Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Hyperbaric bupivacaine (0.75% in dextrose) is used for spinal obstetric anesthesia. Occasional clusters of anesthetic failures occur in this setting, not readily attributable to clinical factors. We hypothesized that cold temperature exposure is related to bupivacaine instability. ⋯ Canadian clinical practice and handling of hyperbaric bupivacaine is consistent. Most respondents indicated an interest in a formal reporting and collection process. Cold exposure did not degrade bupivacaine. A complex and possibly inconsistent reaction involving dextrose was identified that requires further analysis of a larger sample size to elucidate the mechanisms.
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Ocular injury and vision loss are rare complications of surgery. Spine surgery has been identified as particularly high risk for postoperative vision loss; nevertheless, ocular injuries have not been comprehensively assessed in this patient population. ⋯ Although not representing a causal relationship, these data suggest that surgical factors may have a greater role than demographic characteristics or other clinical factors in the development of perioperative ocular injury. Surgeons, anesthesiologists, and patients should be aware of the increased risk of ocular injury that accompanies longer, more extensive spine operations.