scholarly journals Complete spinal block after spinal anesthesia with low-dose bupivacaine in the elderly

2015 ◽  
Vol 1 (10) ◽  
Author(s):  
Nguyen Trung Kien ◽  
Nguyen Truong Giang ◽  
Sinh Nguyen ◽  
Nguyen Ngoc Thach ◽  
Vo Van Hien
Keyword(s):  
Spinal Anesthesia ◽  
Low Dose ◽  
The Elderly ◽  
Spinal Block

scholarly journals PERIOPERATIVE EFFECTS OF INTRATHECAL CLONIDINE AND FENTANYL WITH HYPERBARIC BUPIVACAINE IN SPINAL ANESTHESIA FOR VAGINAL HYSTERECTOMY

2016 ◽  
Vol 9 (5) ◽  
pp. 245
Author(s):  
Suman Chattopadhyay ◽  
Mallika Datta ◽  
Biswanath Biswas
Keyword(s):  
Placebo Group ◽  
Spinal Anesthesia ◽  
Low Dose ◽  
Mechanisms Of Action ◽  
Spinal Block ◽  
Hyperbaric Bupivacaine ◽  
Prolonged Duration ◽  
Group A ◽  
Group B ◽  
Intrathecal Clonidine

ABSTRACTObjectives: Intrathecal fentanyl and clonidine are effective analgesics with different mechanisms of action. This study compares 25 µg of both thesedrugs given intrathecally regarding onset, quality, and duration of hyperbaric bupivacaine-induced spinal block and side effects.Methods: A total of 90 patients of ASA I and II were randomly allocated into three equal groups. Group A received 0.5 ml of 0.9% normal saline(placebo), Group B and Group C received 25 µg fentanyl and clonidine intrathecally added to 2.5 ml of 0.5% hyperbaric bupivacaine, respectively. Theonset and regression time of sensory and motor blocks were recorded along with hemodynamic change, side effects, pain intensity (in terms of visualanalog score (VAS), and time to first rescue analgesic.Results: Intrathecal clonidine (25 μg) significantly prolongs sensory and motor blocks, with prolonged duration of analgesia in comparison withintrathecal fentanyl (25 µg) (325±15 minutes vs. 240±7.6 minutes). VAS score was similar, but sedation was more in clonidine group.Conclusion: We conclude that low-dose intrathecal clonidine is an effective adjuvant to bupivacaine for spinal anesthesia and provides betterpostoperative analgesia in comparison with intrathecal fentanyl.Keywords: Clonidine, Fentanyl, Bupivacaine, Regional, Spinal, Postoperative pain.

scholarly journals The Levels and Duration of Sensory and Motor Blockades of Spinal Anesthesia in Obese Patients That Underwent Urological Operations in the Lithotomy Position

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Taner Ciftci ◽  
Ali Bestemi Kepekci ◽  
Hatice Pınar Yavasca ◽  
Hayrettin Daskaya ◽  
Volkan İnal
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Spinal Anesthesia ◽  
Tissue Blood Flow ◽  
Spinal Block ◽  
Lithotomy Position ◽  
Obese Patients ◽  
Hemodynamic Changes ◽  
Nonobese Patients ◽  
Transurethral Prostate Resection

Obesity has a significant effect on the cephalic spread of a spinal block (SB) due to a reduction in cerebrospinal fluid (CSF). SB is controlled by the tissue blood flow in addition to the CSF. Some positions and techniques of surgery used can cause changes in hemodynamics. We investigated effects of hemodynamic changes that may occur during Transurethral prostate resection (TUR-P) and lithotomy position (LP) at the SB level in obese versus nonobese individuals. Sixty patients who had undergone TUR-P operation under spinal anesthesia were divided into a nonobese (BMI<25 kg/m2, Group N) or obese (BMI≥30 kg/m2, Group O) group. SB assessments were recorded afterthe LP. SB at 6 and 120 min and the peak SB level were compared between two groups. Hemodynamics were recorded after LP. Peak and 6 min SB levels were similar between the groups, while 120 min SB levels were significantly higher for Group O (P<0.05). Blood pressure (BP) after the LP was significantly higher for Group N (P<0.05). LP and TUR-P increased the BP in Group N when compared to Group O. The increase in hemodynamics enhances the blood flow in the spinal cord and may form similar SB levels in nonobese patients to those in obese patients. However, SB time may be longer in obese patients.

scholarly journals Sufentanil in combination with low-dose hyperbaric bupivacaine in spinal anesthesia for cesarean section: a randomized clinical trial

2016 ◽  
Vol 66 (6) ◽  
pp. 622-627 ◽  
Author(s):  
Alexandre Dubeux Dourado ◽  
Ruy Leite de Melo Lins Filho ◽  
Raphaella Amanda Maria Leite Fernandes ◽  
Marcelo Cavalcanti de Sá Gondim ◽  
Emmanuel Victor Magalhães Nogueira
Keyword(s):  
Clinical Trial ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Randomized Clinical Trial ◽  
Low Dose ◽  
Hyperbaric Bupivacaine

Hemodynamic Effects of Spinal Anesthesia in the Elderly

1997 ◽  
Vol XLI (2) ◽  
pp. 92
Author(s):  
J. F. FAVAREL-GARRIGUES ◽  
F. SZTARK ◽  
M. E. PETITJEAN ◽  
M. Thicp?? ◽  
P. Lassi?? ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
The Elderly ◽  
Hemodynamic Effects

scholarly journals Assessment of Maternal Satisfaction and Associated Factors among Parturients Who Underwent Cesarean Delivery under Spinal Anesthesia at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2019

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Samuel Debas Bayable ◽  
Seid Adem Ahmed ◽  
Girmay Fitiwi Lema ◽  
Debas Yaregal Melesse
Keyword(s):  
Logistic Regression ◽  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Associated Factors ◽  
Northwest Ethiopia ◽  
Anesthetic Technique ◽  
Spinal Block ◽  
Maternal Satisfaction ◽  
Cross Sectional ◽  
Multivariable Logistic Regression

Background. Spinal anesthesia is the most common anesthetic technique for cesarean delivery. Patient satisfaction is a subjective and complicated concept, involving physical, emotional, psychological, social, and cultural factors. Regular evaluation of maternal satisfaction related to anesthesia service is an important parameter to the required changes and expansion of high-quality care services. We aimed to assess maternal satisfaction and associated factors among parturients who underwent cesarean delivery under spinal anesthesia. Methods. Institutional-based cross-sectional study was conducted from February to May 2019. A total of 383 parturients were enrolled to assess maternal satisfaction using a 5-point Likert scale. Both bivariable and multivariable logistic regression analyses were done. Variables of p value ≤0.2 in the bivariable analysis were a candidate for multivariable logistic regression. A p value <0.05 was considered as significantly associated with maternal satisfaction at 95% CI. Results. This study revealed that 315 (82.3%) of the parturients were satisfied. Single spinal prick attempts (AOR = 2.08, 95% CI = 1.05–4.11), successful spinal block (AOR = 7.17, 95% CI = 3.33–15.43), less incidence of postdural puncture headache (AOR = 2.36, 95% CI = 1.33–4.20), and prophylactic antiemetic use (AOR = 0.35, 95% CI = 0.19–0.66) were positively associated with maternal satisfaction. Conclusions. The overall maternal satisfaction receiving spinal anesthesia was considerably low. Single spinal prink attempts, successful spinal block, and less incidence of postural puncture headache can increase maternal satisfaction. Therefore, effective perioperative management, skillful techniques, and using the small-gauge Quincke spinal needle (25–27 gauge) may increase the maternal satisfaction and quality of spinal anesthesia management.

Low-dose S-ketamine for postoperative pain in cesarean section with spinal anesthesia

2007 ◽  
Vol 24 (Supplement 39) ◽  
pp. 144
Author(s):  
E. Suppa ◽  
R. Pinto ◽  
B. A. Zanfini ◽  
A. Valente ◽  
G. Draisci
Keyword(s):  
Postoperative Pain ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Low Dose

scholarly journals Amiodarone Toxicity Screening: What are the Clinicians Supposed to Tell Patients

2020 ◽  
pp. 1-5
Author(s):  
John D Rozich ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Low Dose ◽  
The Elderly ◽  
Toxicity Screening ◽  
Nonvalvular Atrial Fibrillation ◽  
Routine Testing ◽  
Continued Use

The use of amiodarone in clinical practice continues to be widespread in the setting of nonvalvular atrial fibrillation (NVAF). Use of amiodarone continues especially in the elderly where the drug’s favorable characteristics and outcomes in the setting of chronic kidney disease coupled to its low inherent proarrhythmic profile has ensured its continued use. The present work focuses on the information that clinicians should tell their patients regarding requisite toxicity screening during daily treatment with amiodarone when it is maintained at a low dose of 200 mgs per day or less. Several questions need be answered in pursuit of the fundamental query as to whether routine testing for toxicity should still be advised. Most importantly, has ongoing screening shown to be of any proven value?

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