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subarachnoid block

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
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
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
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
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
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
Amit Agrawal, Veena Asthana, J P Sharma, Vineeta Gupta
BACKGROUND: Subarachnoid block is the preferred technique for providing anesthesia for patients undergoing cesarean section. Various pharmacological agents in added to local anesthetics (LA) modify their original effects in terms of block characteristics and quality of analgesia. However, there is ongoing debate about this practice of using adjuncts with LA. We tested whether addition of lipophilic versus lipophobic opioids to LA gives any clinical benefits to maternal and fetal outcome when used in these patients requiring spinal anesthesia...
September 2016: Anesthesia, Essays and Researches
Joseph M Neal, Francis V Salinas, Daniel S Choi
OBJECTIVE: Local anesthetic-induced myotoxicity occurs consistently in animal models, yet is reported rarely in humans. Herein, we describe 3 sentinel cases of local anesthetic myotoxicity after continuous adductor canal block (ACB). CASE REPORT: Three patients underwent total knee arthroplasty that was managed with subarachnoid block plus ACB induced with 1.5% lidocaine or 1.5% mepivacaine bolus followed by 2% ropivacaine at 8 mL/h. Although initial postoperative recovery was normal, each patient on either postoperative day 1 or 2 developed progressive, profound weakness of the quadriceps muscles...
September 22, 2016: Regional Anesthesia and Pain Medicine
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
Stephen Odunayo Ikuerowo, Alaba Fredrick Doherty, Muftau Jimoh Bioku, Abimbola Ayodeji Abolarinwa, Adekunle Azeez Adebayo, Steves Olaide Oyeleke, Olufunmilade Akinfolarin Omisanjo
BACKGROUND: Prostate cancer is the most commonly diagnosed cancer in men in Nigeria and most cases present when the disease is already in an advanced stage. Radical prostatectomy for early prostate cancer is therefore not a commonly performed operation by urologists in Nigeria. We have had training and significant experience in radical retropubic prostatectomy. We, therefore, report the outcome of our initial experience. MATERIALS AND METHODS: We review the record of men with early prostate cancer who had radical retropubic prostatectomy in our institution from 2007 to 2015...
July 2016: Nigerian Medical Journal: Journal of the Nigeria Medical Association
Sunil Kumar Sinha, Yudhyavir Brahmchari, Manpreet Kaur, Aruna Jain
BACKGROUND AND AIMS: Unilateral paravertebral block (PVB) as a sole anaesthetic technique is underutilised even in experienced hands. Hence, this study was undertaken regarding the efficacy and safety of PVB and compared with subarachnoid block (SAB) for inguinal hernia repair procedures. METHODS: Sixty-three consenting adult male patients scheduled for unilateral inguinal hernia repair were randomly assigned to receive either PVB or SAB (Group P: PVBs at T10-L2 levels, 5 mL of 0...
July 2016: Indian Journal of Anaesthesia
Sudarshan Kumar Chaudhary, Ravinder Kumar Verma, Shelly Rana, Jai Singh, Bhanu Gupta, Yuvraj Singh
BACKGROUND AND AIMS: The advent of ultrasonographic-guided techniques has led to increased interest in femoro-sciatic nerve block (FSNB) for lower limb surgeries. α2-agonists have been used recently as adjuvants to local anaesthetics in nerve blocks. We aimed to compare equal doses of clonidine or dexmedetomidine as an adjuvant to levobupivacaine in FSNB for post-operative analgesia. METHODS: Ninety patients scheduled to undergo below knee orthopaedic surgeries under subarachnoid block were divided into three groups: Group LL (n = 30) patients received 38 mL of 0...
July 2016: Indian Journal of Anaesthesia
L E Fanton, C G Macedo, K E Torres-Chávez, L Fischer, C H Tambeli
BACKGROUND: Testosterone protects male rats from Temporomandibular Joint (TMJ) pain. This study investigated whether this protective effect is mediated by an organizational action of testosterone during nervous system development, by central estrogen and androgen receptors and by the 5α-reduced metabolite of testosterone, dihydrotestosterone. METHODS: A pharmacological approach was used to assess the ability of the androgen receptor antagonist flutamide, the estrogen receptor antagonist ICI 182780 and the 5-α reductase inhibitor dutasteride to block the protective effect of testosterone, evaluated through the behavioral response induced by a TMJ injection of 0...
July 23, 2016: Pharmacology, Biochemistry, and Behavior
Gao Cheng, Wei H Yu, Cong Yan, Yao Liu, Wei J Li, Dong D Zhang, Nan Liu
The present research was designed to investigate whether endothelin-1 (ET-1) secretion can be induced by oxyhemoglobin and whether nuclear factor κB (NF-κB) is involved in the regulation of ET-1 transcription in cerebrovascular muscle cells. Cerebrovascular muscle cells isolated from a rabbit basilar artery were stimulated by oxyhemoglobin (OxyHb) and ET-1 production was increased significantly in the supernatant. Inhibition of NF-κB with pyrrolidine dithiocarbamate and small interfering RNA decreased the expression of ET-1...
August 17, 2016: Neuroreport
Anja I Srienc, Kyle R Biesecker, Angela M Shimoda, Joanna Kur, Eric A Newman
Cortical spreading depolarization is a metabolically costly phenomenon that affects the brain in both health and disease. Following severe stroke, subarachnoid hemorrhage, or traumatic brain injury, cortical spreading depolarization exacerbates tissue damage and enlarges infarct volumes. It is not known, however, whether spreading depolarization also occurs in the retina in vivo. We report now that spreading depolarization episodes are generated in the in vivo rat retina following retinal vessel occlusion produced by photothrombosis...
September 2016: Journal of Cerebral Blood Flow and Metabolism
Ajay R Vellore, Christopher B Robards, Steven R Clendenen
Spinal stenosis is a potentially serious condition that can lead to myelopathies and autonomic instability, both of which, as a result, may complicate anesthetic management. Additionally, neuraxial anesthesia appears to increase the risk of worsened neurological outcomes in this population. A 56-year-old female with spinal stenosis, autonomic dysfunction, and known difficult airway who required anesthesia for repair of a femur fracture is presented. After pre-operative arterial line and femoral block placement, an ultrasound guided subarachnoid block was safely placed...
February 2016: Middle East Journal of Anesthesiology
Rachna Prasad, Rs Raghavendra Rao, Ashwini Turai, P Prabha, R Shreyavathi, Karuna Harsoor
BACKGROUND AND AIMS: Combined spinal-epidural (CSE) anaesthesia is being increasingly used for effective post-operative analgesia. This study was designed to evaluate the effect of epidural clonidine on characteristics of spinal anaesthesia for gynaecological surgeries. METHODS: This was a prospective randomised, double-blind, controlled study involving sixty patients belonging to American Society of Anesthesiologists Physical Status I and II who underwent gynaecological surgeries were randomly divided into clonidine (C) group and saline (S) group of thirty each...
June 2016: Indian Journal of Anaesthesia
Arvinder Pal Singh, Ravinder Kaur, Ruchi Gupta, Anita Kumari
BACKGROUND AND AIMS: This study aims to compare the anesthesia characteristics between buprenorphine and fentanyl when added as an adjuvant to intrathecal ropivaciane in an attempt to prolong the duration of spinal anesthesia. MATERIAL AND METHODS: The present prospective double-blind study was undertaken on ninety American Society of Anesthesiologist I and II patients between 18 and 60 years of age undergoing subarachnoid block for lower limb surgery. Group I (n = 30) patients were administered 3 ml of intrathecal solution (2...
April 2016: Journal of Anaesthesiology, Clinical Pharmacology
Yun-xia Cai, Kui Zeng, Juan Ni, Wei Huang
OBJECTIVE: To evaluate the effect of horizontal and trendelenburg left lateral position on the onset time and the spread of intrathecal isobaric bupivacaine for elective cesarean delivery. METHODS: 180 parturients were enrolled to undergo elective cesarean delivery with combined spinal-epidural anesthesia (CSE). They were randomly divided into 3 groups (n = 60) according to the different positions during anesthesia: Group I horizontal position, Group II trendelenburg position 5 degrees, Group III trendelenburg position 10 degrees...
March 2016: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
Tumul Chowdhury, Bernhard Schaller
Hypotension and bradycardia are commonly observed after the spinal anesthesia and various mechanisms have been postulated for these hemodynamic changes.A middle-aged otherwise healthy male Caucasian patient developed several episodes of bradycardia postoperatively after the umbilical hernia repair under subarachnoid block (SAB) while trying to lean forward and move his legs. Episodes were aborted when patient was advised to relax in supine position.The common mechanism of bradycardia and hypotension under SAB is postulated as sympathetic blockade, decrease venous return, and parasympathetic over-dominance leading to a decrease in right arterial pressure and pressure in the great veins as they enter the right atrium...
May 2016: Medicine (Baltimore)
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