIMS: Twin pregnancy with monochorionic placenta may be associated with arteriovenous vascular anastomosis of the placental vessels resulting in twin-to-twin transfusion syndrome (TTTS) and twin reversed arterial perfusion syndrome (TRAP). Foetoscopic LASER ablation (FLA) is the treatment of choice in reducing foetal mortality related to this. METHODS: A retrospective review of medical records of 41 FLA procedures for TTTS and TRAP were analysed for anaesthetic management...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27988917/is-the-perfusion-index-useful-in-early-detection-of-high-spinal-subarachnoid-block-during-cesarean-section
#8
Kazuhide Takeyama, Yosuke Suzuki, Masanobu Yoshikawa, Toshiyasu Suzuki
OBJECTIVE: To investigate the usefulness of the perfusion index (PI) in the early detection of high spinal subarachnoid block (SAB) for cesarean section (CS). METHOD: SAB was applied in patients of CS. The patients was subdivided into two groups, according to the highest level of block: the Ce group (cervical spine level) and the Th group (thoracic spine level). The PI values in the finger and toe, and vital signs were measured at pre- and post-SAB in both groups together with SAB level...
December 20, 2016: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/27935779/treatment-and-prevention-of-spinal-induced-hypotension-in-the-cesarean-section-patient-what-does-the-evidence-say
#9
Joseph E Pellegrini
Most anesthesia providers prefer to do a subarachnoid block (SAB) for cesarean section because of its rapid onset and reliability to provide adequate anesthesia. However an effect of the SAB is that it causes a spinal-induced hypotension (SIH) in up to 85% of the population. There have been multiple studies that assessed fluid administration, vasopressor administration, maternal positioning, or serotonin blockers given prophylactically to attenuate the SIH response. Despite these multiple studies, the method to prevent and treat SIH remains varied from one anesthesia practice to another...
January 2017: Annual Review of Nursing Research
https://www.readbyqxmd.com/read/27906937/transversus-abdominis-plane-block-in-the-management-of-acute-postoperative-pain-syndrome-after-caesarean-section-a-randomized-controlled-clinical-trial
#10
Pierfrancesco Fusco, Vincenza Cofini, Emiliano Petrucci, Paolo Scimia, Tullio Pozone, Giuseppe Paladini, Gaspare Carta, Stefano Necozione, Battista Borghi, Franco Marinangeli
BACKGROUND: The international literature is unclear regarding the analgesic efficacy of the transversus abdominis plane block (TAPB) after a Caesarean section (CS). OBJECTIVES: The aim of this study was to determine whether a correctly performed ultrasound-guided TAPB (USG-TAPB) could provide better control of acute postoperative pain during the first 72 hours after CS and if it could provide a faster postoperative recovery. STUDY DESIGN: A double-blind, randomized, controlled clinical trial on pregnant women who underwent CS...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27877098/accidental-epidural-injection-of-rocuronium-in-a-pediatric-patient-a-case-report-and-literature-review
#11
Ting-Ting Wu, David S Hoff
Accidental administration of non-epidural drugs into the epidural or subarachnoid spaces may be associated with unexpected pain, morbidity, adverse effects, increased level of care, prolonged hospital stay, and mortality. We describe a 12-month-old admitted for secondary-stage hypospadias reconstruction. General anesthesia was induced with sevofiurane and a peripheral catheter was placed. Instead of ropivacaine, rocuronium (80 mg; 6.3 mg/kg) was injected into the epidural space by the caudal route. Surgery was uneventful and was completed 160 minutes after rocuronium was given...
September 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27871563/fascia-iliaca-block-vs-intravenous-fentanyl-as-an-analgesic-technique-before-positioning-for-spinal-anesthesia-in-patients-undergoing-surgery-for-femur-fractures-a-randomized-trial
#12
Rajashree Madabushi, Geetha C Rajappa, Prathima P Thammanna, Sadasivan S Iyer
STUDY OBJECTIVE: Pain arising from femur fractures is of severe nature. Surgery for fixation of femoral fractures may be done under spinal anesthesia. We conducted this study to compare the analgesic efficacy of fascia iliaca compartment block (FICB) and intravenous fentanyl (IVF) before positioning for spinal anesthesia. DESIGN: Randomized controlled trial. SETTING: Operating room. PATIENTS AND INTERVENTIONS: Sixty patients aged 25 to 75 years, with American Society of Anesthesiologists status I to III, undergoing surgery for femur fracture were chosen for the study and randomized into 2 groups...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27792212/postoperative-analgesia-for-elective-total-knee-arthroplasty-under-subarachnoid-anesthesia-with-opioids-comparison-between-epidural-femoral-block-and-adductor-canal-block-techniques-with-and-without-perineural-adjuvants-a-prospective-randomized-clinical-trial
#13
José R Ortiz-Gómez, Marta Perepérez-Candel, José M Vázquez-Torres, José M Rodriguez-Del Río, Berta Torrón-Abad, Inocencia Fornet-Ruiz, Francisco J Palacio-Abizanda
BACKGROUND: Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. The main hypothesis was that nerve blocks improve postoperative analgesia especially if perineural adjuvants are added. METHODS: Immediate postoperative pain (24 h) was evaluated every hour in 639 patients using a verbal rating 11-point scale for patient self-reporting of pain (VRS-11). All patients received subarachnoid anesthesia and were randomly allocated in 8 groups: control group, epidural (EA) and single shots femoral (FNB) or adductor canal blocks (ACB), both with and without adjuvants: dexamethasone (+Dexa) or dexmedetomidine (+Dexm)...
October 28, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27774520/inducible-nitric-oxide-synthase-nos-2-in-subarachnoid-hemorrhage-regulatory-mechanisms-and-therapeutic-implications
#14
Sana Iqbal, Erik G Hayman, Caron Hong, Jesse A Stokum, David B Kurland, Volodymyr Gerzanich, J Marc Simard
Aneurysmal subarachnoid hemorrhage (SAH) typically carries a poor prognosis. Growing evidence indicates that overabundant production of nitric oxide (NO) may be responsible for a large part of the secondary injury that follows SAH. Although SAH modulates the activity of all three isoforms of nitric oxide synthase (NOS), the inducible isoform, NOS-2, accounts for a majority of NO-mediated secondary injuries after SAH. Here, we review the indispensable physiological roles of NO that must be preserved, even while attempting to downmodulate the pathophysiologic effects of NO that are induced by SAH...
2016: Brain Circulation
https://www.readbyqxmd.com/read/27755950/matrine-alleviates-early-brain-injury-after-experimental-subarachnoid-hemorrhage-in-rats-possible-involvement-of-pi3k-akt-mediated-nf-%C3%AE%C2%BAb-inhibition-and-keap1-nrf2-dependent-ho-1-inductionn
#15
X Liu, X Zhang, K Ma, R Zhang, P Hou, B Sun, S Yuan, Z Wang, Z Liu
Matrine is a quinolizidine alkaloid derived from the herb Radix Sophorae Flavescentis, and possesses anti-oxidant, anti-inflammatory and anti-tumoral properties. However, its effectiveness against subarachnoid hemorrhage (SAH) is not well known. In this study, we investigated the effects of matrine on early brain injury (EBI) and the related potential mechanisms following SAH in rats. Our results showed that matrine pretreatment partially alleviated SAH-induced EBI, including neurological deficit, severity of SAH grade, brain edema, and blood-brain barrier (BBB) disruption in rats...
September 30, 2016: Cellular and Molecular Biology
https://www.readbyqxmd.com/read/27754129/os-25-04-the-changes-of-arterial-stiffness-monitored-with-cardio-ankle-vascular-index-cavi-during-raised-intracranial-pressure-in-the-rabbit
#16
Chikao Miyazaki, Mao Takahashi, Kazuhiro Shimizu, Tatsuo Chiba, Takenori Morisita, Tomoyuki Yamamoto, Nobuo Sugo, Akira Takahara, Kohji Shirai
OBJECTIVE: Cardio ankle vascular index (CAVI) is reflecting stiffness of the arterial tree from the origin of aorta to the ankles. We observed elevated CAVI in patients who suffered from apoplexy attack. To clarify the role and the mechanism by which arterial stiffness elevated just after apoplexy attack, the effect of enhanced intracranial pressure (ICP) by injecting saline into the cisterna magna of the rabbit on blood pressure, CAVI and cervical blood flow, were studied. Furthermore the role of sympathetic nerve was studied...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27746562/a-comparative-study-on-effect-of-addition-of-clonidine-and-fentanyl-as-adjuvants-to-local-anaesthetics-for-subarachnoid-block-in-patients-undergoing-lumbar-laminectomies
#17
Umesh K Dash, S Kiran, Urvashi Tandon, Kavitha Jinjil
BACKGROUND: The synergism between local anesthetic agents such as bupivacaine with intrathecal adjuvants such as opioids and clonidine is well established. AIMS: This study evaluates the clinical efficacy of clonidine75 μg versus fentanyl 25 μg as adjuvants to bupivacaine for spinal anesthesia. SETTINGS AND DESIGN: A prospective, randomized, parallel arm study was conducted over a period of 12 months in a tertiary care hospital. MATERIALS AND METHODS: Sixty patients were divided randomly into two groups, Group C and Group F...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746546/comparison-of-clonidine-and-fentanyl-as-adjuvant-to-ropivacaine-in-spinal-anesthesia-in-lower-abdominal-surgeries
#18
Radhe Sharan, Rajan Verma, Akshay Dhawan, Jugal Kumar
BACKGROUND: Ropivacaine, a newer local anesthetic, is gaining increased acceptance due to its improved safety profile over bupivacaine and lignocaine. Analgesic adjuvants have proved to be valuable in improving the quality of anesthesia and duration of analgesia. AIM: To compare the efficacy of clonidine and fentanyl as adjuvants to ropivacaine in spinal anesthesia in lower abdominal surgeries. MATERIALS AND METHODS: A randomized, double-blind control study was carried out in 100 patients who were randomly divided into two groups...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746542/a-randomized-controlled-study-between-fentanyl-and-butorphanol-with-low-dose-intrathecal-bupivacaine-to-facilitate-early-postoperative-ambulation-in-urological-procedures
#19
Arvind Kumar, Ritesh Kumar, Vinod Kumar Verma, Chandrakant Prasad, Rajesh Kumar, Shashi Kant, Gunjan Kumar, Neha Singh, Rupam Kumari
INTRODUCTION: Opioids are widely used in conjunction with local anesthetics as they permit the use of lower dose of local anesthetics while providing adequate anesthesia and analgesia. It both provides adequate anesthesia as well as lower drug toxicity neuraxial administration of opioids in conjunction with local anesthetics improves the quality of intraoperative analgesia and prolongs the duration of postoperative analgesia. Bupivacaine is the most commonly used drug for subarachnoid block due to its lesser side effects...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27746531/effect-of-adding-clonidine-to-intrathecal-bupivacaine-on-the-quality-of-subarachnoid-block-a-prospective-randomized-double-blind-study
#20
Srivishnu Vardhan Yallapragada, Nagendra Nath Vemuri, Mastan Saheb Shaik
CONTEXT: The purpose of adding an adjuvant to local anesthetic in a central neuraxial blockade is to augment the desirable pharmacological actions of the agent and/or to minimize its undesirable pharmacological effects. Clonidine is an alfa-2 receptor agonist which has gained popularity in recent times as an adjuvant in spinal anesthesia. AIMS: To evaluate the influence of clonidine on the hemodynamic stability and the duration of anesthesia when added to intrathecal hyperbaric bupivacaine...
September 2016: Anesthesia, Essays and Researches
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