Background: The effect of adding vasoconstrictors to local anesthetics for spinal anesthesia is controversial. The aim of this study was to investigate the effect of phenylephrine on neural blockade and hemodynamic changes in spinal anesthesia in elderly patients.
Methods: Thirty patients, aged >65 years, undergoing transurethral surgery were allocated into two groups to receive spinal anesthesia using hyperbaric tetracaine 0.5% with or without phenylephrine 0.025%. The doses of tetracaine were determined in proportion to the height of the patients. The level of sensory block and blood pressure were recorded every 5 and 1 min for 15 minutes after intrathecal injection.
Results: There was no significant difference regarding the time of onset of anesthesia, maximum level of blocks and blood pressures between the groups.
Conclusions: The addition of phenylephrine to hyperbaric tetracaine in spinal anesthesia did not affect the extent of sensory blocks and hemodynamic changes in elderly patients.
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Medicina (Kaunas)
December 2024
Department of Urology, C.Ur.E.-Centro Urologico Europeo, Hesperia Hospital, 41125 Modena, Italy.
To prove the feasibility of continuous spinal extraperitoneal robot-assisted laparoscopic radical prostatectomy (cseRALP) in order to expand the pool of eligible patients. : According to IDEAL guidelines, a consecutive cohort of patients who underwent cseRALP was enrolled. Pre-, intra-, and post-operative data were collected, with particular focus on safety and oncological outcomes.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
The optimal anesthetic technique for category 2 and 3 cesarean deliveries remains debated, with concerns about impacts on decision-to-delivery interval (DDI) and perinatal outcomes. This study examined the influence of epidural, spinal, and general anesthesia on DDI, surgical and postoperative complications, and neonatal outcomes. : This prospective cohort study at a tertiary perinatology center enrolled parturient women undergoing category 2 and 3 cesarean deliveries.
View Article and Find Full Text PDFInt J Obstet Anesth
December 2024
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham & Women's Hospital, Harvard Medical School, United States.
Arachnoid cysts are fluid-filled cavities that are usually asymptomatic and do not require surgical intervention. However, there are concerns and limited literature on the safety of neuraxial procedure in obstetric patients with cranial arachnoid cysts. We describe the anesthetic management of a pregnant patient with a large arachnoid cyst with mass effect on the cerebellum who presented in labor.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
September 2024
K. Bicetre School of Medicine, Paris-Saclay University, Département d'Anesthésie, Hôpital Antoine Béclère - APHP.Université Paris-Saclay, 157 rue de la porte de Trivaux, 92140, CLAMART, France. Electronic address:
This article offers a comprehensive clinical update on best practices for neuraxial and general anesthesia in cesarean delivery, the most frequently performed major surgical procedure globally. Current evidence-based strategies to address common anesthetic challenges, such as maternal hypotension and intraoperative breakthrough pain, are discussed in detail. Practical approaches for optimizing maternal hemodynamic stability, including the use of vasopressors, fluid management and maternal positioning, are reviewed.
View Article and Find Full Text PDFActa Ortop Mex
January 2025
Unidad de Investigación. Clínica INDISA. Santiago, Chile.
Introduction: therapeutic equivalence has been established in the effectiveness of peripheral nerve blocks in the management of pain in the postoperative period of anterior cruciate ligament reconstruction. However, it is unknown whether this effect is modulated by the anesthesiologist's experience. The objective was to describe the effectiveness of peripheral nerve blocks during the first 24 hours of the postoperative period, considering patient characteristics and the anesthesiologist's experience.
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