British journal of anaesthesia
-
Degenerative processes of the lumbar spine may change the position of the sympathetic trunk which might cause failure of sympathetic blocks owing to inadequate distribution of local anaesthetic. ⋯ Spondylophytes influenced the location of the LST and the distribution of the local anaesthetic. The local anaesthetic should wash around the spondylophyte to reach all possible locations of the chain. The medial margin of the psoas muscle was confirmed to be a consistent reference point at intervertebral disc level L2/3.
-
Case Reports
Venous air embolism and intracardiac thrombus after pressurized fibrin glue during liver surgery.
After segmental liver resection, a fibrin glue aerosol was used to stop diffuse bleeding from the liver resection site. Immediately after pressurized administration, severe hypotension and bradycardia occurred, requiring cardiopulmonary resuscitation and inotropic support. ⋯ In addition, a 3 cm floating thrombus was detected in the right ventricle. This case demonstrates that sprayed fibrin glue can cause life-threatening air embolism and intracardiac thrombus formation in liver surgery.
-
Randomized Controlled Trial Comparative Study
Spinal anaesthesia for ambulatory arthroscopic surgery of the knee: a comparison of low-dose prilocaine and fentanyl with bupivacaine and fentanyl.
Prospective data on the use of prilocaine for ambulatory spinal anaesthesia remain limited. We compared the behaviour and characteristics of subarachnoid block using prilocaine and fentanyl with that of bupivacaine and fentanyl. ⋯ The combination of prilocaine and fentanyl is a better alternative to that of low-dose bupivacaine and fentanyl, for spinal anaesthesia in ambulatory arthroscopic knee surgery.
-
Randomized Controlled Trial
ED₅₀ and ED₉₅ of intrathecal levobupivacaine with opioids for Caesarean delivery.
This prospective randomized double-blind dose-response study aimed to determine the ED₅₀ and ED₉₅ of intrathecal levobupivacaine combined with morphine and sufentanil for elective Caesarean delivery. ⋯ When combined with intrathecal sufentanil 2.5 µg and intrathecal morphine 100 µg, the ED₉₅ of intrathecal levobupivacaine is 12.9 mg for Caesarean delivery. If doses of levobupivacaine less than the ED₉₅, particularly near the ED₅₀, are used, these doses should be administered under a CSE technique.