1/2. cauda equina syndrome after spinal anaesthesia with hyperbaric 5% lignocaine: a review of six cases of cauda equina syndrome reported to the Swedish Pharmaceutical insurance 1993-1997.Six cases of cauda equina syndrome with varying severity were reported to the Swedish Pharmaceutical insurance during the period 1993-1997. All were associated with spinal anaesthesia using hyperbaric 5% lignocaine. Five cases had single-shot spinal anaesthesia and one had a repeat spinal anaesthetic due to inadequate block. The dose of hyperbaric 5% lignocaine administered ranged from 60 to 120 mg. Three of the cases were most likely caused by direct neurotoxicity of hyperbaric 5% lignocaine. In the other 3 cases, direct neurotoxicity was also probable, but unfortunately radiological investigations were not done to definitely exclude a compressive aetiology. All cases sustained permanent neurological deficits. We recommend that hyperbaric lignocaine should be administered in concentrations not greater than 2% and at a total dose preferably not exceeding 60 mg.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/2. water and electrolyte changes during transuretheral resection of the prostate under spinal anaesthesia.Systemic absorption of irrigating fluid during TUR prostatectomy under spinal anaesthesia was measured in 40 patients and correlations made under clinical, hemodynamic and laboratory observations. Results showed that the CVP monitoring is a helpful parameter in early detection of the hypervolemic hyponatremic syndrome. Serial determination of serum sodium level is important in detecting hyponatremia. Out of the 40 patients, one patient developed acute hypervolemic hyponatremic syndrome. The syndrome was detected early by the significant rise in CVP and the drop in serum sodium level and P.C.V. Intravenous infusion of 250 ml hypertonic saline slowly was followed by marked diuresis and uneventful recovery.- - - - - - - - - - ranking = 0.83333333333333keywords = anaesthesia (Clic here for more details about this article) |