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Continuous Spinal Anesthesia in Precarious Patients: An experience in Lubumbashi DR Congo

Open Journal of Anesthesiology 2023年第11期13卷 226-233页

作者： Wasso Milinganyo eddy Timothée Dontaine Sagboze Zalambo Sandra Kibonge Mukakala Augustin Zirhumana Namegabe Franck Somwa Muhemedi Lucien Mukalay Banza Yves Tshisuz Nawej Christian Nguz A. Kutshid Nathan Kanyanda Nafatalewa Dimitri Ilunga Banza Mannix Mulewa Umba Deogracias Manika Muteya Michel Mbuyi Musanzayi Sébastien Arung Kalau Willy Iteke Fefe Karl-Rivain Department of Anesthesia and Critical Care University Clinics of Lubumbashi Lubumbashi DR Congo Department of Surgery Great Hospital of Charleroi Charleroi Belgium Department of Surgery University Clinics of Lubumbashi Lubumbashi DR Congo Department of Surgery Medicine School Official University of Bukavu Bukavu DR Congo Department of Anesthesia and Critical Care Diamant Medical Center Lubumbashi DR Congo

Background: Continuous spinal anesthesia (CSA) is an underused technique in modern anesthesia practice. Compared with other techniques of neuraxial anesthesia, CSA allows incremental dosing of an intrathecal local anesthetic for an indefinite duration, whereas traditional single-shot spinal anesthesia (SSA) usually involves larger doses, a finite, unpredictable duration, and greater potential for detrimental hemodynamic effects including hypotension, and epidural anesthesia via a catheter may produce lesser motor block and suboptimal anesthesia in sacral nerve root distributions. It is indicated in elderly patients undergoing lower limbs and sub umbilical surgery. Aim: This work aims to highlight the advantages of CSA on hemodynamic stability and as an alternative to heavy anesthetic procedures in already fragile patients. Case presentation: Our cases were two elderly patients, both of them with past stories of cardiac diseases. Both of them were undergoing amputation indicated for wet gangrene on lower limbs. They had unstable hemodynamics states due to inflammatory state. They were all rated ASA 3. CSA was performed with low doses of local anesthetics and maintenance by reinjections of mixture with the same doses. The interventions took place without major incidents and all patients survived. Conclusion: CSA is an underused technique in modern anesthesia. However, there is renewed interest due to the quality of the blocs and the hemodynamics stability. We report a case series of 2 elderly patients with past stories of cardiac diseases undergoing amputation for dry gangrene that had been operated under CSA.

关键词： Continuous Spinal Anesthesia (CSA) Precarious Patient Dry Gangrene elderly Subject DR Congo

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Nature：死亡的肿瘤细胞释放出胞内钾离子来阻断免疫系统

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现代生物医学进展 2016年第31期16卷 I0002-I0002页

作者： Robert eil, Suman K. Vodnala, David Clever, Christopher A. Klebanoff, Madhusudhanan Sukumar, Jenny H. Pan, Douglas C. Palmer, Alena Gros, Tori N. Yamamoto, Shashank J. Patel, Geoffrey C. Guittard, Zhiya Yu, David S. Schrump, W. Marston Linehan, nicholas P. Restifo Christopher A. Klebanoff Valentina Carbonaro, Klaus Okkenhaug, Rahul Roychoudhuri National Cancer Institute National Institutes of Health (NIH) Bethesda Maryland 20892 USA Center for Cell engineering and Department of Medicine Memorial Sloan Kettering Cancer Center New York New York 10065 USA Laboratory of Lymphocyte Signalling and Development The Babraham Institute Cambridge CB22 3AT UK

在一项新的研究中。来自美国国家癌症研究所和英国巴布拉汉研究所的研究人员发现当肿瘤组织死亡时从它当中泄露出来的一种无机离子起着阻止抗肿瘤免疫细胞发挥功能的作用。这一发现为开发调动免疫系统抵抗癌症的疗法提供一种新的方法。... 详细信息

在一项新的研究中。来自美国国家癌症研究所和英国巴布拉汉研究所的研究人员发现当肿瘤组织死亡时从它当中泄露出来的一种无机离子起着阻止抗肿瘤免疫细胞发挥功能的作用。这一发现为开发调动免疫系统抵抗癌症的疗法提供一种新的方法。相关研究结果在线发表在Nature期刊上。

关键词：免疫系统肿瘤细胞死亡钾离子免疫细胞无机离子肿瘤组织研究人员

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