Journal of clinical and diagnostic research : JCDR
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We would like to report 2 cases where we encountered a rare complication of hypertension without tachycardia after the administration of an interscalene block. We have tried to explain the same with the anatomical correlations.
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Laryngoscopy and tracheal intubation is invariably associated with a reflex sympathetic pressor response resulting in elevated heart rate and blood pressures. This may prove detrimental in high risk patients. Objective of this study is to compare the effects of lignocaine and fentanyl in attenuation of this pressor response to laryngoscopy and tracheal intubation. ⋯ Attenuation of pressor response is seen both with lignocaine and fentanyl. Of the two drugs fentanyl 4mgicrogram i.v. bolus provides a consistent, reliable and effective attenuation as compared to lignocaine 1.5mg/kg iv. bolus.
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Tuberculosis is the commonest of the infections world wide and it can affect almost any part of the body, most commonly the thorax. The spine is affected in 50 % of the cases of skeletal tuberculosis. A tuberculous infection of the spine causes a bony destruction and collapse of the vertebrae, with a gibbus deformity, skip lesions, an intervertebral disc involvement, an epidural abscess, a paravertebral abscess and oedema in the soft tissue planes. Magnetic Resonance Imaging (MRI) is the most valuable investigation in the patients with spinal tuberculosis, as it can clearly demonstrate all of the above findings. ⋯ The MRI scan is highly sensitive in the detection of various pathological processes of Pott's spine and the patterns of occurrence of these findings were analyzed in this study. Since the incidence and prevalence of tuberculosis are dependent on various epidemiologically sensitive parameters, this study can provide a benchmark, against which the results of studies which will be done in the future can be compared.