The Recovery Profile of Hyperbaric Spinal Anesthesia With Lidocaine, Tetracaine, and Bupivacaine

Frey, Kere; Holman, Stephen W.; Mikat-Stevens, Marianne; Vazquez, John; White, Lee; Pedicini, Eric; Sheikh, Taqdees; Kao, T. C.; Kleinman, Bruce; Stevens, Rosemary

doi:10.1097/00115550-199823020-00008

Cited by 27 publications

(15 citation statements)

References 10 publications

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“…Information about the time it takes a patient to void, ambulate, and completely resolve sacral anesthesia after spinal anesthesia is important. [ 25 51 ] Delayed recovery due to spinal-epidural hematoma following spinal anesthesia is reported. The incidence of hematoma is <1 in 150,000 epidurals and 1 in 220,000 following spinal anesthesia.…”

Section: Regional Anesthesiamentioning

confidence: 99%

Delayed recovery from anesthesia: A postgraduate educational review

2016

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Delayed awakening from anesthesia remains one of the biggest challenges that involve an anesthesiologist. With the general use of fast-acting anesthetic agents, patients usually awaken quickly in the postoperative period. The time to emerge from anesthesia is affected by patient factors, anesthetic factors, duration of surgery, and painful stimulation. The principal factors responsible for delayed awakening following anesthesia are anesthetic agents and medications used in the perioperative period. Nonpharmacological causes may have a serious sequel, hence recognizing these organic conditions is important. Certain underlying metabolic disorders such as hypoglycemia, severe hyperglycemia, and electrolyte imbalance, especially hypernatremia, hypoxia, hypercapnia, central anticholinergic syndrome, chronic hypertension, liver disease, hypoalbuminemia, uremia, and severe hypothyroidism may also be responsible for delayed recovery following anesthesia. Unexpected delayed emergence after general anesthesia may also be due to intraoperative cerebral hypoxia, hemorrhage, embolism, or thrombosis. Accurate diagnosis of the underlying cause is the key for the institution of appropriate therapy, but primary management is to maintain airway, breathing, and circulation. This comprehensive review discusses the risk factors, causes, evaluation and management of delayed recovery based on our clinical experience, and literature search on the internet, supported by the standard textbooks of anesthesiology.

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Section: Regional Anesthesiamentioning

confidence: 99%

Delayed recovery from anesthesia: A postgraduate educational review

2016

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“…Symptoms such as sweating, myalgia, mental dullness, irritability, and palpitations also occur rather than muscle weakness during the attacks [7].…”

Section: Discussionmentioning

confidence: 99%

Atypical Presentation of Periodic Paralysis: A Case Report

Işıklar¹

2019

CMI

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Hypokalemic periodic paralysis (HPP) is a kind of periodic paralysis, which is a heterogeneous group of muscle diseases. It is characterized by episodes of flaccid and sudden muscle weakness.Here, we present a case of HPP. The patient was referred to our department because of severe dizziness and fall. After a comprehensive evaluation, a markedly low potassium was detected. The patient’s symptoms resolved after replacement of potassium and he was discharged without deficits. Even though the literature reports an association with exercise, carbohydrate load, and stress, further workup in our patient revealed no association with these precipitants. A proper differential diagnosis should rule out other causes of weakness and paralysis, thus allowing a timely treatment.

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“…These include paresthesias, sweating, myalgia, extreme fatigue, thirst, shortness of breath (either due to anxiety or to the episode itself), palpitations, clumsiness, irritability, and mental dullness. 10 Weakness is a common, yet nonspecific presentation of various neurological and non-neurological conditions.…”

Section: Discussionmentioning

confidence: 99%

“…These include paresthesias, sweating, myalgia, extreme fatigue, thirst, shortness of breath (either due to anxiety or to the episode itself), palpitations, clumsiness, irritability, and mental dullness. 10 ECG, TSH, free T3 and T4 are the minimum indicated laboratory investigations, with renal and adrenal function also recommended. It is important to note that this disorder is autosomal dominant in two-thirds of cases; with male preponderance when providing genetic counselling.…”

Section: Discussionmentioning

confidence: 99%

Hypokalemic periodic paralysis: a case report

Kibe¹,

Biniwale²,

Biniwale³

2017

Int J Res Med Sci

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Hypokalemic periodic paralysis (HPP), a clinical syndrome characterized by low serum potassium, is a rare but treatable cause of acute muscular weakness. The etiology can be attributed to various factors and can be either idiopathic or due to secondary causes. The approach to a case of HPP involves identifying the underlying etiology and prompt replenishment and maintenance of the potassium levels. Further management depends on the cause, frequency of attacks, severity of symptoms and the duration of the illness.

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The Recovery Profile of Hyperbaric Spinal Anesthesia With Lidocaine, Tetracaine, and Bupivacaine

Cited by 27 publications

References 10 publications

Delayed recovery from anesthesia: A postgraduate educational review

Delayed recovery from anesthesia: A postgraduate educational review

Atypical Presentation of Periodic Paralysis: A Case Report

Hypokalemic periodic paralysis: a case report

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