Journal of clinical anesthesia
-
Spontaneous spinal epidural hematoma is a rare occurrence during pregnancy with only five cases described in the literature since 1900. Even in the general population, the frequency of spontaneous spinal epidural hematoma is extremely low and the etiology unclear. Several theories exist for the cause of spontaneous spinal epidural hematoma, however, none has gained uniform acceptance. ⋯ We hypothesize that the cause of spontaneous spinal epidural hematoma is multifactorial, and pregnancy-induced structural changes in arterial walls and hemodynamic changes may play a role. In addition, we postulate that the origin of the bleeding is arterial, rather then venous. Lastly, the symptoms, diagnosis, and management of spontaneous spinal epidural hematoma during pregnancy are discussed.
-
Case Reports
Spinal epidural hematoma following central neuraxial blockade and subcutaneous enoxaparin: a case report.
An elderly patient developed a spinal epidural hematoma 3 days after lumbar puncture resulting in paraplegia. Concurrent administration of enoxaparin, aspirin, ketorolac, and a traumatic tap were implicated in causation.
-
To test the hypothesis that effective pulmonary capillary blood flow can be a useful indicator for estimating appropriate oxygenation and ventilation during one-lung ventilation in lung surgery. ⋯ Effective pulmonary capillary blood flow index and effective pulmonary blood stroke flow index are useful indicators for determining appropriate oxygenation therapy during one-lung ventilation.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Effect of intraoperative magnesium infusion on perioperative analgesia in open cholecystectomy.
To study the role of magnesium sulphate (MgSO4) on analgesic requirement, pain, discomfort, and sleep during perioperative period. ⋯ Administration of intraoperative MgSO4 as an adjuvant analgesic in patients undergoing open cholecystectomy resulted in better pain relief and comfort in the first postoperative hour, but it did not significantly decrease the postoperative morphine requirement. Magnesium sulphate resulted in better sleep quality during the postoperative period, without any significant adverse effects. The role of MgSO4 as an adjuvant analgesic in open cholecystectomy needs to be studied further.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Increased success rate with infraclavicular brachial plexus block using a dual-injection technique.
To test the hypothesis that dual injection of the local anesthetic in coracoid infraclavicular brachial plexus block might enhance both sensory and motor block for anesthesia of the upper limb when compared with a single-injection technique. ⋯ Dual injection of local anesthetic guided by nerve stimulator increases the efficacy of coracoid block when compared with a single injection of the same dose of local anesthetic.