Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
The authors report a case of a patient who developed spinal subdural haematoma after a series of epidural blood patches to alert anaesthetists to this rare complication. ⋯ Epidural blood patch is not without complications. Transient backache and/or radiculopathy may occur in up to one-third of patients receiving a blood patch. If signs and symptoms continue or worsen, a spinal subarachnoid and/or subdural haematoma should be suspected and neurosurgical opinion sought. The technique used to identify the epidural space is important in preventing subdural injection of blood. The needle should be withdrawn after dural puncture and the epidural space identified at a different level. Blood patches may carry a higher risk of serious complications after multiple epidural phenol injections because of fibrosis and obliteration of the epidural space. Magnetic resonance scans reliably demonstrate the extent of the pathology. If diagnosed and treated before irreversible changes occur, spinal intradural haematoma can result in complete recovery.
-
To present a case of delayed neuraxial blockade after interscalene brachial plexus block. ⋯ This example of delayed central neural blockade complicating interscalene block is presented in contrast to other reports, which have usually occurred promptly after injection, accompanied by complete sensory and motor block requiring cardio-respiratory support. The presumed mechanism of the delayed onset of bilateral neuraxial spread was a dural cuff puncture with slow CSF spread from a plexus sheath "depot" of local anaesthetic.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Prophylactic antiemetic therapy with ondansetron, tropisetron, granisetron and metoclopramide in patients undergoing laparoscopic cholecystectomy: a randomized, double-blind comparison with placebo.
Postoperative nausea and vomiting (PONV) is a distressing adverse effect of general anaesthesia. The aim of the current study was to compare the antiemetic activity of different 5-hydroxytryptamine3 receptor antagonists with that of metoclopramide and placebo. ⋯ Ondansetron, when given prophylactically resulted in a significantly lower incidence of PONV than metoclopramide and placebo. Metoclopramide was ineffective.