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subarachnoid block

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https://www.readbyqxmd.com/read/29084192/transient-left-ventricular-dysfunction-due-to-coronary-spasm-after-spinal-anesthesia-with-bupivacaine-a-case-report
#1
Waldemar Elikowski, Małgorzata Małek-Elikowska, Marek Słomczyński, Karolina Horbacka, Jarosław Bartkowski, Bartosz Kalawski
Bupivacaine is a long-acting local anesthetic (LA) used for cutaneous infiltration, peripheral nerve blocks, epidural and spinal anesthesia. However, its application may result in cardiovascular complications such as: hypotension, bradycardia, cardiac arrest and toxic myocardial injury. The authors describe a 53-year-old male with a history of cigarette smoking, admitted for an elective inguinal hernia surgery. Before surgery, the patient received subarachnoid injection of bupivacaine (20 mg). After the operation, he developed transient hypotension...
October 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29077615/the-effect-of-adding-subarachnoid-epinephrine-to-hyperbaric-bupivacaine-and-morphine-for-repeat-cesarean-delivery-a-double-blind-prospective-randomized-control-trial
#2
Daniel Katz, Joshua Hamburger, David Gutman, Ryan Wang, Hung-Mo Lin, Michael Marotta, Jeffrey Zahn, Yaakov Beilin
BACKGROUND: Spinal anesthesia has become the most common type of anesthetic for cesarean delivery. The major limitation to spinal anesthesia is that the duration of the anesthetic may not be adequate in the event of a prolonged surgery. Some practitioners add epinephrine to hyperbaric bupivacaine to increase the duration, although its effect has not been fully studied. We therefore aimed to evaluate whether adding epinephrine to the spinal medication prolongs the duration of action of the resultant block in women presenting for repeat cesarean delivery...
October 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28991062/electron-microscopy-of-dural-and-arachnoid-disruptions-after-subarachnoid-block
#3
Miguel Angel Reina, Anna Puigdellívol-Sánchez, Stephen P Gatt, José De Andrés, Alberto Prats-Galino, André van Zundert
BACKGROUND: It has been customary to attribute postdural puncture headache (PDPH) incidence and severity to size and nature of the dural hole produced during major neuraxial blockade or diagnostic dural puncture. Needle orientation in relation to the direction of dural fibers was thought to be of importance because of the propensity for horizontal bevel placement to cause cutting rather than splitting of the dural fibers. METHODS: In vitro punctures of stringently quality-controlled human dural sac specimens were obtained with 27-gauge (27G) Whitacre needle (n = 33), with 29G Quincke used parallel to the spinal axis (n = 30), and with 29G Quincke in perpendicular approach (n = 40)...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28980306/effect-of-maternal-oxygen-inhalation-on-foetal-free-radical-activity-a-prospective-randomized-trial
#4
V Ahuja, S Gombar, S Jaswal, J Kaur, P Gupta, D Chawla, A Huria, S Singh
BACKGROUND: Maternal inhalation of 35-40% oxygen concentration has no significant effect on foetal partial pressure of oxygen, and 60-100% produced maternal and foetal hyperoxia with increased free radical activity. The benefit of 50% maternal oxygen inhalation on foetal oxygenation, oxidant stress and total antioxidant status (TAS) during Caesarean section (CS) has not been simultaneously evaluated. METHODS: In this prospective, randomized, controlled trial 120 ASA physical status I-II, term pregnant women were recruited to elective CS (n = 60) and emergency CS (n = 60) and received either 50% oxygen or air inhalation following subarachnoid block (SAB)...
October 5, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28978899/subarachnoid-block-induced-deafferentation-pain-successfully-treated-with-pentazocine
#5
Hiroaki Kishikawa, Zen'ichiro Wajima, Toshiro Shitara, Toru Shimizu, Hitoshi Adachi, Atsuhiro Sakamoto
Deafferentation pain induced by subarachnoid block (SAB) is rare, but it can appear in the form of recurrent phantom lower limb pain, new acute-onset stump pain in amputees, lower limb pain in patients with tabes dorsalis, and neuropathic pain. We have previously reported that thiopental is an effective treatment for deafferentation pain induced by therapeutic SAB applied to treat neuropathic pain of central origin. Here, we report the case of an amputee who developed new stump pain in his lower limb immediately after subarachnoid tetracaine was administered prior to appendectomy...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28928563/comparative-study-of-constant-dose-intrathecal-hypobaric-levobupivacaine-with-varying-baricities-in-lower-limb-surgeries
#6
K P Biji, M Sunil, K T Ramadas
BACKGROUND: Hypobaric spinal anesthesia is advantageous for unilateral lower extremity fractures as it obviates pain of lying on fractured limb for performing subarachnoid block. AIMS: This study compares block characteristics and complications of three different baricities of constant dose intrathecal hypobaric levobupivacaine to determine an optimum baricity. SETTINGS AND DESIGN: One-twenty American Society of Anesthesiologists Physical Status 1 and 2 patients aged 18-65 years undergoing unilateral lower limb surgeries were divided into three equal groups for this prospective cohort study...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928553/comparison-of-intrathecal-clonidine-and-fentanyl-as-adjuvant-to-hyperbaric-bupivacaine-in-subarachnoid-block-for-lower-limb-orthopedic-surgery
#7
Sidharth Sraban Routray, Khageswar Raut, Amit Pradhan, Abhilash Dash, Mina Soren
BACKGROUND: Many studies are there using adjuvants such as clonidine and fentanyl with bupivacaine in the subarachnoid block for prolonging postoperative analgesia. However, literature is divided regarding the dosage and efficacy of both intrathecal adjuvants. Furthermore, these adjuvants have their own side effects. Hence, search for ideal intrathecal adjuvant between clonidine and fentanyl to bupivacaine goes on. AIM: The aim of the present study was to compare the effect of intrathecal clonidine and fentanyl as adjuvant to bupivacaine in the subarachnoid block for lower limb orthopedic surgery...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928550/evaluating-the-efficacy-of-tramadol-as-an-adjuvant-to-intrathecal-isobaric-levobupivacaine-for-elective-infraumbilical-surgeries
#8
Dewan Roshan Singh, Hajer Mohamed, N Krishnaveni, Kusha Nag
BACKGROUND: Long-acting local anesthetics are used in subarachnoid block to increase the duration of anesthesia. Adjuvants are added to improve the duration of analgesia. SETTINGS: Randomized controlled trial was conducted in the Department of Anesthesiology in a tertiary care hospital. AIMS AND OBJECTIVES: The objective of this study was to evaluate the efficacy of low-dose tramadol as an intrathecal adjuvant to levobupivacaine in terms of duration of analgesia, onset of sensory blockade, onset of motor blockade, and duration of motor blockade...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928546/influence-of-addition-of-dexmedetomidine-or-fentanyl-to-bupivacaine-lumber-spinal-subarachnoid-anesthesia-for-inguinal-hernioplasty
#9
Ayman Eskander T Saadalla, Osama Yehia A Khalifa
BACKGROUND: No drug, used as adjuvant to spinal bupivacaine, has yet been identified that specifically inhibits nociception without its associated side effects. AIM OF THE WORK: The purpose of this study is to compare the efficacy of dexmedetomidine and fentanyl with spinal bupivacaine in inguinal hernioplasty. PATIENTS AND METHODS: Sixty patients of inguinal hernioplasty were randomly allocated to one of three groups, Group C (n = 20) - the patients received 15 mg hyperbaric bupivacaine + 0...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28893017/a-comparative-study-of-analgesic-effect-of-intrathecal-nalbuphine-and-fentanyl-as-adjuvant-in-lower-limb-orthopaedic-surgery
#10
Shagufta Naaz, Usha Shukla, Swati Srivastava, Erum Ozair, Adil Asghar
INTRODUCTION: Intrathecal opioids when added to local anaesthetics decrease their dosage and provide haemodynamic stability. Nalbuphine is an agonist-antagonist and acts on kappa receptors providing analgesia. AIM: The study aims to compare the analgesic efficacy of fentanyl with that of two doses of nalbuphine when used with injection bupivacaine heavy in spinal anaesthesia. MATERIALS AND METHODS: A randomised, double blinded, prospective study on 90 patients of ASA I and II undergoing lower limb orthopaedic surgery under subarachnoid block was done...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28829798/dexmedetomidine-as-a-neuraxial-adjuvant-for-prevention-of-perioperative-shivering-meta-analysis-of-randomized-controlled-trials
#11
Jian Zhang, Xuena Zhang, Hui Wang, Haibin Zhou, Tian Tian, Anshi Wu
BACKGROUND: Dexmedetomidine, a highly selective α2-adrenoceptor agonist, has been investigated for anti-shivering effects in some trials. This current meta-analysis was conducted to evaluate the effectiveness of dexmedetomidine as a neuraxial adjuvant in preventing perioperative shivering. METHODS: This systematic review and meta-analysis was registered in PROSPERO [www.crd.york.ac.uk/PROSPERO] with the unique identification number CRD42017055991. The electronic databases PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) were searched to select high-quality randomized controlled trials (RCTs) that evaluated the anti-shivering efficacy for neuraxial application dexmedetomidine as local anesthetic adjuvant...
2017: PloS One
https://www.readbyqxmd.com/read/28757829/effect-of-dexmedetomidine-as-an-adjuvant-to-bupivacaine-in-femoral-nerve-block-for-perioperative-analgesia-in-patients-undergoing-total-knee-replacement-arthroplasty-a-dose-response-study
#12
Senthil K Packiasabapathy, Lokesh Kashyap, Mahesh K Arora, Ravinder Kumar Batra, V K Mohan, Ganga Prasad, C S Yadav
CONTEXT: Dexmedetomidine is being increasingly used in nerve blocks. However, there are only a few dose determination studies. AIMS: To compare two doses of dexmedetomidine, in femoral nerve block, for postoperative analgesia after total knee arthroplasty (TKA). SETTINGS AND DESIGN: A prospective, randomized, controlled trial was conducted in the Department of Anesthesia at AIIMS, a Tertiary Care Hospital. MATERIALS AND METHODS: Sixty American Society of Anesthesiologists I-II patients undergoing TKA under subarachnoid block were randomized to three Groups A, B, and C...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28663649/the-analgesic-efficacy-of-dexamethasone-added-to-ropivacaine-in-transversus-abdominis-plane-block-for-transabdominal-hysterectomy-under-subarachnoid-block
#13
Jyoti P Deshpande, Poonam S Ghodki, Shalini P Sardesai
BACKGROUND AND AIMS: Ultrasound-guided transversus abdominis plane (TAP) block has been proven as a safe and effective analgesic technique for several lower abdominal surgeries. Various adjuvants have been used to intensify the quality and prolong the local anesthetic effect. We evaluated the analgesic efficacy of dexamethasone addition to ropivacaine in TAP block following open abdominal hysterectomy. MATERIALS AND METHODS: After clearance from the Institutional Ethics Committee, a double-blind, prospective, randomized study was carried out on sixty patients aged 40-60 years posted for elective open abdominal hysterectomy comparing bilateral TAP block using 20 ml of 0...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663609/efficacy-of-dexmedetomidine-infusion-for-procedural-comfort-and-intraoperative-sedation-in-patients-undergoing-surgeries-with-subarachnoid-block-a-randomized-double-blind-clinical-trial
#14
Dewan Roshan Singh, Kusha Nag, Amrutha Bindu Nagella, V R Hemanth Kumar, Antony John Charles
INTRODUCTION: There is increasing evidence to include sedation as an integral part of regional anesthesia to ensure patient comfort. This may compromise patient cooperation, an important component of regional anesthesia. We decided to determine the efficacy of dexmedetomidine (0.3 μg/kg/h and 0.5 μg/kg/h) for allaying procedural discomfort and ensuring their cooperation in patients undergoing surgery with subarachnoid block. SETTING: Tertiary care center. MATERIALS AND METHODS: Sixty patients with the American Society of Anesthesiologists physical status Class I and II posted for surgeries under subarachnoid block were randomized into two groups of 30 each to receive dexmedetomidine in a loading dose of 1 μg/kg in both groups followed by continuous infusion of 0...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28616651/comparison-of-efficacy-of-transversus-abdominis-plane-block-and-iliohypogastric-ilioinguinal-nerve-block-for-postoperative-pain-management-in-patients-undergoing-inguinal-herniorrhaphy-with-spinal-anesthesia-a-prospective-randomized-controlled-open-label-study
#15
Onur Okur, Zeki Tuncel Tekgul, Nazif Erkan
PURPOSES: The purpose of this study was to compare the effects of lateral abdominal transversus abdominis plane block (TAP block) and iliohypogastric/ilioinguinal nerve block (IHINB) under ultrasound guidance for postoperative pain management of inguinal hernia repair. Secondary purposes were to compare the complication rates of the two techniques and to examine the effects of TAP block and IHINB on chronic postoperative pain. METHODS: This was a prospective randomized controlled open-label study...
October 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28601919/cerebellar-exposure-to-cell-free-hemoglobin-following-preterm-intraventricular-hemorrhage-causal-in-cerebellar-damage
#16
Alex Adusei Agyemang, Kristbjörg Sveinsdóttir, Suvi Vallius, Snjolaug Sveinsdóttir, Matteo Bruschettini, Olga Romantsik, Ann Hellström, Lois E H Smith, Lennart Ohlsson, Bo Holmqvist, Magnus Gram, David Ley
Decreased cerebellar volume is associated with intraventricular hemorrhage (IVH) in very preterm infants and may be a principal component in neurodevelopmental impairment. Cerebellar deposition of blood products from the subarachnoid space has been suggested as a causal mechanism in cerebellar underdevelopment following IVH. Using the preterm rabbit pup IVH model, we evaluated the effects of IVH induced at E29 (3 days prior to term) on cerebellar development at term-equivalent postnatal day 0 (P0), term-equivalent postnatal day 2 (P2), and term-equivalent postnatal day 5 (P5)...
June 10, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28576642/the-pathway-of-subarachnoid-csf-moving-into-the-spinal-parenchyma-and-the-role-of-astrocytic-aquaporin-4-in-this-process
#17
Fang Wei, Cui Zhang, Rong Xue, Lidong Shan, Shan Gong, Guoqing Wang, Jin Tao, Guangyin Xu, Guoxing Zhang, Linhui Wang
AIMS: It has been proved that cerebrospinal fluid (CSF) in the subarachnoid space could reenter the brain parenchyma via the perivascular space. The present study was designed to explore the pathway of subarachnoid CSF flux into the spinal cord and the potential role of aquaporin-4 (AQP4) in this process. MAIN METHODS: Fluorescently tagged cadaverine, for the first time, was used to study CSF movement in mice. Following intracisternal infusion of CSF tracers, the cervical spinal cord was sliced and prepared for fluorescence imaging...
August 1, 2017: Life Sciences
https://www.readbyqxmd.com/read/28562733/randomized-clinical-study-on-the-analgesic-effect-of-local-infiltration-versus-spinal-block-for-hemorrhoidectomy
#18
RANDOMIZED CONTROLLED TRIAL
Luis Antônio Borges, Plínio da Cunha Leal, Ed Carlos Rey Moura, Rioko Kimiko Sakata
BACKGROUND AND OBJECTIVES: Postoperative analgesia and early recovery are important for hospital discharge. The primary objective of this study was to compare the analgesic effectiveness of perianal infiltration and subarachnoid anesthesia for hemorrhoidectomy. The secondary objective was to compare time to discharge, adverse effects and complications. DESIGN AND SETTING: Randomized, prospective and comparative study at Dr. Mário Gatti Hospital. METHODS: Forty patients aged 18-60, in American Society of Anesthesiologists physical status category 1 or 2, were included...
May 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28554709/ultrasound-guided-genicular-nerve-block-for-pain-control-after-total-knee-replacement-preliminary-case-series-and-technical-note
#19
V González Sotelo, F Maculé, J Minguell, R Bergé, C Franco, X Sala-Blanch
INTRODUCTION: Total knee arthroplasty (TKA) is an operation with moderate to severe postoperative pain. The Fast-Track models employ local infiltration techniques with anaesthetics at high volumes (100-150ml). We proposed a genicular nerve block with low volume of local anaesthetic. The aim of our study is to evaluate the periarticular distribution of these blocks in a fresh cadaver model and to describe the technique in a preliminary group of patients submitted to TKA. MATERIALS AND METHODS: In the anatomical phase, 4 genicular nerves (superior medial, superior lateral, inferior medial and inferior lateral) were blocked with 4ml of local anaesthetic with iodinated contrast and methylene blue in each (16ml in total)...
May 26, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28551594/awake-caudal-anaesthesia-in-neonates-young-infants-for-improved-patient-safety
#20
Wan Yen Lim, Sujani Anuruddhika Wijeratne, Evangeline Hua Ling Lim
Caudal epidural block in a conscious infant is a recognised technique that allows the avoidance of general anaesthesia and risks associated with it. It is also technically easier to perform reliably compared with an awake subarachnoid block in skilled hands.(1) While local anaesthetic systemic toxicity is a rare complication of caudal anaesthesia, this case illustrates the potential for caudal anaesthesia done awake in enhancing patient safety through early recognition of local anaesthetic systemic toxicity...
May 27, 2017: BMJ Case Reports
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