Volume 2 Issue 1
Bladder Distension Precipitates Severe Bradycardia Under Spinal Anaesthesia
A 73 years old gentleman scheduled for TURP, suffering from coronary heart disease and chronic atrial fibrillation (AF). His pre-hospital admission medication included isosorbide dinitrate 40 mg twice daily orally, digoxin 0.25 mg and aspirin 75 mg orally daily. Preoperative examination and investigations confirmed the diagnosis of AF; otherwise, he had compensated cardiac conditions.
Neuroleptic Malignant Syndrome and Dantrolene. A Case Report
Gustavo Cruz Suarez MD*, Sergio Jaramillo MD, Beatriz Sanchez MD, Fredy Ariza MD, Angy Cruz MD
Neuroleptic malignant syndrome is a rare condition; manifestations include severe autonomic dysfunction, hyperthermia and muscle rigidity, among others. This may occur in response to drugs that interact with dopaminergic pathways. Diagnosis of this syndrome is mainly clinical since there is no specific laboratory test for this condition and it has a high mortality rate given its multiorgan involvement. This is a case report of a patient who developed neuroleptic malignant syndrome that was managed with supportive therapy and dantrolene.
Comparison of Peripheral Nerve Blocks vs. Local Tissue Infiltration for Wrist Surgery: Effect on Postoperative Outcomes
Ofelia L. Elvir-Lazo, M.D, Paul F. White, PhD, MD*, Dermot P. Maher, MD MS, Stuart H Kuschner, MD, David A Kulber MD, Myles J Cohen MD, Christine Pham, BA, Roya Yumul MD, PhD, Ronald H. Wender MD
Local anesthetics are frequently administered during superficial ambulatory surgery procedures to reduce intra- and postoperative pain scores and opioid requirements. We designed a study to compare the analgesic efficacy of a peripheral nerve block (PNB) to local tissue infiltration for elective wrist surgery. We hypothesized that the use of a PNB would provide more effective pain relief after surgery.
Ketamine for Management of Refractory Shivering During Spinal Anaesthesia
Gentle S Shrestha*, Bijendra D Joshi
Shivering following spinal anaesthesia is common. It is associated with increase in physiological stress, plasma catecholamine and cardiac output. Various pharmacological agents have been shown to be effective for preventing and managing postanaesthesia shivering. However, little is known about management of refractory shivering. Here we present a case of intraoperative refractory shivering following spinal anaesthesia, which was effectively managed with ketamine.