A modified retrobulbar block for microphthalmia using ultrasound guidance in a cat

BACKGROUND: The retrobulbar block in children is used to enucleate analgesia in the intra- and postoperative period and prevent oculocardiac reflex (OCD), postoperative nausea, and vomiting. However, when the block is performed blindly, it results in serious complications. AIM: This study aimed to evaluate the efficacy and safety of a retrobulbar block performed under ultrasound guidance compared with a retrobulbar block performed blindly during enucleation of the eyeball in children with retinoblastoma. MATERIALS AND METHODS: A prospective randomized controlled trial was performed. The study included 40 patients who met the inclusion criteria. The patients were divided into two groups: 20 patients who underwent ultrasound-guided retrobulbar blockade (RBВ + ultrasound) and 20 patients who underwent blindly retrobulbar blockade (RBВ). RESULTS: There was an insignificant decrease in intraoperative opioid requirements in the RBB + ultrasound group, where the average dose of fentanyl was 41.4 g/kg, and in the RBB group, 4.70.8 g/kg (p 0.05). The time before the administration of the first dose of analgesic in the postoperative period was 4.70.8 h in the RBB group and 11.73.3 h in the RBB + ultrasound group (p 0.05). VAS and CHIPPS scores obtained 6 h after the end of surgery in the RBB + ultrasound and RBB groups were 1.8 (1.2; 2) and 2.5 (3.8; 4.5) points (p 0.05), respectively. CONCLUSION: There was no statistically significant difference between the time of the retrobulbar blockade under ultrasound guidance and the retrobulbar regional block performed blindly. Retrobulbar blockade performed under ultrasound guidance provides a decrease in intraoperative opioid requirements, stable intraoperative hemodynamics, and longer postoperative analgesia.

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Bilateral hearing loss following a retrobulbar block

Yearbook of Otolaryngology-Head and Neck Surgery ◽

10.1016/s1041-892x(07)70030-6 ◽

2007 ◽

Vol 2007 ◽

pp. 31

Author(s):

M.M. Paparella

Keyword(s):

Hearing Loss ◽

Bilateral Hearing Loss ◽

Retrobulbar Block

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Ultrasound guidance for internal jugular vein catheterization

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1053/jcan.2001.28348 ◽

2001 ◽

Vol 15 (6) ◽

pp. 803-803

Author(s):

Martin J. Ruth ◽

David H. T. Scott

Keyword(s):

Internal Jugular Vein ◽

Ultrasound Guidance ◽

Jugular Vein ◽

Internal Jugular Vein Catheterization ◽

Vein Catheterization

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Placental Transfer of Vitamin K1 and Its Implications in Fetal Hemostasis

Thrombosis and Haemostasis ◽

10.1055/s-0038-1647631 ◽

1988 ◽

Vol 60 (01) ◽

pp. 039-043 ◽

Cited By ~ 52

Author(s):

L Mandelbrot ◽

M Guillaumont ◽

M Leclercq ◽

J J Lefrère ◽

D Gozin ◽

...

Keyword(s):

Vitamin K ◽

High Performance ◽

Ultrasound Guidance ◽

Placental Transfer ◽

Vitamin K1 ◽

Vitamin K Deficiency ◽

Prothrombin Activity ◽

Oral Supplementation ◽

K Deficiency ◽

The Mean

SummaryVitamin K status was evaluated using coagulation studies and/ or vitamin IQ assays in a total of 53 normal fetuses and 47 neonates. Second trimester fetal blood samples were obtained for prenatal diagnosis under ultrasound guidance. Endogenous vitamin K1 concentrations (determined by high performance liquid chromatography) were substantially lower than maternal levels. The mean maternal-fetal gradient was 14-fold at mid trimester and 18-fold at birth. Despite low vitamin K levels, descarboxy prothrombin, detected by a staphylocoagulase assay, was elevated in only a single fetus and a single neonate.After maternal oral supplementation with vitamin K1, cord vitamin K1 levels were boosted 30-fold at mid trimester and 60 fold at term, demonstrating placental transfer. However, these levels were substantially lower than corresponding supplemented maternal levels. Despite elevated vitamin K1 concentrations, supplemented fetuses and neonates showed no increase in total or coagulant prothrombin activity. These results suggest that the low prothrombin levels found during intrauterine life are not due to vitamin K deficiency.

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AORTA Registry 7F vs 11-12 F access

Journal of Endovascular Resuscitation and Trauma Management ◽

10.26676/jevtm.v3i1.79 ◽

2019 ◽

Vol 3 (1) ◽

Cited By ~ 1

Author(s):

Reviewer Joseph DuBose ◽

Jonathan Morrison ◽

Megan Brenner ◽

Laura Moore ◽

John B Holcomb ◽

...

Keyword(s):

Ultrasound Guidance ◽

Balloon Occlusion ◽

Aortic Occlusion ◽

Severely Injured ◽

Distal Extremity ◽

Low Profile ◽

Transfusion Requirements ◽

Thrombotic Complications ◽

Device Use ◽

Endovascular Balloon Occlusion

ABSTRACT Introduction: The introduction of low profile devices designed for Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) after trauma has the potential to change practice, outcomes and complication profiles related to this procedure. Methods: The AAST Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery (AORTA) registry was utilized to identify REBOA patients from 16 centers -comparing presentation, intervention and outcome variables for those REBOA via traditional 11-12 access platforms and trauma-specific devices requiring only 7 F access. Results:From Nov 2013-Dec 2017, 242 patients with completed data were identified, constituting 124 7F and 118 11-12F uses. Demographics of presentation were not different between the two groups, except that the 7F patients had a higher mean ISS (39.2 34.1, p = 0.028). 7F device use was associated with a lower cut-down requirement for access (22.6% vs. 37.3%, p = 0.049) and increased ultrasound guidance utilization (29.0% 23.7%, p = 0.049). 7F device afforded earlier aortic occlusion in the course of resuscitation (median 25.0 mins vs. 30 mins, p = 0.010), and had lower median PRBC (10.0 vs. 15.5 units, p = 0.006) and FFP requirements (7.5 vs. 14.0 units, p = 0.005). 7F patients were more likely to survive 24 hrs (58.1% vs. 42.4%, p = 0.015) and less likely to suffer in-hospital mortality (57.3% vs. 75.4%, p = 0.003). Finally, 7F device use was associated with a 4X lower rate of distal extremity embolism (20.0% vs. 5.6%, p = 0.014;OR 95% CI 4.25 [1.25-14.45]) compared to 11-12F counterparts. Conclusion: The introduction of trauma specific 7F REBOA devices appears to have influenced REBOA practices, with earlier utilization in severely injured hypotensive patients via less invasive means that are associated with lower transfusion requirements fewer thrombotic complications and improved survival. Additional study is required to determine optimal REBOA utilization.

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