European journal of anaesthesiology
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We recently demonstrated that intrathecal bupivacaine before or after acute photochemical spinal injury improved functional outcome in rats. However, the closest model to spinal trauma is the contusive weight-drop method. The aim of this study was to evaluate functional, electrophysiological and anatomical consequences of a contusive spinal-cord lesion in rats with or without an intrathecal injection of bupivacaine. ⋯ Intrathecal 0.5% bupivacaine provide a neuroprotective effect by decreasing functional, electrophysiological and anatomical consequences after a contusive spinal cord injury.
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Although an epidural autologous blood patch is considered the most effective treatment for post dural puncture headache, which sometimes occurs following spinal or inadvertent spinal anaesthesia, there remains a need for alternative materials for epidural patches. We investigated the potential neurotoxicity of Dextran 40 (Rheomacrodex) and Polygeline (Haemaccel) used for this purpose in a rat model. ⋯ No deleterious effects, clinical or cellular, were evident in this rat model when Dextran 40 or Polygeline were injected intrathecally. Thus, both substances can be considered as possible alternative materials for epidural patches.
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Colloids such as hydroxyethyl starch (HES), gelatin, dextran and albumin are useful for maintaining renal perfusion and function. The comparative renal effects of colloids have not been previously reviewed. ⋯ Colloids display important differences in their actions on the kidney. These contrasting renal effects should be considered in making fluid management decisions.
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The local anaesthetic prilocaine has a low systemic toxicity mainly because of a high absorption in the lung and a large volume of distribution and thus is associated with a lower risk of neurological or cardiac side-effects. However, the major disadvantage is the formation of methaemoglobin by its metabolite o-toluidine. This prospective observational study was performed to identify factors that are associated with increased prilocaine-induced methaemoglobinaemia. ⋯ The use of prilocaine for regional block is safe, since the older patients who might be more susceptible to suffer from clinical symptoms of methaemoglobinaemia usually form less methaemoglobin. However, since prediction of high methaemoglobin levels is difficult, anaesthesiologists performing regional blocks in patients who might be jeopardized by a decreased oxygen transport capacity should avoid high doses of prilocaine.