Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1999
Comparative StudyA comparison of the monitors INVOS 3100 and NIRO 500 in detecting changes in cerebral oxygenation.
Measurements of cerebral haemoglobin oxygenation of 2 near-infrared spectroscopy devices (INVOS 3100 and NIRO 500) were compared during and after hypocapnia. ⋯ Changes in cerebral haemoglobin oxygenation state were reflected more accurately by INVOS 3100 than NIRO 500. The cause may be the different technology of the monitors, since INVOS 3100 eliminates the contribution of extracranial oxygenation.
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Acta Anaesthesiol Scand · Apr 1999
Case ReportsCauda equina syndrome after spinal anaesthesia with hyperbaric 5% lignocaine: a review of six cases of cauda equina syndrome reported to the Swedish Pharmaceutical Insurance 1993-1997.
Six cases of cauda equina syndrome with varying severity were reported to the Swedish Pharmaceutical Insurance during the period 1993-1997. All were associated with spinal anaesthesia using hyperbaric 5% lignocaine. Five cases had single-shot spinal anaesthesia and one had a repeat spinal anaesthetic due to inadequate block. ⋯ In the other 3 cases, direct neurotoxicity was also probable, but unfortunately radiological investigations were not done to definitely exclude a compressive aetiology. All cases sustained permanent neurological deficits. We recommend that hyperbaric lignocaine should be administered in concentrations not greater than 2% and at a total dose preferably not exceeding 60 mg.
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Acta Anaesthesiol Scand · Apr 1999
Case ReportsMethemoglobinemia after axillary block with bupivacaine and additional injection of lidocaine in the operative field.
Methemoglobinemia may occur after the administration of various drugs, including some local anesthetics. We report a patient with chronic renal failure and ischemic heart disease who developed clinically significant methemoglobinemia after an axillary block with bupivacaine and additional injection of lidocaine in the operative field. Although the two local anesthetics usually do not cause methemoglobinemia, we suspect that the displacement of lidocaine from protein binding by bupivacaine, in combination with metabolic acidosis and treatment with other oxidants, was the reason for the development of methemoglobinemia.