Anesthesia and analgesia
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Anesthesia and analgesia · Dec 1987
Central nervous system complications after 6000 retrobulbar blocks.
Six thousand consecutive patients in whom retrobulbar anesthesia was performed by an anesthesiologist before ophthalmic surgery were studied. Sixteen patients (1 in 375) developed signs and symptoms presumed to be caused by the direct spread of the local anesthetic agents to the central nervous system. These signs and symptoms ranged from drowsiness, blindness of the contralateral eye, abnormal shivering, or vomiting, through to respiratory depression, apnea, hemiplegia, aphasia, convulsions, unconsciousness, and cardiopulmonary arrest. ⋯ The time of the onset of symptoms after the retrobulbar injection was variable (average 8 min, range 2 to 40 min). The possibility of a life-threatening complication occurring was rare (1 in 750) but unpredictable. The need for closely monitored anesthesia care of all patients having surgery under retrobulbar anesthesia is stressed.
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Anesthesia and analgesia · Dec 1987
Comparative StudyA new parascalene approach to the brachial plexus in children: comparison with the supraclavicular approach.
A technique for blocking the brachial plexus was designed after reevaluation of the gross anatomy of the neck in children. It consists of penetrating the perineural sheath at the level of the omohyoid muscle using a strictly anterior-posterior direction for insertion of the needle. ⋯ Insulated needles and a nerve stimulator were used with both techniques. Although both techniques produced a high degree of sensory blockade in almost all infraclavicular branches of the brachial plexus, the parascalene approach proved to be easier and more reliable while also being almost free of complications.
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Anesthesia and analgesia · Dec 1987
Comparative StudyComparison of the toxicity of I-653 and isoflurane in rats: a test of the effect of repeated anesthesia and use of dry soda lime.
The low solubility and high stability of the new volatile anesthetic, I-653, suggest that this agent should have little or no toxic effect. This hypothesis was tested using repeated exposures to I-653, to isoflurane, or to no anesthetic. ⋯ Specimens were taken from brain, pituitary, lung, heart, duodenum, pancreas, kidney, and liver. No tissue damage attributable to either anesthetic was found nor was weight gain affected.
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Anesthesia and analgesia · Nov 1987
Clinical Trial Controlled Clinical TrialIncidence of hypotension associated with epidural anesthesia using alkalinized and nonalkalinized lidocaine for cesarean section.
The onset of epidural anesthesia is accelerated by alkalinization of lidocaine with added epinephrine (LE). The possibility that decreases in systolic blood pressure (SBP) are also enhanced was studied in 21 patients having elective cesarean sections. ⋯ These differences were noted despite the fact that patients given LE + HCO3 received no less ephedrine and no more additional anesthetic than controls. Possible adverse effects of SBP reduction on uteroplacental blood flow suggest that caution be used in the use of alkalinized LE in obstetrical patients.