scholarly journals The Initial Subjective Sensory Change in the Dermatome During Intrathecal Injection of Plain Bupivacaine Predicts the Spread of Sensory Blockade: A Prospective Multi-Level Modeling Study

2019 ◽  
Vol 9 (5) ◽  
Author(s):  
Akifumi Kanai ◽  
Yuriko Niki ◽  
Norihito Hayashi ◽  
Shinji Maeda ◽  
Kazunobu Horie ◽  
...  
Keyword(s):  
Intrathecal Injection ◽  
Sensory Blockade ◽  
Sensory Change ◽  
Multi Level ◽  
Modeling Study

scholarly journals Repeat Spinal Anaesthesia for Caesarean section: An Experience at Paropakar Maternity and Women’s Hospital

2018 ◽  
Vol 12 (2) ◽  
pp. 58-60
Author(s):  
Ritu Pradhan ◽  
Sangeeta Shrestha ◽  
Tara Gurung ◽  
Amirbabu Shrestha
Keyword(s):  
Caesarean Section ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Intrathecal Injection ◽  
Common Adverse Effect ◽  
Haemodynamic Effects ◽  
Sensory Blockade ◽  
Repeat Administration ◽  
Complete Failure ◽  
Motor Effects

Aims: This study aims to review the haemodynamic effects of the repeat spinal anaesthesia and to identify the different doses of Bupivacaine heavy used for the repeat spinal anaesthesia for the failed spinal in caesarean section.Methods: This study was conducted by reviewing medical anaesthesia records of the cases of the repeat spinal anesthesia regarding any adverse haemodynamic effects. The second dose of bupivacaine heavy, maximum sensory blockade and intraoperative events like bradycardia, hypotension, high spinal, nausea vomiting, conversion to general anaesthesia and inadequate block were also reviewed.Results: Out of 8040 caesarean section under subarachnoid block, 51(0.63%) cases were conducted under repeat spinal anaesthesia from April 2014 to December2016. All the cases had complete spinal failure with no sensory and motor effects even after 10 minutes of the intrathecal injection. The second dose of bupivacaine heavy used was variable but reduced than the first dose. The most common adverse effect was hypotension (27.5%). 50% of cases were uneventful. One case was converted to general anaesthesia even after repeat spinal anaesthesia and 9.8% cases had high spinal above T4.Conclusions: Repeat administration of Bupivacaine heavy in reduced dose and volume can be used in complete failure of administration of first spinal anaesthesia. However, it always requires careful assessment and the judicious monitoring.

scholarly journals Incidence of hypotension between Intrathecal Hyperbaric Bupivacaine with and without Fentanyl in Geriatric Patients Undergoing Urological Surgeries

2019 ◽  
Author(s):  
Thavat Chanchayanon ◽  
Mareeya Chearong ◽  
Piyaporn Vasinanukorn ◽  
Natsana Withayanuphakorn ◽  
Tidarat Sangkaew
Keyword(s):  
Geriatric Patients ◽  
Intrathecal Injection ◽  
Intrathecal Administration ◽  
P Value ◽  
Sensory Level ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Thoracic Level ◽  
Significant Difference ◽  
Group B

Objective: We aimed to assess the efficacy, the incidence of hypotension and adverse consequences of using intrathecal hyperbaric bupivacaine in comparison to a combination of low dose hyperbaric bupivacaine and fentanyl, in geriatric patients undergoing urological surgeries.Material and Methods: Our study was a prospective, triple-blinded and randomized controlled. One hundred and fortyeight geriatric participants scheduled for urological surgeries were randomly assigned into two groups: Group B (n=74) received intrathecal injection with 0.5% hyperbaric bupivacaine 1.5 milliliters (ml) alone (7.5 milligrams; mg), while Group F (n=74) received 0.5% hyperbaric bupivacaine 1 ml (5 mg) plus 0.5 ml of fentanyl (25 micrograms; mcg) making up to a total volume of 1.5 ml.Results: One hundred and forty-eight patients were included however, six patients were excluded from statistical analysis, due to an inadequate level of anesthesia; hence, 142 patients were analyzed. The incidence of hypotension in group B was: 9.7%, and in group F the percentage was 12.9%, respectively (p-value=0.74). There was no significant difference in regards to the highest sensory level in both groups. The anesthesia level in group B was Thoracic level 11 (T10-T12), and in group F it was 11 (T10-T12) (p-value=0.68), while the analgesia level in group B was Thoracic level 7 (T6-T8) with group F being a Thoracic level 6 (T6-T8) (p-value=0.16). The occurrence of bradycardia, and respiratory depression did not differ between the 2 groups.Conclusion: Intrathecal administration of 5 mg of 0.5% hyperbaric bupivacaine, plus 25 mcg of fentanyl provided an adequate level of sensory blockade, but did not decrease the frequency of hypotension.

scholarly journals Body habitus does not influence spread of sensory blockade after the intrathecal injection of a hypobaric solution in term parturients

2003 ◽  
Vol 50 (7) ◽  
pp. 689-693 ◽  
Author(s):  
Cynthia A. Wong ◽  
Dominador Cariaso ◽  
Eric C. Johnson ◽  
Diana Leu ◽  
Robert J. McCarthy
Keyword(s):  
Intrathecal Injection ◽  
Sensory Blockade ◽  
Body Habitus ◽  
Influence Spread

Verlaufsanalyse wöchentlicher Selbst- und Fremdeinschätzungen in der Langzeittherapie suchtkranker Jugendlicher

2019 ◽  
Vol 47 (2) ◽  
pp. 126-137
Author(s):  
Ferdinand Keller ◽  
Tatjana Stadnitski ◽  
Jakob Nützel ◽  
Renate Schepker
Keyword(s):  
Allen Vier ◽  
Multi Level

Zusammenfassung. Fragestellung: Über Veränderungen in der emotionalen Befindlichkeit von Jugendlichen während einer Suchttherapie ist wenig bekannt. Methode: Die Jugendlichen füllten wöchentlich einen entsprechenden Fragebogen aus, analog ihre Bezugsbetreuer eine parallelisierte Kurzfassung. Von 42 Jugendlichen liegen insgesamt 853 Bogen und von den Bezugsbetreuern 708 Bogen vor. Die Fragebogen wurden zunächst faktorenanalytisch hinsichtlich ihrer Dimensionalität ausgewertet, anschließend wurden gruppenbezogene Verlaufsanalysen (Multi-Level-Modelle) und Abhängigkeitsanalysen auf Einzelfallebene (Zeitreihenanalysen) durchgeführt. Ergebnisse: Im Jugendlichenfragebogen ergaben sich vier Faktoren: negative Befindlichkeit, Wertschätzung von Therapie/Betreuung, Motivation und Suchtdynamik. Die Übereinstimmung zwischen den Jugendlichen- und der (einfaktoriellen) Betreuereinschätzung fiel insgesamt niedrig bis mäßig aus, brachte aber auf Einzelfallebene differenziertere Ergebnisse. Im Verlauf nahmen die Werte auf allen vier Jugendlichenskalen ab. Einzig der Verlauf der Wertschätzung in der Eingewöhnungsphase war prädiktiv für den späteren Abbruch der Maßnahme: Bei den Abbrechern nahm die Wertschätzung ab, während sie bei den Beendern initial stieg. Schlussfolgerungen: Der bedeutsamste Faktor in Bezug auf die Therapiebeendigung suchtkranker Jugendlicher scheint die Wertschätzung von Therapie/Betreuung zu sein, während die Motivation jugendtypische Schwankungen aufweist. Der Suchtdynamik kam eine deutlich weniger bedeutende Rolle zu als allgemein angenommen. Programme in der Langzeittherapie sollten die Wertschätzung von Therapie/Betreuung künftig mehr fokussieren als die Suchtdynamik.

A Multi-level Measure Of Safety Climate And Associations With Safety Behaviors In The Fire Service

2017 ◽  
Author(s):  
Todd D. Smith ◽  
Mari-Amanda Dyal ◽  
Yongjia Pu ◽  
Stephanie Dickinson ◽  
David M. DeJoy
Keyword(s):  
Safety Climate ◽  
Fire Service ◽  
Safety Behaviors ◽  
Multi Level
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