Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2020
Case ReportsTransient paraplegia revealed by intraoperative neurophysiological monitoring: was it caused by the epidural anesthetic or an epidural hematoma?
Our case report describes the electrophysiological features associated with the development of a spinal epidural hematoma during surgery of the lumbar spine. It stresses the importance of the evaluation of nonsurgical factors, which can potentially affect intraoperative evoked potentials; in this case, epidural local anesthetic or epidural hematoma.
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Anesthesia and analgesia · Mar 2020
Clinical Trial Controlled Clinical TrialPostoperative myalgia after succinylcholine: no evidence for an inflammatory origin.
A common side effect associated with succinylcholine is postoperative myalgia. The pathogenesis of this myalgia is still unclear; inflammation has been suggested but without convincing evidence. We designed the present study to investigate whether an inflammatory reaction contributes to this myalgia. The incidence and severity of succinylcholine-associated myalgia was determined in 64 patients pretreated with saline or dexamethasone before succinylcholine (n = 32 for each). Incidence and severity of myalgia did not differ significantly between the two groups: 15 patients in the dexamethasone group complained of myalgia compared with 18 patients in the saline group, and severe myalgia was reported by five patients and three patients, respectively (not significant). At 48 h after surgery, 12 patients in both groups still suffered from myalgia (not significant). In addition, interleukin-6 (IL-6) as an early marker of inflammation was assessed in a subgroup of 10 patients pretreated with saline. We found an increase of IL-6 for only three patients, but only one patient reported myalgia; no relationship between myalgia and the increase of IL-6 was found. In conclusion, there is no evidence for an inflammatory origin of succinylcholine-associated myalgia. ⋯ Administration of dexamethasone before succinylcholine was not effective in decreasing the incidence or the severity of succinylcholine-induced postoperative myalgia. Furthermore, there was no significant relationship between postoperative myalgia and time course of interleukin-6 concentrations, a marker of inflammation. Pretreatment with dexamethasone is not justified to prevent postoperative myalgia after succinylcholine.
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Anesthesia and analgesia · Mar 2020
Randomized Controlled Trial Comparative StudyUltrasound-Assisted Versus Landmark-Guided Spinal Anesthesia in Patients With Abnormal Spinal Anatomy: A Randomized Controlled Trial.
Spinal ultrasound improves first-pass success for patients with abnormal spinal anatomy undergoing spinal block, although there was no difference in total procedure time.
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