scholarly journals An Epidural Anaesthetic with Unusual Complications

1978 ◽  
Vol 6 (3) ◽  
pp. 263-264 ◽  
Author(s):  
Elizabeth Maycock

Respiratory paralysis and prolonged duration of anaesthesia followed lumbar epidural block with bupivacaine. Subdural, extra arachnoid block is postulated.

1981 ◽  
Vol 9 (2) ◽  
pp. 150-153 ◽  
Author(s):  
N. Soni ◽  
R. Holland

Following lumbar epidural anaesthetic a 17-year-old primigravida developed a sensory block extending to C6 and a motor block affecting her legs, arms and intercostal muscles. The progression of clinical events suggests a subdural injection of bupivacaine.


2021 ◽  
Vol 8 (4) ◽  
pp. 561-566
Author(s):  
Nishit Sud ◽  
Sunil Sinha

Vaginal hysterectomy Surgery with long acting local anaesthetic like bupivacaine still requires higher doses of analgesics in the post-operative period. Dexmedetomidine is highly selective αadrenoreceptor agonist and sympatholytic drug is a useful adjunct drug in patients undergoing vaginal hysterectomy under continuous spinal epidural block (CSE). We sought to study duration of perioperative analgesia, observe the intra-operative and post-operative hemodynamic changes and post-operative sedation effect of dexmedetomidine.: The study groups were divided as Group D (study group) administered 1 µg/kg Dexmedetomidine and Group C (control group) administered 0.9% saline drip at the rate of 1ml/kg. Dexmedetomidine group had prolonged duration of sensory blockade, duration for 2 dermatomal regression of sensory blockade and the duration for motor block regression to Modified Bromage scale 0. This group had prolonged duration of Time to first request for rescue analgesic.14% patients required mephentermine for management of hypotension.Intraoperative diastolic blood pressure (DBP) was lower in study group while Intraoperative Systolic blood pressure (SBP) was comparable in both the groups. Intravenous dexmedetomidine significantly decreases the heart rate and is associated with higher incidence of bradycardia. It is effective in providing postoperative analgesia and in preventing postoperative shivering with reduced incidence of postoperative nausea and vomiting.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sahar Kamal Mohamed Abo Elela ◽  
Dalia Abd Elhamid Nasr ◽  
Maha Sadek Elderh ◽  
Karim Mohamed Salah Elgawish

Abstract Background Epidural anesthesia is one of the preferred modes of regional anesthesia for lower limb orthopedic surgeries. This technique provides not only peri-operative anesthesia but also post-operative analgesia. Bupivacaine is commonly used local anesthetic in epidural anesthesia, many adjuvants added to local anesthetics to enhance the quality and duration of surgical anesthesia, among them are opioids, alpha 2 agonists. Opioids like fentanyl have been a popular choice, it offers faster onset and prolongs the duration of analgesia. Recently, alpha 2 agonists like clonidine and dexmedetomidine have been also used in prolonging the duration of epidural analgesia. Aim of the Work To compare the efficacy of using fentanyl and dexmedetomidine with bupivacaine in epidural block for knee surgeries, the time of onset of sensory, motor blockade and the duration of this blockade. Patients and Methods After obtaining approval from the Research Ethical Committee of Ain Shams University, this study was conducted in the operating theatres of Ain Shams University Hospital. It was a prospective double-blind randomized clinical study. Study period was 6 months. Results A total of 50 patients out of 71 consecutive patients met the inclusion criteria and consented for study. These 50 patients were randomized into two groups of 25 each. Out of the total patients, 33 were male and 17 were female. Conclusion Dexmedetomidine as an adjuvant to epidural bupivacaine is a better alternative to fentanyl as it shows faster onset of sensory and motor block, lesser time to attain maximum sensory level and prolonged duration of anesthesia.


1985 ◽  
Vol 53 (01) ◽  
pp. 095-098 ◽  
Author(s):  
C R Jones ◽  
R McCabe ◽  
C A Hamilton ◽  
J L Reid

SummaryPaired blood samples were obtained from mothers (venous) and babies (cord venous blood) at the time of delivery by caesarean section under epidural anaesthetic. Fetal platelets failed to aggregate in response to adrenaline in vitro although adrenaline could potentiate the threshold response to adenosine diphosphate (1 μM). Fetal platelet responses to collagen and 8 Arg vasopressin did not differ significantly from maternal responses. Maternal and fetal platelets also showed similar inhibition of aggregation after activation of adenylate cyclase (PGE1 and parathormone), in contrast to the inhibition of adenylate cyclase by adrenaline.Alpha2 adrenoceptors were investigated using [3H] yohimbine binding receptor number and were reduced modestly but significantly on fetal compared to maternal platelets. The failure of fetal platelet aggregation in response to adrenaline appears to be related to a failure of receptor coupling and may represent a delayed maturation of fetal platelet alpha receptors or a response- to increased circulating catecholamines during birth.


1961 ◽  
Vol 38 (1) ◽  
pp. 73-87 ◽  
Author(s):  
Christian Lauritzen ◽  
Semih Velibese

ABSTRACT A description is given of experimental investigations and preliminary clinical experience with the long-acting oestriol compound polyoestriol phosphate – a water-soluble polymere of oestriol and phosphoric acid. The compound seems to exert all the physiologically important effects of oestriol. Even with high doses the hormone causes no proliferation of the endometrium and no withdrawal bleeding. It has no untoward effect on metabolism. It decreases slightly the cholesterol concentration (to the extent of ⅓–⅕ of the effect produced by long-acting oestradiol esters). The compound has a wide therapeutic range. No side-effects have been observed. Doses of 10 mg or more have a prolonged duration. Additional prolongation of the effect is largely dependent on dosage. To ensure an effect lasting for 4 weeks 40 mg polyoestriol phosphate (corresponding with 30 mg oestriol) is required – an amount which roughly corresponds with physiological quantitative data. The compound, which involves an interesting new principle of prolongation, was most effectively used in the treatment of menopausal symptoms and genital organic disorders. For these indications it can be recommended without reservation.


2020 ◽  
Vol 22 (1) ◽  
pp. 104
Author(s):  
Peter Franz ◽  
Wiebke Ewert ◽  
Matthias Preller ◽  
Georgios Tsiavaliaris

The actomyosin system generates mechanical work with the execution of the power stroke, an ATP-driven, two-step rotational swing of the myosin-neck that occurs post ATP hydrolysis during the transition from weakly to strongly actin-bound myosin states concomitant with Pi release and prior to ADP dissociation. The activating role of actin on product release and force generation is well documented; however, the communication paths associated with weak-to-strong transitions are poorly characterized. With the aid of mutant analyses based on kinetic investigations and simulations, we identified the W-helix as an important hub coupling the structural changes of switch elements during ATP hydrolysis to temporally controlled interactions with actin that are passed to the central transducer and converter. Disturbing the W-helix/transducer pathway increased actin-activated ATP turnover and reduced motor performance as a consequence of prolonged duration of the strongly actin-attached states. Actin-triggered Pi release was accelerated, while ADP release considerably decelerated, both limiting maximum ATPase, thus transforming myosin-2 into a high-duty-ratio motor. This kinetic signature of the mutant allowed us to define the fractional occupancies of intermediate states during the ATPase cycle providing evidence that myosin populates a cleft-closure state of strong actin interaction during the weak-to-strong transition with bound hydrolysis products before accomplishing the power stroke.


2013 ◽  
Vol 79 (7) ◽  
pp. 1095-1099 ◽  
Author(s):  
Claudio Oliviero ◽  
Stefan Kothe ◽  
Mari Heinonen ◽  
Anna Valros ◽  
Olli Peltoniemi
Keyword(s):  

Zygote ◽  
2021 ◽  
pp. 1-6
Author(s):  
Victor Tosin Okomoda ◽  
Haziqah Jumahat Nursyaza ◽  
Ijabo Oga Samuel ◽  
Anuar Hassan ◽  
Abraham Sunday Oladimeji ◽  
...  

Summary The optimum distance and duration of ultraviolet (UV) irradiation for the complete inactivation of African catfish Clarias gariepinus egg nucleus was investigated in this study. The UV light was suspended above the unfertilized eggs at four distances (5, 10, 20 and 30 cm) and for five durations (1, 2, 3, 4 and 5 min). Then, the irradiated eggs were activated with sperm from diploid C. gariepinus and cold shocked at 5°C for 5 min just moments before cell cleavage. Ploidy analysis was performed using karyotype chromosome counting. The results obtained suggested that the further the distance, the better the hatchability rate, however prolonged duration seemed to significantly reduced hatchability. All treatments with surviving progenies at the end of the study showed evidence of successfully diploid gynogen (2n = 56) induction at different percentages. However, the optimal protocol that gave a moderately high hatchability/survival rate and completely induced gynogens was exposure of the eggs to UV irradiation at 20 cm for 1 min. It was concluded that the distance and duration of UV irradiation affects gynogenetic induction in African catfish C. gariepinus.


2019 ◽  
Vol 147 ◽  
Author(s):  
L. J. Robertson ◽  
T. T. Temesgen ◽  
K. R. Tysnes ◽  
J. E. Eikås

AbstractIn the autumn of 2018, an outbreak of cryptosporidiosis affected adult employees from the same company in Western Norway. The organism wasCryptosporidium parvum, GP60 subtype IIaA14G1R1. All those infected had drunk from the same container of self-pressed apple juice. Incubation period (1 week) and clinical signs were similar among those infected, although some experienced a more prolonged duration of symptoms (up to 2–3 weeks) than others. The infections resulted after consumption from only one of 40 containers of juice and not from any of the other containers. It seems that althoughCryptosporidiumoocysts were detected in a sample from another container, the contamination did not affect the whole batch. This is perhaps indicative of a restricted contamination event, either from contaminated ground in the orchard, or during collection of the fruit, or during processing. Although outbreaks of food-borne cryptosporidiosis have previously been associated with consumption of contaminated apple juice, most of the more recent outbreaks of food-borne cryptosporidiosis have been associated with salad vegetables or herbs. This outbreak, the first outside USA reported to be associated with apple juice, is a timely reminder that such juice is a suitable transmission vehicle forCryptosporidiumoocysts, and that appropriate hygienic measures are essential in the production of such juice, including artisanal (non-commercial) production.


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