Failure of Neuraxial Blocks and Etiologic Factors

Özdemir, Halime; Kayhan, Zeynep

doi:10.5222/jtaics.2011.198

Cited by 3 publications

(3 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In all blocks, according to the power of correlation; the independent risk factors were determined as paramedian approach, peripheral vascular disease, epidural block, duration of surgical intervention, expertise requirement, chronic obstructive pulmonary disease, neurological disease, and body weight (15). In our study, inadequate anesthesia application (17.5%) was detected in 12 patients in Group P and in 2 patients in Group M ( Table 2).…”

Section: Discussionmentioning

confidence: 65%

Which Approach is Preferred in Spinal Anesthesia: Median or Paramedian? Comparison of Early and Late Complications

Bayindir¹,

Özcan²,

Koçyiğit³

et al. 2017

Istanbul Med J

View full text Add to dashboard Cite

Spinal anesthesia is often preferred in short-term surgeries because it is a low-cost technique that can be applied easily, has a high success rate, and allows fast mobilization and early feeding (1). The side effects in this application can vary with the technique that is used (2). Inadequate spinal anesthesia, high or total spinal block, cardiac arrest, respiratory arrest, systemic toxic reaction, hypotension, bradycardia, nausea/vomiting, headache, spinal puncture pain, meningitis or meningismus, neurological sequelae, urinary retention, and hearing loss may be seen as a result of the effect created by the spread of the local anesthetic agent in the subarachnoid space (3).In our study, we aimed to compare the early and late complication rates of two different techniques (median or paramedian approach) in spinal anesthesia, which is the most preferred anesthetic method in our clinic for short-term surgeries. Material and MethodsOur study was conducted after the ethics committee approval no. 42883194-01/10405, dated November 18th, 2014, was received from the Ethics Committee of Fırat University Hospital. Of 282 patients who underwent short-term surgeries under spinal anesthesia between January 1st, 2014, and March 1st, 2014, 80 patients aged 18-65 years and classified as ASA I/II/III according to the American Society of Anesthesiologists (ASA) classification, who could be reached at telephone numbers that we had on file, were included in the study. Since the study was retrospective, informed consents were not received from the patients. The files of the patients were obtained from the archive, and the patients in whom the median technique was used were included in Group M (n=40), and those in whom the paramedian technique was used were included in Group P (n=40). Demographic data (age, gender, height, weight), ASA, the number of spinal anesthesia applications, duration of surgery, preoperative and intraoperative heart rate (HR), and mean arterial pressure (MAP) were recorded from the anesthesia follow-up chart, and the discharge durations from the hospital and the number of patients who underwent urinary catheterization were recorded from the nurse observation forms. Information was received from the patients who were contacted by phone about postoperative headache, pain at the site of procedure, hearing complaints, and about the other complaints. Which Approach is Preferred in Spinal Anesthesia: Median or Paramedian? Comparison of Early and Late ComplicationsIntroduction: Spinal anesthesia is usually preferred for short-time surgery; the side effects of the process can show difference with techniques. We aimed to compare early and late complications of median and paramedian techniques in spinal anesthesia.Methods: Eighty patients with American Society of Anesthesiologists (ASA) I-III were allocated into the following two groups: Group M (median) and Group P (paramedian). Demographic data of the patients, ASA score, number of spinal anesthesia application, total surgery time, discharge time from the hospital, h...

show abstract

Section: Discussionmentioning

confidence: 65%

Which Approach is Preferred in Spinal Anesthesia: Median or Paramedian? Comparison of Early and Late Complications

Bayindir¹,

Özcan²,

Koçyiğit³

et al. 2017

Istanbul Med J

View full text Add to dashboard Cite

show abstract

“…9 Öz-demir ve ark.nın nöroaksiyel blok başarısızlığı üze-rine yaptıkları çalışmada genel başarısızlık oranı %5,4, spinal başarısızlık oranı ise %3,9 olarak saptanmıştır. 15 Çalışmamızda başarısızlık oranı %6,5 olarak bulunmuş olup, benzer çalışmalara göre yüksektir. Bu oranın yüksek çalışmasında sebebinin spinal anestezi işlemlerinin büyük kısmını (%64) farklı kıdemdeki asistanların gerçekleştir-mesi ve uygulayıcıların sürekli olarak değişmesinin etkili olduğu kanaatindeyiz.…”

Section: Bulgularunclassified

“…Bunu destekler şekilde Özdemir ve ark.nın yaptıkları çalışmada, ileri yaş, blok başarı-sızlığında risk faktörü olarak bulunmuştur. 15 Tessler ve ark.nın yaşlı hasta grubunda nöroaksiyel blok başarısını değerlendirdikleri çalışmada; yaşa bağlı olarak anatomik değişiklikler, vertebral çökme ve vertebral aralıklarda daralma gibi iğnenin, subaraknoid aralığa yerleşmesini zorlaştıran yapısal değişimlerin olduğunu bildirilmiştir. Aynı çalışmada, vertebral kolonun fleksibilitesini kaybetmesi sonucunda lomber kurvatürün fleksiyonunun kısıtlı olması da yine iğne yerleşimini zorlaştıran bir diğer etmen olarak bildirilmiştir.…”

Section: Bulgularunclassified

The Effective Factors on Block Success

Turan¹,

Bombacı²,

Yılmaz³

et al. 2017

Turkiye Klinikleri J Anest Reanim

View full text Add to dashboard Cite

Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışma ile spinal girişimlerimizdeki başarısızlık oranlarının ve başarısızlığa yol açan nedenlerin ortaya koyulması hedeflemiştir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmamız bir eğitim ve araştırma hastanesinin ameliyathanelerinde spinal girişim uygulanan hastaların, prospektif incelenmesine dayanmaktadır. Çalışmaya alınan her bir hasta için yaş, cinsiyet, tanı, geçireceği cerrahi, kliniği, uygulayıcının tecrübesi, iğne çapı-tipi, ilaç dozu, deneme sayısı, spinal aralık, ve bloğun sonucu (başarılı/başarısız) kaydedildi. Hastalar, spinal anestezi sonucu başarılı olanlar Grup 1; başarısız olanlar Grup 2 olmak üzere iki gruba ayrıldı. B Bu ul lg gu ul la ar r: : Çalışmaya toplam 1.499 hasta dâhil edildi. Başarısızlık oranımız %6,5 olarak saptandı. Lojistik regresyon analizi yapıldığında yaş, uygulayıcının tecrübesi, iğne tipi, iğne çapı, hasta pozisyonu, lokal anestezik dozu, deneme sayısı bağımsız değişkenler olarak saptandı. Uygulayıcının, kıdemi 1 yıl ve 1 yıldan daha az olan asistanlar olduğu girişimlerde (p:0.0021); yan yatar pozisyonda (p:0.000); 27 gauge ve "pencil point" iğne kullanıldığında (p:0.000) ve girişim sayısının 3 ten fazla olduğu vakalarda (p:0.004) başarısızlık oranı yüksek bulundu. Grup 2'nin yaş ortalaması da Grup 1'e oranla anlamlı derecede yüksek bulundu p(0.000). S So on nu uç ç: : Spinal anestezi uygulamalarında teknik sebeplere ve uygulayıcı deneyim eksikliğine bağlı başarısızlıklar sıklıkla görülmektedir. İğne tipi, iğne çapı, hasta pozisyonu, lokal anestezik dozu, uygulayıcının tecrübesi, çalışmamızda başarısız sonucu etkileyen faktörlerdir. Uygulayıcının tecrübesinin artırılması ve kullanılan malzeme seçiminde daha dikkatli olunması durumunda başarısız blok oranının minimuma indirilebileceği sonucuna varılmıştır.A An na ah ht ta ar r K Ke el li im me el le er r: : Anestezi, spinal; anestezi, genel; enjeksiyonlar, spinal; sinir bloğu A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of this study is to analyze the incidence and reasons of failure for spinal anesthesia. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : This study was designed prospectively in an education and research hospital. Data of patients operated with spinal anesthesia in one year's time were recorded. Age, gender, type of surgery, the practitioner's level of experience, needle gauge and type, dosage and density of the local anesthetic, number of puncture attempts, level of puncture, and results of the intervention (failure/success) were recorded for each patient. R Re es su ul lt ts s: A total of 1.499 patients were included in the study. The overall spinal failure rate was 6.5%. The patients were divided into two groups as Group 1 with successful and Group 2 with failed spinal anesthesia. With logistic regression analysis of the data of age, level of experience, needle type and gauge, patient position, local anesthetic dosage and the number of puncture attempts were found as independent variables of the failure. Less than 1 year pract...

show abstract

Should the Paramedian Approach be the First Choice in Spinal Anesthesia of Geriatric Patients? Prospective Randomized Clinical Trial

Arslan¹,

Şahin²

2022

BMB

View full text Add to dashboard Cite

Failure of Neuraxial Blocks and Etiologic Factors

Cited by 3 publications

References 28 publications

Which Approach is Preferred in Spinal Anesthesia: Median or Paramedian? Comparison of Early and Late Complications

Which Approach is Preferred in Spinal Anesthesia: Median or Paramedian? Comparison of Early and Late Complications

The Effective Factors on Block Success

Should the Paramedian Approach be the First Choice in Spinal Anesthesia of Geriatric Patients? Prospective Randomized Clinical Trial

Contact Info

Product

Resources

About