RAEducation » Pathophysiology

What do you do when your block appears permanent?

BlueNeedle — Sat, 06 Mar 2010 18:00:25 +0000

Alain Borgeat presents a fantastic case discussion reviewing the management of a continuous interscalene block which appears to last a bit longer than usual. Dr. Borgeat deserves notable credit for also reviewing the psychosocial effects resulting from such situations. This should be required reading for all trainees before they are allowed to pick up a needle.

Case Scenario: Neurologic Complication after Continuous Inte… : Anesthesiology.

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Zofran Can! Well, sorta, when it comes to the Bezold-Jarisch reflex…

admin — Thu, 11 Jun 2009 21:56:42 +0000

To cap off this week’s case discussion, we’d like to return to the last teaser of a question:

What does ondansetron have to do with hypotension when the Bezold-Jarisch reflex is involved?

This article from RA&PMdescribes ondansetron’s possible role in hypotension, the Bezold-Jarisch reflex, and neuraxial anesthesia. Importantly, this review concerns spinal, and not epidural, anesthesia. However the mechanism described may also function similarly following hypotension and bradycardia seen with epidurals.

More literature can be found here. A nice review of the Bezold-Jarisch reflex itself from the BJA in 2001 can be found here.

For the pharmacologists and structural biologists among us, here is a very cool Wikipedia article on the discovery and drug development of seratonin receptor antagonists.

Kudos to Drs. Lucas and Koyyalamundi for picking up on the involvement of seratonin in this reflex through their comments this week.

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RAPM: A Case of Liver Trauma With a Blunt Regional Anesthesia Needle While Performing Transversus Abdominis Plane Block

admin — Thu, 23 Apr 2009 17:00:37 +0000

This letter is in reply to a case described by Farooq et al that we posted yesterday. Worth reading to see how O’Donnell et al have modified their practice over time to incorporate the use of ultrasound.

A Case of Liver Trauma With a Blunt Regional Anesthesia Needle While Performing Transversus Abdominis Plane Block
O’Donnell, Brian D. MB FCARCSI, MSc; Mannion, Stephen MB FCARCSI, MRCPI, MD

Regional Anesthesia and Pain Medicine:
January/February 2009 – Volume 34 – Issue 1 – pp 75-76
doi: 10.1097/AAP.0b013e3181934050
Letters to the Editor

A Case of Liver Trauma With a Blunt Regional Anesthesia Need… : Regional Anesthesia and Pain Medicine
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Perineural infusion of local anesthetics.

admin — Wed, 03 Dec 2008 18:00:00 +0000

Perineural infusion of local anesthetics.

Anesthesiology. 2006 Apr;104(4):872-80

Authors: Boezaart AP

PMID: 16571984 [PubMed - indexed for MEDLINE]

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Thin sharp needles around the dura.

admin — Sat, 22 Nov 2008 01:17:48 +0000

Thin sharp needles around the dura.

Reg Anesth Pain Med. 2006 Jul-Aug;31(4):388-9

Authors: Boezaart AP, Franco CD

PMID: 16857562 [PubMed - indexed for MEDLINE]

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