British journal of anaesthesia
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Parallel-walled spinal needles ≤ 22 G are routinely used for lumbar puncture, despite a reported ≥ 32% incidence of post-dural puncture headache. A tapered spinal needle (22 G shaft, 27 G tip) is in use in our institution. We hypothesized that despite the smaller dural puncture hole, this needle has similar cerebrospinal fluid (CSF) pressure equilibration times and CSF sampling times to a standard 22 G needle and assessed a range of spinal needles using an experimental pulsatile CSF reservoir. ⋯ A 22/27 G tapered spinal needle has similar flow properties to the 22 G needle, despite a 27 G tip.
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Microcirculatory and mitochondrial dysfunction are important factors in the development of septic shock. In this study, we investigated the effects of fluid resuscitated endotoxaemic shock and norepinephrine treatment on intestinal microcirculation and mitochondrial function in sheep. ⋯ Although fluid resuscitated endotoxaemic shock increased regional blood flow, microcirculatory and mitochondrial alterations were still present. Restoring MAP with norepinephrine did not affect ileal microcirculation or mucosal acidosis, indicating that perfusion pressure manipulation is of limited importance to the intestinal microcirculation in established endotoxaemic shock.
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As general anaesthesia may compromise the immune system, it has been hypothesized that latent varicella-zoster virus is more likely to be reactivated and cause herpes zoster in mothers after Caesarean deliveries under general anaesthesia. Our study was thus aimed at investigating the risk of herpes zoster among women during the first year after Caesarean deliveries under either general or regional anaesthesia. ⋯ In this series, there was a small increased risk of herpes zoster in the year after Caesarean delivery with general anaesthesia. Future studies are needed to further investigate these findings.