scholarly journals Spinal Myoclonus – A rare complication of spinal anaesthesia

Author(s):  
M S Prabhu

Spinal segmental myoclonus is a rare type of myoclonic disorder that may occur during spinal anaesthesia. A few cases of spinal myoclonus have been reported after administration of intrathecal bupivacaine. The exact cause and pathophysiology of spinal myoclonus is unknown. We report a case of a 28-year-old female who underwent caesarean section under spinal anaesthesia with 0.5% hyperbaric bupivacaine. Myoclonic movements appeared in the early postoperative period in the left lower limb. The myoclonus was acute and transient. The patient recovered completely without any neurological complications. After ruling out all the possible causes, spinal myoclonus diagnosis was made, and the patient was discharged on the 3rd postoperative day. Keywords: Spinal anaesthesia, Spinal myoclonus, Myoclonus

2019 ◽  
Vol 07 (01) ◽  
pp. e51-e54
Author(s):  
Mila Stajevic ◽  
Milorad Bijelovic ◽  
Jovan Kosutic ◽  
Radoje Simic

AbstractThe modified Ravitch technique with metal struts and the Nuss operation have been the dominant operative techniques for treatment of pectus excavatum in the previous decades. We present devastating postoperative complications of a 16-year-old boy after the modified Ravitch procedure for a severe deformity utilizing two metal bars. Four months following surgery, one strut was removed after the displacement noted on a regular postoperative examination. Ten days after the strut removal, the patient complained of lower limb pain but the sensations were attributed to physical inactivity. Two months later, after pain intensification, the boy was diagnosed with bilateral arterial and venous lower limb thromboses and subsequently, the migration of the remaining metal strut intracardially with the free end in the left ventricular cavity embedded in massive thrombi. An urgent cardiac procedure was performed and the bar removed. Postoperatively, the boy made a full cardiac recovery but with severe neurological complications and subsequent death. Migration of metal struts is a rare complication and, except in our case, had been dealt with successfully. This case should emphasize more attention to the postoperative follow-up management of such patients.


2006 ◽  
Vol 23 (4) ◽  
pp. 285-291 ◽  
Author(s):  
S. Karaman ◽  
S. Kocabas ◽  
M. Uyar ◽  
S. Hayzaran ◽  
V. Firat

2021 ◽  
Vol 71 (6) ◽  
pp. 2078-81
Author(s):  
Hina Iftikhar ◽  
Aneel Aslam ◽  
Habib Ur Rehman ◽  
Zulfiqar Ali ◽  
Mohammad Ali Abbass ◽  
...  

Objective: To compare the effect of 0.5% and 0.75% hyperbaric Bupivacaine on haemodynamic stability in terms of mean systolic blood pressure and heart rate recorded at 4 min in patients undergoing caesarian section in spinal anesthesia. Study Design: Quasi experimental study. Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital, Malir, from Jul to Dec 2018. Methodology: The patients were assigned in two groups (A and B) using lottery method. Group A received 0.5% hyperbaric Bupivacaine solution. Group B received 0.5% hyperbaric Bupivacaine solution. Spinal anaesthesia was given, blood pressure and heart rate were recorded. Data were analyzed in SPSS version 23. Both groups were compared for mean systolic blood pressure and heart rate by using independent sample t-test. Results: The mean age of patients was 29.62 ± 6.21 years in 0.75% Bupivacaine group while 29.31 ± 6.20 years in 0.5% Bupivacaine group. The mean systolic blood pressure of patients was 111.63 ± 5.96 mmHg in 0.75% Bupivacaine group while 117.16 ± 7.12 mmHg in 0.5% Bupivacaine group. The difference was significant in both groups (p-value <0.05). The mean heart rate of patients was 92.27 ± 4.71 beats per min (bpm) in 0.75% Bupivacaine group while 97.68 ± 4.58 bpm in 0.5% Bupivacaine group. The difference was significant in both groups (p-value <0.05). Conclusion: 0.5% hyperbaric Bupivacaine was better than 0.75% hyperbaric Bupivacaine solution in spinal anaesthesia during caesarean section.


2009 ◽  
Vol 20 (2) ◽  
pp. 61-65 ◽  
Author(s):  
Md Raihan Uddin ◽  
Lutful Aziz ◽  
SN Samad Choudhury

The aim of the study was to compare the antiemetic effects of oral ondansetron (8mg) and granisectron (2mg) for prevention of PONV following elective caesarean section. Ninety parturients scheduled for elective caesarean section under spinal anaesthesia were randomly allocated into three groups. Group A (n=30) were received vitamin tab, group B (n=30) parturients were received oral ondansectron (8mg) & group C (n=30) parturients were received oral granisetron (2mg). Anesthetic procedure was common to all groups. Emetic episodes in early postoperative period (1st 24 hrs.) were recorded and compared in different study groups. Emetic episodes were observed in six parturients (20%) in group A (control), 3 parturients in group B (3%) and 3 parturients in group C (3%). So to conclude, minimal emetic episodes were observed in early postoperative period in parturients who had received ondensetron or granisetron than the control group. Keywords: LUCS, PONV, Ondansetron, and Granisetron. Journal of BSA, Vol. 20, No. 2, July 2007 p.61-65


1996 ◽  
Vol 77 (2) ◽  
pp. 145-149 ◽  
Author(s):  
C J Chung ◽  
S H Bae ◽  
K Y Chae ◽  
Y J Chin

2021 ◽  
Vol 15 (6) ◽  
pp. 2153-2155
Author(s):  
Arshi Naz ◽  
Mirza Shahzad Baig ◽  
Vijai Kumar ◽  
Samita S Khan ◽  
Sidra Javed ◽  
...  

Objective: To compare the analgesic effectiveness of Dexmedetomidine and Fentanyl as an adjuvant to 0.5% Bupivacaine in spinal anaesthesia for patients undergoing lower limb surgery. Study Design: Randomized controlled trial. Place & Duration:The study was conducted at department of Anesthesia, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi for duration from 15thJuly2020 to 15thFebruary 2021. Methods: In this study 52 patients of both genders undergoing lower limb surgeries were included. Patient’s ages were ranging from 20 to 70 years. All the patients were divided into two Groups. Group A included 26 patients and received Inj. Dexmedetomidine 10 μg in 0.5ml normal saline with 12.5mg of 0.5% hyperbaric bupivacaine, Group B had 26 patients and received 25mg fentanyl with 12.5mg of 0.5% hyperbaric bupivacaine. Time to achieve T10 blockade, time to first rescue analgesia were examined and compare between both groups. All the statistical data was analyzed by SPSS 24.0. P-Value <0.05 was significantly considered. Results: Mean age of group A was 40.52±12.28 years and in group B it was 40.14±13.34 years. There were 18 (69.23%) male patients and 8 (30.77%) females in group A while in Group B 19 (73.08%) patients were male and 7 (26.92%) were females. No significant difference was observed between both groups regarding time to T10 blockade with p-value >0.05. A significant difference was found regarding time to rescue analgesia, in Group A it was 426.58±92.44 minutes and in Group B, it was 206.44±48.47 minutes (p-value <0.0001). Patients’ satisfaction was high in dexemedetomidine group as compared to fentanyl group. Conclusion: Dexmedetomidine 10 μg with 0.5% bupvicaine showed better effectiveness regarding time to first rescue analgesia as compared to fentanyl. No significant difference was observed regarding time to sensory blockade between both medications. Keywords: Dexmedetomidine, Fentanyl, Spinal Anaesthesia, Lower Limb Surgery, Sensory Block, Analgesia


2009 ◽  
Vol 20 (2) ◽  
pp. 51-55
Author(s):  
MA Karim ◽  
Debasish Banik ◽  
Abdul Hye ◽  
Qumrul Huda ◽  
MMH Laskar ◽  
...  

Ninety unpremeditated patients (20-40 years) undergoing caesarean section were allocated randomly to receive 0.5% hyperbaric bupivacaine 2ml at the site of L2-3, L3-4 and L4-5 intervertebral space. Spinal injection was performed to all patients with a 25-gauge Quincke spinal needle. The onset time of analgesia at T10 and T6 was significantly faster and the level of analgesia at 5 and 10 min was significantly higher after injection at L2-3. But the maximum height (T4) of analgesia at 15 and 20 min after injection and the number of episodes of hypotension were not significantly different among the three groups. Key words: Spinal anaesthesia, hyperbaric bupivacaine, site of injection, spread of anaesthesia.   Journal of BSA, Vol. 20, No. 2, July 2007 p.51-55


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