Reversal of profound and "deep" residual rocuronium-induced neuromuscular blockade by sugammadex: a neurophysiological study.

Background: Sugammadex is the first of a new class of selective relaxant binding drugs developed for the rapid and complete reversal of neuromuscular blockade (NMB) induced by the aminosteroid neuromuscular blocking drugs rocuronium and vecuronium. Neuromuscular blocking drugs block the transmission from the peripheral nerve to the muscle units, with reduction and disappearance of the evoked electromyographic activity. Usually, neuromuscular monitoring for the investigational reversal drug is performed by calibrated acceleromyography.

Analgesia before performing a spinal block in the sitting position in patients with femoral shaft fracture: a comparison between femoral nerve block and intravenous fentanyl.

We conducted this prospective, randomized study to compare the analgesic effect of femoral nerve block and IV fentanyl administration when given to facilitate the sitting position for spinal anesthesia in patients undergoing surgery for femoral shaft fracture. Five minutes before the placement of spinal block, group FEM patients (n = 10) received a femoral nerve block with lidocaine 1.5% 15 mL, and group IVA patients (n = 10) received IV fentanyl 3 microg/kg.

[Treatment of intracranial aneurysm in interventional neuroradiology. What problems for the anesthetist?].

Aim: To outline the most occurring complications during endovascular treatment of intracranial aneurysms.

Design: Retrospective review of thirty-four patients treated from October 1994 to February 1996 with the placement of mechanically detachable microcoils inside the aneurysmal sac.

Setting: Interventional neuroradiology suite equipped for anesthetic care.

The optimal dose of local anaesthetic in the orthogonal two-needle technique. Extent of sensory block after the injection of 20, 30 and 40 mL of anaesthetic solution.

Ninety patients undergoing scheduled upper limb orthopaedic surgery were studied to determine the optimal anaesthetic dose using the 'orthogonal two-needle technique'. The patients were randomly assigned to one of three groups to receive one of three different volumes (20, 30 and 40 mL) (n = 30) of anaesthetic solution (a mixture of equal parts of 0.5% bupivacaine with adrenaline 1:200,000 and 2% lignocaine).

Postspinal headache in Taylor's approach: a comparison between 21- and 25-gauge needles in orthopaedic patients.

A randomized study was carried out on 160 patients aged 30-60 years with the aim of finding a method of preventing postdural puncture headache (PDPH). In Taylor's lumbosacral approach to the subarachnoid space, two different needle sizes were used (21-gauge versus 25-gauge) for injecting the anaesthetic solution. Our results show an overall incidence of PDPH in nearly 8% of patients, with no significant difference related to the size of the needle employed.

Effect of injection speed on anaesthetic spread during axillary block using the orthogonal two-needle technique.

One hundred patients undergoing scheduled upper limb orthopaedic surgery were studied to determine if the speed of injection of the local anaesthetic solution could modify the extent and depth of anaesthesia with the axillary approach to the brachial plexus. The blocks were performed using the 'orthogonal two-needle technique' in which two needles are positioned on the upper and on the lower aspect of the axillary artery, orthogonal to the neurovascular bundle and directed towards the fascial compartment containing the radial nerve. The patients were randomly assigned to one of three groups to receive one of three injection rates (10, 20 and 30 s) (n = 30).

[Intracardial knotting of a Swan-Ganz catheter. Description of a clinical case].

A 79 year old female was admitted to CTO Intensive Care Unit in the immediate postoperative period of orthopedic surgery. A Swan-Ganz fiber optic catheter was inserted through the right internal jugular vein but it was not possible to obtain a satisfactory tracing off pulmonary artery occlusion pressure. We experienced a remarkable trouble to withdraw the catheter in order to repeat the insertion.

How many interscalenic blocks are there? A comparison between the lateral and posterior approach.

This study compares the areas of analgesia obtained with the lateral and posterior approaches to the interscalene space after injection of equal volumes of anaesthetic solution (40 ml of a mixture of 0.5% bupivacaine with adrenaline 1:200,000 and 2% lignocaine in equal parts). There was a significant difference in the distribution of the areas of analgesia between the two approaches.

[The external jugular vein course as surface landmark in subclavian perivascular block].

A study of 88 orthopaedic patients undergoing upper limb surgery, was carried out using the external jugular vein as surface landmark of the brachial plexus in subclavian perivascular technique. A significant statistical relationship was found between the insertion point of the needle, relatively to the external jugular vein course, and the block outcome. The best results were observed when the needle was inserted on the postero-lateral side of the vein or when the insertion point coincided with the vein course.

[How many interscalene blocks are there? Reflections on 109 cases studied with various techniques].

The effects of interscalene block were studied on 109 patients undergoing upper extremity elective orthopaedic surgery. Blocks were performed in a non-randomized manner with three different techniques, the site where anaesthetic solution was injected being the main distinguishing mark. The anaesthetic solution was injected into the interscalenic compartment both in the case of patients where classic technique had been carried out and in the group where the nerve stimulator had been used.