Brit J Hosp Med
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Amiodarone is an antiarrhythmic drug used to treat cardiac tachyarrhythmias. It has many adverse effects, with thyroid dysfunction one of the most notable. ⋯ There are two types of amiodarone-induced thyrotoxicosis: type 1 occurs in those with pre-existing thyroid disease and is treated with thionamide, whereas type 2 occurs in those without and is treated with glucocorticoids. Patients with amiodarone-induced hypothyroidism may be given levothyroxine to replace thyroid hormone, but in some cases, the appropriate management may be cessation of amiodarone.
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Barbotage refers to the repeated aspiration and re-injection of CSF following injection of local anaesthetic into the intrathecal space, and its practice varies among anaesthetists. This article reviews the evidence for and against this practice to alter block dynamics following intrathecal injection reserved for spinal anaesthesia.