New method of epidural anesthesia in closed blunt chest injury

The thoracic epidural anesthesia is the most suitable method for the treatment of the closed blunt chest injury but there is probability of the spinal cord injuiry. The original method combining the efficiency of classic thoracic epidural anesthesia with safety and simplicity of lumbar epidural anesthesia is suggested. This method is based on the postulates of the molecular hydrokinetic theory. Two catheters ends are disposed in lumbar epidural space in distance about two inches between them. Through one catheters end the anesthetic solution and through others end the 0,9% saline are injected synchronously in equal volumes. Hydroplunger phenomenon provides the upward anesthetic solution spreading

Pneumocephalus After Dural Puncture During Epidural Analgesia: A Case Report

Lumbar epidural anesthesia commonly used to control post-operation pain. The ‘loss-ofresistance’ to air technique (LORA) generally engaged in the appreciation of the epidural space. One of the rare but serious side effects of this technique is pneumocephalus. We report a case of sudden frontal and parietal headache after a dural puncture during the performance of epidural analgesia using the LOR to air technique. Keywords: Epidural analgesia; ‘loss-of- resistance’ to air technique (LORA); Pneumocephalus; loss of consciousness; headache.

Comparison of Lidocaine-Xylazine and Procaine-Xylazine for Lumbar Epidural Anesthesia in Cattle

Lumbar epidural anesthesia is commonly utilized in veterinary medicine for diagnostic, obstetrical, and surgical intervention in the abdominal and perineal regions of large animals. The aim of this study was to directly compare the time to onset and duration of epidural anesthesia produced by lidocaine-xylazine and procaine-xylazine combinations to that produced by xylazine alone in cattle. A total of 24 healthy adult Holstein dairy cows were included in this study. The time to onset and duration of anesthesia were recorded. The heart rate, respiratory rate, and rectal temperature were recorded at 0 minute and at 10, 20, 30, 60, and 90 minutes after the epidural administration of each treatment. The time to onset of anesthesia did not significantly differ between the xylazine only group and the lidocaine-xylazine and procaine-xylazine combination groups. The duration of anesthesia in the xylazine only group was significantly shorter than that in the lidocaine-xylazine and procaine-xylazine combination groups (p < 0.05). Ataxia was not observed in any group. The heart rate, respiratory rate, and rectal temperature values in all the treatment groups throughout the study did not significantly differ from those at baseline. We found that administration of procaine hydrochloride in combination with xylazine hydrochloride, an α2-adrenergic receptor agonist, offers the same time to onset and duration of anesthesia as does epidural anesthesia using a combination of lidocaine hydrochloride and xylazine hydrochloride. Furthermore, this combination of treatments did not cause adverse effects in the cardiovascular and respiratory systems. These findings indicate that combined administration of procaine and xylazine is an economic and useful approach for epidural anesthesia.

Horner’s Syndrome with Unilateral Brachial Plexus Blockade Mimicking Cerebrovascular Accident Following Lumbar Combined Spinal Epidural Analgesia for Labor

Horner’s Syndrome (HS) with brachial plexus involvement following lumbar epidural anesthesia may be a startling event for the patient and providers. We present a case of Horner’s Syndrome and complete brachial plexus blockade following epidural bolus of lidocaine for labor analgesia that was initially misdiagnosed as a cerebrovascular accident. Use of the catheter was discontinued and the episode resolved with expectant management. This complication is otherwise benign and resolves without sequelae.