The reported incidence of blood vesselpuncture after placement of a needle and catheter into the lumbar epidural space in obstetric practice appears to vary between 1 and This study was undertaken to assess the incidence of blood zwsel puncture related to catheter insertion. Two methods of catheter placement were used to see ifthere were any difference in the incidence of vesselpuncture. The incidence of blood cessel puncture afrer direct catheter placement was found to be 97: compared to 39; after prior injection of 10 ml of O.So/i plain bupiuacaine into the epidural space. (p = 0.05)
Three doses (1.5, 2.0 and 2.5 mg kg-1) of diisopropyl phenol (ICI 35 868) were compared for induction and maintenance of anaesthesia in healthy females undergoing short gynaecological procedures. Induction of anaesthesia was smooth and rapid. Cardiovascular changes (which were dose-dependent) included a decrease in arterial pressure and an increase in heart rate. These changes were magnitudes comparable to those reported for other induction agents. Recovery from the effects of the drug was rapid and uneventful.
Simultaneous blood samples from an artery, a peripheral vein and a central vein were analysed for ICI 35868 concentrations following an induction dose of 2.0 mg kg-1 administered i.v. over 60 s, to five patients before cardiac surgery. Up to 60 s after the end of the administration of the drug there were wide differences in drug concentration between the sampling sites. Thus, any attempt to correlate effect with blood concentration over this early period would be problematic. From 60 s there were no significant differences in drug concentration between the three sites. Thus, as long as the mixing period is allowed for, peripheral venous sampling provides an acceptable alternative to arterial puncture in studies to correlate drug effect and concentration and for pharmacokinetic investigations.
Pediatric trigger thumb is an uncommon condition with a calculated incidence of 3 per 1000 live births or less. Some reports have suggested a congenital etiology while others could not find a single case of pediatric trigger thumb at birth. This article reports the occurrence of bilateral trigger thumbs in identical twins, age 3 years and 9 months, affecting their thumbs to similar extents, which may suggest a congenital etiology.Congenital etiology for trigger thumb has been proposed for many reasons: occurrence in infants, occurrence in twins, occasional bilaterality, possible presence of triggering at birth, and absence of history of trauma. The occurrence of pediatric trigger thumb in twins has been reported 3 times in the literature; all reported cases were bilateral, as in our case.The mean age at presentation of pediatric trigger thumb is 2 years. The thumb is usually held in a fixed flexion position (mimicking a fracture). Examination usually reveals a palpable nodule in the flexor pollicis longus tendon at the metacarpal joint. This is an important clinical sign. Triggering in children, however, is rare. Macroscopically, there is a nodular thickening of the tendon itself. Pathological changes can be found in the tendon, tendon sheath, or both. A specimen taken from one of the nodules in our case showed degenerative changes while those from both pulleys were normal.Pediatric trigger thumb responds predictably to A1 pulley release, preferably before age 4 years, although milder cases may resolve spontaneously.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.