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A Systematic Review of Antibiotic Administration Incidents Involving Neuraxial Routes: Clinical Analysis, Contributing Factors and Prevention Approaches.
Pain Ther
January 2025
Department of Anaesthesia, Tawam Hospital, PO Box 15258, Al Ain, United Arab Emirates.
Introduction: This review aimed to investigate the inadvertent administration of antibiotics via epidural and intrathecal routes. The secondary objective was to identify the contributing human and systemic factors.
Methods: PubMed, Scopus and Google Scholar databases were searched for the last five decades (1973-2023).
Development of an ultrasound-guided proximo-medial approach for injection of the carpal flexor tendon sheath in horses and comparison with the conventional proximo-lateral ´blind` technique.
J Equine Vet Sci
December 2024
Equestria Centro Médico Equino, Región de Valparaíso, Quillota 2260000, Chile.
The aim of this prospective case-control study was to describe and implement a reliable, accurate, and straightforward ultrasound-guided proximo-medial approach technique for injecting the carpal flexor tendon sheath in horses. The proximo-medial ultrasound-guided approach for intrathecal access to the carpal canal, as described in this study, was firstly developed on ten cadaveric limbs using an undiluted ionic iodinated contrast medium. Landmarks were identified, and the access point was established.
View Article and Find Full Text PDFRight Drug in the Wrong Place: The Effects of Inadvertent Intrathecal Tranexamic Acid.
Cureus
October 2024
Anesthesiology, Unidade Local de Saúde da Região de Aveiro, Aveiro, PRT.
Tranexamic acid (TXA) is an antifibrinolytic drug widely used to reduce blood loss in major surgeries and trauma patients, thus reducing morbimortality. In recent years, clinical indications for TXA have expanded, including many off-label uses. This broad use has led to an increased incidence of reported side effects and administration errors with serious neurological and cardiovascular outcomes, such as seizures, myoclonus, and arrhythmias.
View Article and Find Full Text PDFAccidental Intrathecal Tranexamic Acid Injection During Caesarean Section: A Case Report.
Case Rep Anesthesiol
October 2024
Department of Obstetrics and Gynaecology, Muhimbili National Hospital, Dar es Salaam, Tanzania.
Tranexamic acid (TXA) is increasingly used in the management of haemorrhage during and after delivery and haemorrhage caused by other medical conditions due to its efficacy and safety. However, increasing report of fatal complications from inadvertent intrathecal TXA injection remains a cause of concern. The aim of this case report is to demonstrate clinical presentation and predictors of accidental intrathecal injection of TXA within the structure and processes of care in a health facility.
View Article and Find Full Text PDFIntrathecal catheter placement after inadvertent dural puncture in the obstetric population: management for labour and operative delivery. Guidelines from the Obstetric Anaesthetists' Association.
Anaesthesia
December 2024
Department of Anaesthesia, London North West University Healthcare NHS Trust, London, UK.
Background: Anaesthetists of all grades who work on a labour ward are likely to be involved in the insertion or management of an intrathecal catheter after inadvertent dural puncture at some point in their careers. Although the use of intrathecal catheters after inadvertent dural puncture in labour has increased in popularity over recent decades, robust evidence on best practice has been lacking.
Methods: The Obstetric Anaesthetists' Association set up an expert working party to review the literature.
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