Predictors of the variability in neuromuscular block duration following succinylcholine: A prospective, observational study.

Background: The duration of neuromuscular block (NMB) following succinylcholine administration is characterised by a high interindividual variability. However, this has not yet been quantified in a large sample of surgical patients. The significance of underlying clinical factors is unknown.

Perioperative administration of fibrinogen does not increase adverse cardiac and thromboembolic events after cardiac surgery.

Background: Although infusion of fibrinogen concentrate is increasingly used in bleeding patients after cardiac surgery, safety data are scarce. We aimed to evaluate the effect of perioperative administration of fibrinogen concentrate on postoperative morbidity and mortality in patients undergoing cardiac surgery.

Methods: During a 2 yr study period, 991 patients underwent cardiac surgery at a single university centre and were eligible for propensity score (PS) matching.

Spinal anesthesia revisited: toxicity of new and old drugs and compounds.

Purpose Of Review: Neural toxicity of substances injected into the intrathecal space has been a matter of debate since the introduction of spinal anesthesia in clinical practice. In recent years, new local anesthetics and adjuvants have been proposed for intrathecal use, and new techniques such as the use of ultrasound have been propagated. The present review summarizes recent clinical and experimental data on the neurotoxic effects of drugs and substances used for or in conjunction with spinal anesthesia.

Speed spinal anesthesia revisited: new drugs and their clinical effects.

Purpose Of Review: Spinal anesthesia (SPA) has not been popular for day-case surgery because of prolonged neurologic blockade with long-acting local anesthetics such as bupivacaine, thereby delaying discharge. Although the intermediate duration of action of lidocaine and mepivacaine appears to be more suitable for day-case surgery, their use is not deemed appropriate by many because of a high incidence of transient neurologic symptoms (TNSs). The present review summarizes recent clinical data on the intrathecal use of alternative local anesthetics and adjuvants that may offer valuable alternatives to general anesthesia in day-case surgery.

Bupivacaine concentrations in lumbar cerebrospinal fluid in patients with failed spinal anaesthesia.

Background: Spinal anaesthesia (SA) has high success rates. However, inadequate block after SA has been reported even in the absence of technical problems. Various mechanisms for failed SA (FSA) have been proposed, but reports of cerebrospinal fluid (CSF) concentrations of local anaesthetics (LA) after FSA are scarce.