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subarachnoid block

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/27746526/efficacy-of-lipophilic-vs-lipophobic-opioids-in-addition-to-hyperbaric-bupivacaine-for-patients-undergoing-lower-segment-caeserean-section
#12
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
https://www.readbyqxmd.com/read/27662067/local-anesthetic-induced-myotoxicity-after-continuous-adductor-canal-block
#13
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
https://www.readbyqxmd.com/read/27643056/os-25-04-the-changes-of-arterial-stiffness-monitored-with-cardio-ankle-vascular-index-cavi-during-raised-intracranial-pressure-in-the-rabbit
#14
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/27630388/outcome-of-radical-retropubic-prostatectomy-at-the-lagos-state-university-teaching-hospital
#15
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
https://www.readbyqxmd.com/read/27512167/the-comparative-evaluation-of-safety-and-efficacy-of-unilateral-paravertebral-block-with-conventional-spinal-anaesthesia-for-inguinal-hernia-repair
#16
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
https://www.readbyqxmd.com/read/27512164/ultrasound-guided-femoro-sciatic-nerve-block-for-post-operative-analgesia-after-below-knee-orthopaedic-surgeries-under-subarachnoid-block-comparison-between-clonidine-and-dexmedetomidine-as-adjuvants-to-levobupivacaine
#17
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
https://www.readbyqxmd.com/read/27461546/activational-action-of-testosterone-on-androgen-receptors-protects-males-preventing-temporomandibular-joint-pain
#18
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
https://www.readbyqxmd.com/read/27391329/nuclear-factor-%C3%AE%C2%BAb-is-involved-in-oxyhemoglobin-induced-endothelin-1-expression-in-cerebrovascular-muscle-cells-of-the-rabbit-basilar-artery
#19
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
https://www.readbyqxmd.com/read/27389181/ischemia-induced-spreading-depolarization-in-the-retina
#20
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
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