scholarly journals Comparative Study between Magnesium Sulfate and Pethidine for Controlling Shivering after Spinal Anesthesia

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
N M Ali ◽  
R A Mahrose ◽  
S M Elsayed
Keyword(s):  
Magnesium Sulfate ◽  
Spinal Anesthesia ◽  
Motor Neurons ◽  
Muscle Tone ◽  
Muscular Activity ◽  
Renshaw Cells ◽  
Patient Consent ◽  
Duration Of Surgery ◽  
Induced Changes ◽  
Informed Patient

Abstract Background Shivering is an involuntary muscular activity. Increased muscle tone during shivering is due to temperature-induced changes in neuronal activity in the reticular formation. Synchronization of motor neurons during shivering may be mediated by recurrent inhibition through renshaw cells. Aim of the Work To verify the efficacy of magnesium sulfate for controlling post spinal shivering, to compare the efficacy of magnesium sulfate and pethidine for controlling post spinal shivering and to detect the side effects of both magnesium sulfate and pethidine after their use for controlling post spinal shivering. Patients and Methods This prospective study was conducted at El-Matarya Teaching Hospital from 2018 till 2019. After obtaining approval from the Research Ethical Committee of Ain Shams University, informed patient consent was obtained before the procedure. After giving the spinal anesthesia, only patients who developed post-spinal shivering were followed for the study. 60 patients with post-spinal shivering were included with the following criteria: Results Regarding age, weight, height and duration of surgery; there were no statistically significant differences between the two studied groups. Comparison of the two studied groups revealed no statistically significant changes at all times of measurement. Conclusion Magnesium sulfate in a dose of 30 mg/kg IV infusion in 100 ml normal saline over 10 min is effective for control of post spinal shivering. Pethidine in a dose of 0.5 mg/kg IV bolus is effective for control of post spinal shivering.

scholarly journals Comparison of patient and surgeon satisfaction in patients undergoing knee arthroscopy with peripheral nerve block versus spinal anesthesia

2021 ◽  
Vol 6 (2) ◽  
pp. 148-152
Author(s):  
Seray Turkmen ◽  
◽  
Mehmet Mutlu
Keyword(s):  
Peripheral Nerve ◽  
Spinal Anesthesia ◽  
Nerve Block ◽  
Knee Arthroscopy ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Surgeon Satisfaction

Objective. This study aims to compare two different methods of regional anesthesia applied for knee arthroscopy in terms of patient and surgeon satisfaction. Materials and Methods. Eighty patients who underwent knee arthroscopy either with spinal anesthesia (SA) or unilateral sciatic and femoral nerve block (SFNB) were included in the study. A nurse conducted a blind study questionnaire to assess the surgeon and patient satisfaction from anesthesia performed at the end of the surgery. Pain score, demographical data, duration of surgery, motor and sensory block duration, time of first rescue analgesia were recorded and analyzed statistically. Results. A statistically significant difference was found between the patient (p = 0.001; p <0.01) and surgeon (p = 0.022; p <0.05) satisfaction rates, these being lower in the group with SFNB comparable to patients with spinal anesthesia. There was a statistically significant difference between the first analgesic requirements of the patients according to the groups (p = 0.001; p <0.01). The first analgesic requirement of the patients who received SFNB was later than in the case of patients who received spinal anesthesia. Conclusions. Patient and surgeon satisfaction with SA was significantly higher than SFNB. The peripheral nerve blocks are inadequate for patient and surgeon satisfaction for knee arthroscopy compared to SA.

scholarly journals Prevention of Shivering during Spinal Anesthesia: Comparison between Tramadol, Ketamine and Ondansetron

2017 ◽  
Vol 56 (208) ◽  
pp. 395-400 ◽  
Author(s):  
Gajal Lakhe ◽  
Krishna Murari Adhikari ◽  
Kiran Khatri ◽  
Anil Maharjan ◽  
Akriti Bajracharya ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Controlled Study ◽  
Sensory Blockade ◽  
Duration Of Surgery ◽  
Keywords Anesthesia ◽  
Baseline Temperature ◽  
Recorded Data ◽  
Prophylactic Use ◽  
American Society ◽  
Group 1

Introduction: Shivering is an unpleasant experience after spinal anesthesia. We conducted this study to evaluate the efficacy of ondansetron, ketamine and tramadol for prevention of shivering. Methods: In this prospective, randomized controlled study, 120 patients aged 18-65 years of American Society of Anesthesiologist (ASA) physical status I&II undergoing various surgical procedures were included and allocated alternately to one of the 4 groups; Normal saline (Group1), Ondansetron 4mg (Group2), Ketamine 0.25mg/kg (Group3) and Tramadol 0.5mg/kg (Group4). Incidence of shivering, effect on hemodynamics, nausea, vomiting, sedation and emergence reactions were recorded. Data was analyzed using SPSS (The Statistical Package for Social Sciences) version 20.0 software. Results: The patients were comparable in terms of demographic variables, baseline temperature, type of surgery, median level of sensory blockade, duration of surgery and anesthesia. Shivering was present in 17 (56.7%), 5 (16.7%), 3 (10%) and 3 (10%) patients respectively in Group 1, 2, 3 and 4 which was statistically significant when compared to Group 1 (P=0.00) The odds of NS and ondansetron, NS and ketamine, NS and tramadol was 6.53, 11.76 and 11.76 respectively which showed that study drugs were effective in preventing shivering. None of the patients were sedated in Group 1 and 2. Mild to moderate sedation was present in Group 3 and 4 (P=0.00). None of the patients had drug related adverse reactions. Conclusions: Prophylactic use of ondansetron, low doses of ketamine and tramadol is effective in preventing shivering post spinal anesthesia without untoward effects. Keywords:  Anesthesia spinal; Ketamine; Ondansetron; Shivering; Tramadol.

Predictors of Hypothermia during Spinal Anesthesia

2000 ◽  
Vol 92 (5) ◽  
pp. 1330-1334 ◽  
Author(s):  
Steven M. Frank ◽  
Hossam K. El-Rahmany ◽  
Christine G. Cattaneo ◽  
Rachel A. Barnes
Keyword(s):  
Body Temperature ◽  
Spinal Anesthesia ◽  
Core Temperature ◽  
Room Temperature ◽  
Radical Retropubic Prostatectomy ◽  
Postanesthesia Care Unit ◽  
Body Habitus ◽  
Retropubic Prostatectomy ◽  
Duration Of Surgery ◽  
High Level

Background Body temperature often is ignored during regional anesthesia, despite evidence that hypothermia occurs commonly. Because hypothermia is associated with adverse clinical outcomes, it is important to recognize predictors of hypothermia and to monitor and control body temperature in patients at risk. The current study was designed to determine the predictors of core hypothermia in patients receiving spinal anesthesia for radical retropubic prostatectomy. Methods Forty-four patients undergoing radical retropubic prostatectomy were studied. A lumbar intrathecal injection of 18-22 mg bupivacaine, 0.75%, with 20 microg fentanyl was given. No active warming measures were used other than intravenous fluid warming. The following clinical variables were assessed as potential predictors of core (tympanic) temperature at admission to the postanesthesia care unit: duration of surgery, average ambient operating room temperature, body habitus, age, and spinal blockade level. Results The mean core temperature at admission to the postanesthesia care unit was 35.1 +/- 0.6 degrees C (range, 33.6-36.3 degrees C). Duration of surgery, ambient operating room temperature, and body habitus were not predictors of hypothermia. A high level of spinal blockade and increasing age were predictors of hypothermia. For each incremental increase in block level, core temperature decreased by 0.15 degrees C, and for each increase in age, core temperature decreased by 0.3 degrees C. Conclusions Although high-level spinal blockade has been associated with decreased thermoregulatory thresholds, no previous study has shown that a higher level of blockade is associated with a greater magnitude of core hypothermia in the clinical setting. As with general anesthesia, advanced age is associated with hypothermia during spinal anesthesia.

The Additional Effect of Magnesium Sulfate to Lidocaine in Spinal Anesthesia for Cesarean Section

2007 ◽  
Vol 3 (5) ◽  
pp. 425-427 ◽  
Author(s):  
M.D. Gita Shoeibi ◽  
M.D. Mustafa Sadegi ◽  
M.D. Abolfazl Firozian ◽  
M.D. Farzaneh Tabassomi
Keyword(s):  
Cesarean Section ◽  
Magnesium Sulfate ◽  
Spinal Anesthesia

Magnesium sulfate at two different doses as an adjuvant to bupivacaine in infraumblical (below knee) orthopedic surgeries under spinal anesthesia

2016 ◽  
Vol 9 (3) ◽  
pp. 416
Author(s):  
Shelly Rana ◽  
SudarshanKumar Chaudhary ◽  
RavinderKumar Verma ◽  
Jai Singh ◽  
Amruth Danesh
Keyword(s):  
Magnesium Sulfate ◽  
Spinal Anesthesia ◽  
Different Doses

Afferent-Induced Changes in Rhythmic Motor Programs in the Feeding Circuitry of Aplysia

2004 ◽  
Vol 92 (4) ◽  
pp. 2312-2322 ◽  
Author(s):  
Avniel N. Shetreat-Klein ◽  
Elizabeth C. Cropper
Keyword(s):  
Sensory Neurons ◽  
Motor Neurons ◽  
Rhythmic Activity ◽  
Motor Program ◽  
Firing Frequency ◽  
Afferent Activity ◽  
Motor Programs ◽  
Rhythmic Motor ◽  
Induced Changes ◽  
The Impact

A manipulation often used to determine whether a neuron plays a role in the generation of a motor program involves injecting current into the cell during rhythmic activity to determine whether activity is modified. We perform this type of manipulation to study the impact of afferent activity on feeding-like motor programs in Aplysia. We trigger biting-like programs and manipulate sensory neurons that have been implicated in producing the changes in activity that occur when food is ingested, i.e., when bites are converted to bite-swallows. Sensory neurons that are manipulated are the radula mechanoafferent B21 and the retraction proprioceptor B51. Data suggest that both cells are peripherally activated during radula closing/retraction when food is ingested. We found that phasic subthreshold depolarization of a single sensory neuron can significantly prolong radula closing/retraction, as determined by recording both from interneurons (e.g., B64), and motor neurons (e.g., B15 and B8). Additionally, afferent activity produces a delay in the onset of the subsequent radula opening/protraction, and increases the firing frequency of motor neurons. These are the changes in activity that are seen when food is ingested. These results add to the growing data that implicate B21 and B51 in bite to bite-swallow conversions and indicate that afferent activity is important during feeding in Aplysia.

scholarly journals Cortical Oscillations during Gait: Wouldn’t Walking Be So Automatic?

2020 ◽  
Vol 10 (2) ◽  
pp. 90 ◽  
Author(s):  
Arnaud Delval ◽  
Madli Bayot ◽  
Luc Defebvre ◽  
Kathy Dujardin
Keyword(s):  
Posterior Parietal Cortex ◽  
Brain Activity ◽  
Muscular Activity ◽  
Cortical Activity ◽  
Muscular Contraction ◽  
Gait Pattern ◽  
Cortical Control ◽  
Time Frequency ◽  
Cortical Oscillations ◽  
Induced Changes

Gait is often considered as an automatic movement but cortical control seems necessary to adapt gait pattern with environmental constraints. In order to study cortical activity during real locomotion, electroencephalography (EEG) appears to be particularly appropriate. It is now possible to record changes in cortical neural synchronization/desynchronization during gait. Studying gait initiation is also of particular interest because it implies motor and cognitive cortical control to adequately perform a step. Time-frequency analysis enables to study induced changes in EEG activity in different frequency bands. Such analysis reflects cortical activity implied in stabilized gait control but also in more challenging tasks (obstacle crossing, changes in speed, dual tasks…). These spectral patterns are directly influenced by the walking context but, when analyzing gait with a more demanding attentional task, cortical areas other than the sensorimotor cortex (prefrontal, posterior parietal cortex, etc.) seem specifically implied. While the muscular activity of legs and cortical activity are coupled, the precise role of the motor cortex to control the level of muscular contraction according to the gait task remains debated. The decoding of this brain activity is a necessary step to build valid brain–computer interfaces able to generate gait artificially.

scholarly journals Dexmedetomidine versus magnesium sulfate as an adjuvant to local anesthetics in spinal anesthesia: a meta-analysis of randomized controlled trials

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094617
Author(s):  
Jinguo Wang ◽  
Zaitang Wang ◽  
Xuesong Song ◽  
Na Wang
Keyword(s):  
Randomized Controlled Trials ◽  
Magnesium Sulfate ◽  
Spinal Anesthesia ◽  
Local Anesthetics ◽  
Sensory Block ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Sensory Blockade ◽  
Randomized Controlled ◽  
Significant Difference

Objective To compare the efficacy of dexmedetomidine and magnesium sulfate as an adjuvant to local anesthetics in spinal anesthesia. Methods A search of PubMed, Medline, Embase, the Cochrane Library, and Google Scholar was performed. Randomized controlled trials comparing the efficacy of dexmedetomidine and magnesium sulfate as a local anesthetic adjuvant in spinal anesthesia were identified. The primary outcome was sensory block duration. The mean difference (MD) or odds ratio along with the 95% confidence interval (CI) was used to analyze the outcomes. Results Six studies involving 360 patients were included. Intrathecal dexmedetomidine was associated with a significantly longer sensory block duration (MD = −73.62; 95% CI = −101.09 to −46.15), faster onsets of sensory blockade and motor blockade, and a longer motor block duration than intrathecal magnesium sulfate. There was no significant difference between the regarding the rates of hypotension, bradycardia, shivering, and postoperative nausea and vomiting between the groups. Conclusions Dexmedetomidine is superior to magnesium sulfate as an adjuvant to local anesthetics in spinal anesthesia because of its more rapid onset and longer duration of spinal block without significant adverse effects.

Low Back Pain in Pregnancy

2003 ◽  
Vol 21 (1-2) ◽  
pp. 36-41 ◽  
Author(s):  
Max Forrester
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Acupuncture Points ◽  
Low Back ◽  
Patient Consent ◽  
The Subject ◽  
Control Pain ◽  
Risk Benefit Analysis ◽  
Informed Patient ◽  
In Pregnancy

The aim of this case report is to discuss the subject of acupuncture in pregnancy and which acupuncture points, or areas, are safe to needle. Low back pain in a 21-year-old Caucasian primigravida at 24 weeks gestation was incapacitating and acupuncture was offered. Prior to pregnancy investigations had excluded a serious organic cause and acupuncture was employed successfully to control pain and improve function. Acupuncture can be offered to sufferers of low back pain in pregnancy after risk / benefit analysis is undertaken and informed patient consent is obtained.

A method for measuring drug-induced changes in limb muscle tone in the rat

1982 ◽  
Vol 5 (1-2) ◽  
pp. 195-200 ◽  
Author(s):  
S.L. Dickinson ◽  
D.A. Longman ◽  
P. Slater
Keyword(s):  
Muscle Tone ◽  
Limb Muscle ◽  
Drug Induced ◽  
Induced Changes
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