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Epidural injection of potassium

Maryam Tahmasbi Sohi, William J Sullivan, Dustin J M Anderson
A 30-year-old man with no significant medical history presented with hypokalemic quadriplegia 4 hours after he received a lumbar transforaminal epidural steroid injection (ESI) containing dexamethasone and lidocaine. A comprehensive workup ruled out acquired and hereditary causes of hypokalemic paralysis. Symptoms gradually resolved within hours after potassium restoration with no residual neurologic deficits. Paralysis after transforaminal ESI is uncommon but has been associated with particulate steroids that can coalesce into aggregates and occlude vessels...
October 24, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
Rahul Ranjan, Naiyer Asif, Sohail Ahmad, Syed Ifthekar
Epidural injection of steroid is given for back pain resistant to other conservative management. Normal saline (NS) is used as diluent in 80 mg methylprednisolone and a local anesthetic. Due to a similar looking ampoule of NS and potassium chloride (KCl), there is a probability of accidental use of KCl instead of NS. We present a case of a 50-year-old male patient having low back ache refractory to other conservative treatments. Epidural injection of steroid was given, but accidently KCl was mixed with methylprednisolone instead of NS...
October 2016: Journal of Craniovertebral Junction and Spine
Nilson Camargo Roso, Pedro Thadeu Galvão Vianna, Yara Marcondes Machado Castiglia, José Reinaldo Cerqueira Braz
BACKGROUND AND OBJECTIVES: There are no studies reporting renal effects promoted by high epidural clonidine doses. This study aimed at evaluating hemodynamic and renal effects of high epidural clonidine doses in dogs. METHODS: This double-blind randomized study involved 20 animals anesthetized with sodium thiopental and fentanyl, which were distributed in two groups: Group 1 or placebo (n = 10), receiving 0.2 saline, and Group 2 or clonidine (n = 10), receiving 0...
June 2005: Revista Brasileira de Anestesiologia
Mohamed Younes, Fadoua Neffati, Mongi Touzi, Saoussen Hassen-Zrour, Yosr Fendri, Ismail Béjia, Adel Ben Amor, Naceur Bergaoui, Mohamed Fadhel Najjar
INTRODUCTION: Whereas the systemic effects of glucocorticoid therapy have been extensively reported, little is known about those of local glucocorticoid injections. The objective of this study was to look for systemic effects of local glucocorticoid injections at two sites in diabetic and non-diabetic patients. METHODS: We studied 29 patients (18 women and 11 men with an age range of 18-86 years). The injection site was the epidural space in 18 patients (4 with and 14 without diabetes) with disk-related sciatica and the shoulder in 11 patients (8 with and 3 without diabetes) with frozen shoulder...
October 2007: Joint, Bone, Spine: Revue du Rhumatisme
Stephen E Abram, Johnny Yi, Andreas Fuchs, Quinn H Hogan
BACKGROUND: Nerve injury that produces behavioral changes of allodynia and hyperalgesia in animals is associated with electrophysiologic changes in dorsal root ganglion (DRG) cells. The introduction of drugs into the DRG or the peripheral nerve that alter calcium, sodium, or potassium channel activity may be of therapeutic benefit after nerve injury. For this reason, the authors sought to determine whether drugs that do not ordinarily cross the blood-nerve barrier will enter the DRG after intravenous or regional injection and to determine whether nerve injury alters drug access to DRGs or peripheral nerves...
July 2006: Anesthesiology
P Singh, K Pratap, Amarpal, P Kinjavdekar, H P Aithal, G R Singh
The study was conducted to evaluate the effects of xylazine alone (0.05 mg/kg), lignocaine alone (2.0 mg/kg) and a combination of xylazine and lignocaine (0.05 mg/kg and 2.0 mg/kg, respectively) after lumbar epidural administration in water buffalo calves. Fifteen nondescript, male water buffalo calves of 6-8 months of age and weighing between 55 and 75 kg were randomly placed in 3 groups (A, B and C). The agents were administered at the 1st lumbar epidural space. Clinico-physiological parameters such as analgesia, ataxia, sedation, salivation, heart rate, respiratory rate and rectal temperature were studied...
September 2005: Journal of the South African Veterinary Association
Ulrike Bischoff, Michael E Bräu, Werner Vogel, Gunter Hempelmann, Andrea Olschewski
(1) Hyperpolarizing voltage steps evoke slowly activating inward currents in a variety of neurones and in cardiac cells. This hyperpolarization-activated inward current (I(h)) is thought to play a significant role in cell excitability, firing frequency, or in setting of the resting membrane potential in these cells. We studied the effects of lidocaine, mepivacaine, QX-314 and bupivacaine as well as its enantiomers on I(h) in the membrane of dorsal root ganglion neurones (DRG). (2) The patch-clamp technique was applied to small dorsal root ganglion neurones identified in 200 micro M thin slices of young rat DRGs...
August 2003: British Journal of Pharmacology
T Asano, S Dohi, H Iida
Potassium (K(+)) channels may play some role in the analgesic actions of mu-opioid agonists and alpha(2)-adrenergic agonists (alpha(2) agonists). We examined whether the adenosine triphosphate-sensitive K(+)(K(+)(ATP)) channel openers, levcromakalim and nicorandil, (given epidurally), might have antinociceptive effects in a tail flick test in adult male Sprague-Dawley rats implanted with a lumbar epidural catheter. The interactions with morphine and an alpha(2) agonist were also examined. The epidural administration of levcromakalim (10 microg, 100 microg) or nicorandil (10 microg, 100 microg) alone did not produce antinociception, but 100 microg levcromakalim or nicorandil did potentiate the antinociceptive effect induced by epidural morphine...
May 2000: Anesthesia and Analgesia
V A Peduto, D Mezzetti, F Gori
We present a case of accidental epidural administration of potassium chloride, which was diagnosed by clinical signs. The genesis of symptoms and signs following such administration is discussed and compared with other published reports.
June 1999: European Journal of Anaesthesiology
M Tanosaki, M Baba, H Miura, M Matsunaga, K Arimura
We report a case of Isaacs' syndrome showing F-wave hyperexcitability which was reversible after either epidural block or plasmapheresis. A 14-year-old girl with progressive muscle cramp and myokymia in the legs showed high amplitude, long duration, polyphasic F-waves after either tibial nerve or peroneal nerve stimulation. Potassium current of PC-12 cell membrane was suppressed by her serum, IgM of which strongly reacted with proteins of approximately 50 kDa of the lysates of a PC-12 cell line. After an epidural nerve block with 1 per cent lidocaine 10 ml, the myokymia temporally improved, during which time the hyperexcitable F-waves became normalized...
January 1999: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
A de Crespigny, J Röther, N van Bruggen, C Beaulieu, M E Moseley
High-speed magnetic resonance imaging was used to perform simultaneous measurements of relative cerebral blood volume (rCBV) and water diffusion changes during spreading depression (SD) induced by cortical potassium chloride application. Rats were fitted epidurally with a rubber chamber. Potassium chloride was perfused through the chamber until SD was indicated by a negative direct current (DC) potential shift. Magnetic resonance imaging scans used echo planar diffusion and T2-weighted images. Iron dextran was injected as a blood pool contrast agent to make subsequent changes in T2 (or T2*) directly proportional to changes in CBV...
September 1998: Journal of Cerebral Blood Flow and Metabolism
Q Timour, P Gaillard, B Bui-Xuan, T Vial, J C Evreux, M Freysz
Cardiac disorders are observed when excessive plasma concentrations of local anaesthetics are reached, following for instance intravascular accidental injection for epidural anaesthesia or brachial plexus block. Bupivacaine particularly, which is one of the most used local anaesthetics, adversely affects intraventricular conduction and cardiac contractile strength from the 3.0-4.0 micrograms/ml blood levels. Depression of conduction is especially to be feared, for it can result in reentrant arrhythmias likely to degenerate into often fatal ventricular fibrillation...
1998: Bulletin de L'Académie Nationale de Médecine
P do Nascimento, N S Módolo, J F Meletti, J R Braz
BACKGROUND AND OBJECTIVES: A combination of epidural and general anesthesia has been widely used to attenuate the surgical stress response and to provide postoperative analgesia. This case report illustrates the use of this anesthetic technique. Analgesia was induced with local anesthetic in the immediate postoperative period using unintentional 19.1% potassium chloride (KCl) as diluent. METHODS: An ASA I male patient was scheduled for surgical correction of idiopathic megaesophagus under continuous epidural anesthesia combined with general anesthesia...
March 1998: Regional Anesthesia and Pain Medicine
T Asano, H Iida, S Dohi, T Masue, H Shimonaka
Recent reports demonstrated that K+ channels could contribute to signal transmission in the brain and spinal cord, and opioids' action may be related to K+ channels' functions. We investigated the antinociceptive effect of epidurally injected ATP-sensitive K+ channel opener, nicorandil, using tail flick test in rats. Epidural nicorandil (100 micrograms.rat-1) increased % maximum possible effect (%MPE) of epidural morphine (1, 10 micrograms.rat-1) from -3% to 40% (P < 0.05) and 46% to 65%, respectively. Epidural glibenclamide (10 micrograms...
November 1996: Masui. the Japanese Journal of Anesthesiology
K Liu, Y Y Chia
Two patients underwent thoracotomy for resection of pulmonary or esophageal carcinoma. Postoperatively, epidural catheters were inserted for pain management. Complaints of severe injection pain over the abdomen or lower extremities were made during one administration of pain medication. Progressive weakness and numbness developed over the lower trunk and lower extremities, with subsequent respiratory difficulties. Potassium chloride (KCl) was suspected to have been mistaken for normal saline as the diluent for morphine...
November 1995: Acta Anaesthesiologica Scandinavica
M De Kock, B Le Polain, D Henin, F Vandewalle, J L Scholtes
BACKGROUND: Clonidine prolongs the duration of sensory and motor block induced by bupivacaine, and this association, in constant infusion by the epidural route, is used for postoperative analgesia. After a near-fatal intravenous bolus of bupivacaine in dogs, clonidine improves ventricular electrophysiologic parameters, but probably worsens bupivacaine-induced bradycardia and depression of the myocardial contractility. The current study, using a rodent animal model, evaluated the influence of clonidine pretreatment on the systemic toxic effects of bupivacaine overdose induced by a constant intravenous infusion...
August 1993: Anesthesiology
J F Maillefert, S Aho, M C Huguenin, C Chatard, T Peere, M F Marquignon, B Lucas, C Tavernier
OBJECTIVES: to evaluate potential systemic effects of a single epidural injection of dexamethasone. PATIENTS AND METHODS: each of nine patients (five males and four females, mean age 47 +/- 11.8 years) admitted for sciatica was given a single epidural injection of 15 mg dexamethasone acetate. Before the injection (D0) and two (D2), seven (D7) and 21 (D21) days after the injection, the following laboratory tests were performed: serum cortisol and ACTH in the morning after an overnight fast, free cortisol in a 24-hour urine collection, fasting serum levels of glucose, triglycerides and cholesterol, serum levels of sodium and potassium...
June 1995: Revue du Rhumatisme: Joint, Bone, Spine Diseases
B Bormann, B Weidler, R Dennhardt, G Sturm, H H Scheld, G Hempelmann
The role of techniques used for management of intra- and postoperative pain on plasma levels of antidiuretic hormone (ADH) was evaluated in 107 patients undergoing abdominal or thoracic surgery. Fifty-one patients had neurolept-anesthesia (NLA) intraoperatively followed by intramuscular piritramide, a long-lasting synthetic narcotic, for relief of postoperative pain. Fifty-six patients had a combination of epidural bupivacaine and NLA intraoperatively followed by epidural fentanyl for relief of postoperative pain...
August 1983: Anesthesia and Analgesia
J Kobielski, K Czerniakowska, E Sokót-Kobielska, K Hoszowski
No abstract text is available yet for this article.
July 1973: Anaesthesia, Resuscitation, and Intensive Therapy
A J Cunningham, M Donnelly, A Bourke, J F Murphy
Ventricular arrhythmia may follow the infiltration of dilute, epinephrine-containing solutions to achieve hemostasis during surgery. The objective of this study was to determine the cardiovascular and metabolic changes associated with the infiltration of 1.5 micrograms/kg epinephrine 1:200,000 in 0.5% lidocaine into the cervix of patients having a cervical cone biopsy under epidural anesthesia. These observations were compared with a control group who were infiltrated with 0.5% plain lidocaine under similar epidural anesthesia during cone biopsy...
July 1985: Obstetrics and Gynecology
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