Southern medical journal
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Southern medical journal · Nov 1993
Case ReportsNeuroimaging of arachnoiditis induced by spinal anesthesia.
Despite the simplicity, effectiveness, and safety of spinal anesthesia, arachnoiditis can occur as a complication. The cause of this is often unknown, especially since disposable spinal kits are now normally used. ⋯ This mode of investigation is often sufficient to establish the diagnosis. When necessary, it can be augmented by myelography and CT.
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Southern medical journal · Nov 1993
Compensation status as a predictor of outcome in nonsurgically treated low back injury.
Whether the compensation status of patients injured in occupational accidents influences treatment outcome remains a controversial issue. This article describes the treatment outcome status of compensated versus noncompensated patients who received comprehensive functional restoration treatment of low back pain in a hospital-based, interdisciplinary, occupational rehabilitation and pain management program. Results of this investigation revealed treatment outcome differences between the two groups in two of three measures at discharge (subjective pain intensity and return-to-work), and outcome differences in one of five measures at 6-month follow-up (subjective pain intensity). Interestingly, significant group differences in return-to-work rates noted at the time of treatment discharge were not found during the follow-up period, with no group outcome difference in return-to-work rates noted at 6-month follow-up.
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Southern medical journal · Nov 1993
Randomized Controlled Trial Clinical TrialEvaluation of flumazenil for reversing the effects of midazolam-induced conscious sedation or general anesthesia.
To evaluate the effectiveness of flumazenil in reversing midazolam-induced conscious sedation and general anesthesia, we gave either flumazenil or placebo to 55 patients in a double-blind manner after surgery. Whether surgery was done under conscious sedation (CS group) or general anesthesia (GA group) depended on the procedure. Recovery was assessed by an Observer Assessment of Alertness and Sedation (OAAS) Scale, Finger-Nose (F-N) test, and picture recall and recognition. ⋯ In both groups, picture recall and recognition improved significantly immediately after flumazenil administration, but this improvement was generally not sustained for pictures shown at later times. These results imply that flumazenil is beneficial for reversing amnesia briefly after midazolam-induced sedation. However, flumazenil hastens recovery only when larger doses of midazolam are used for general anesthesia.
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Drug dispensing error should be considered as a cause of hypoglycemia when the usual initial workup is unrevealing, as in the case described.