Journal of anesthesia
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Journal of anesthesia · Feb 2014
Randomized Controlled Trial Comparative StudyDoes the addition of magnesium to bupivacaine improve postoperative analgesia of ultrasound-guided thoracic paravertebral block in patients undergoing thoracic surgery?
Magnesium is a plentiful intracellular cation that has been reported to possess analgesic effect. The present study was aimed to see whether addition of magnesium to bupivacaine in thoracic paravertebral block (TPVB) improved the analgesic effect after thoracic surgery. ⋯ Addition of magnesium to bupivacaine in TPVB improved the analgesic effect of bupivacaine in patients undergoing thoracic surgery.
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Journal of anesthesia · Feb 2014
Review Case ReportsDexmedetomidine-induced atrioventricular block followed by cardiac arrest during atrial pacing: a case report and review of the literature.
Sinus bradycardia is a well-known consequence of stimulation of presynaptic α2 adrenergic receptors due the adminstration of dexmedetomidine. One of the most serious adverse effects of dexmedetomidine is cardiac arrest. Some cases demonstrating such an arrest due to the indiscriminate use of this drug were recently reported. ⋯ The PQ interval in electrocardiography gradually prolonged during the infusion; finally, complete atrioventricular block and subsequent cardiac arrest occurred. Immediate cardiopulmonary resuscitation was carried out, including re-intubation, and recovery of spontaneous circulation was attained 15 min after the event. The patient was discharged from hospital on the 25th postoperative day without any neurological complications.
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Journal of anesthesia · Feb 2014
Case ReportsDevelopment of takotsubo cardiomyopathy with severe pulmonary edema before a cesarean section.
Takotsubo cardiomyopathy is an acute syndrome involving apical ballooning and consequent dysfunction of the left ventricle. Most cases of left ventricular dysfunction resolve within 1 month. We present the case of a 40-year-old woman who developed severe heart failure caused by takotsubo cardiomyopathy with severe left ventricular dysfunction during the perinatal period. ⋯ Full recovery of cardiac function required almost 1 month, after which she was discharged from the hospital without further complications. This is the first reported case of takotsubo cardiomyopathy induced by a failed intubation during a scheduled cesarean section. Takotsubo cardiomyopathy usually shows a good prognosis, but if this myopathy develops during the perinatal period, it can worsen because of excessive preload following the termination of fetoplacental circulation.