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spinal anesthesia alleviates dextran sodium sulfate-induced colitis by modulating the gut microbiota

World Journal of Gastroenterology 2022年第12期28卷 1239-1256页

作者： Yu Hong Jie Zhao Ye-Ru Chen Zi-Hao Huang Li-Dan Hou Bo Shen Yu Xin Department of General Surgery Sir Run Run Shaw Hospital of Zhejiang UniversityHangzhou 310012Zhejiang ProvinceChina Department of Anaesthesiology Sir Run Run Shaw Hospital of Zhejiang UniversityHangzhou 310012Zhejiang ProvinceChina College of Medicine Zhejiang UniversityHangzhou 310012Zhejiang ProvinceChina Biomedical Research Center Sir Run Run Shaw Hospital of Medical SchoolZhejiang UniversityHangzhou 310012Zhejiang ProvinceChina Department of Anesthesiology Sir Run Run Shaw Hospital of Zhejiang UniversityHangzhou 310012Zhejiang ProvinceChina

BACKGROUND Inflammatory bowel disease(IBD)is a chronic disease with recurrent intestinal *** the exact etiology of IBD remains unknown,the accepted hypothesis of the pathogenesis to date is that abnormal immune responses to the gut microbiota are caused by environmental *** role of the gut microbiota,particularly the bidirectional interaction between the brain and gut microbiota,has gradually attracted more *** To investigate the potential effect of spinal anesthesia on dextran sodium sulfate(DSS)-induced colitis mice and to detect whether alterations in the gut microbiota would be crucial for *** A DSS-induced colitis mice model was *** anesthesia was administered on colitis mice in combination with the methods of cohousing and fecal microbiota transplantation(FMT)to explore the role of spinal anesthesia in IBD and identify the potential mechanisms *** We demonstrated that spinal anesthesia had protective effects against DSS-induced colitis by alleviating clinical symptoms,including reduced body weight loss,decreased disease activity index score,improved intestinal permeability and colonic morphology,decreased inflammatory response,and enhanced intestinal barrier ***,spinal anesthesia significantly increased the abundance of Bacteroidetes,which was suppressed in the gut microbiota of colitis ***,cohousing with spinal anesthetic mice and FMT from spinal anesthetic mice can also alleviate DSS-induced colitis by upregulating the abundance of *** further showed that spinal anesthesia can reduce the increase in noradrenaline levels induced by DSS,which might affect the gut *** These data suggest that microbiota dysbiosis may contribute to IBD and provide evidence supporting the protective effects of spinal anesthesia on IBD by modulating the gut microbiota,which highlights a novel approach for the treatment of IBD.

关键词： spinal anesthesia Inflammatory bowel disease Gut microbiota Intestinal barrier Intestinal inflammation Intestinal immune

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Transient involuntary movement disorder after spinal anesthesia: A case report

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World Journal of Clinical Cases 2021年第26期9卷 7917-7922页

作者： Giyoung Yun Eunsoo Kim Wangseok Do Young-Hoon Jung Hyun-Ju Lee Yesul Kim Department of anesthesia and Pain Medicine Biomedical Research InstitutePusan National University HospitalBusan 49241South Korea Department of anesthesia and Pain Medicine Pusan National UniversitySchool of MedicineYangsan 50612South Korea

BACKGROUND spinal anesthesia is commonly used for various *** many complications occur after induction of spinal anesthesia,involuntary movement is an extremely rare *** SUMMARY Herein,we report the case of a 54-year-old healthy male patient who experienced involuntary movements after intrathecal injection of local *** patient had undergone metal implant removal surgery in both the lower extremities;7 h after intrathecal hyperbaric bupivacaine administration,involuntary raising of the left leg began to occur every 2 *** the movement disorder appeared,the patient was conscious and *** other specific symptoms were noted in the physical examination conducted immediately after the involuntary leg raising started;moreover,the patient's motor and sensory assessments were *** symptom gradually *** hours after the symptom first occurred,its frequency decreased to approximately once every three *** days postoperatively,the symptoms had completely disappeared without *** Anesthesiologists should be aware that movement disorders can occur after spinal anesthesia and be able to identify the cause,such as electrolyte imbalance or epilepsy,since immediate action may be required for ***,it is crucial to know that involuntary movement that develop following spinal anesthesia is mostly self-limiting and may not require additional costly examinations.

关键词： Movement disorder spinal anesthesia Bupivacaine Dexmedetomidine Case report

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Total spinal anesthesia caused by lidocaine during unilateral percutaneous vertebroplasty performed under local anesthesia:A case report

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World Journal of Clinical Cases 2022年第25期10卷 9050-9056页

作者： Yu-Fei Wang Zhao-Yue Bian Xin-Xian Li Yun-Xiang Hu Lin Jiang Department of Anesthesiology Taizhou People’s HospitalTaizhou 225300Jiangsu ProvinceChina Department of Spine Surgery The People’s Hospital of Liuyang CityLiuyang 410300Hunan ProvinceChina Department of Orthopedics Dalian Municipal Central Hospital Affiliated of Dalian Medical UniversityDalian 116021Liaoning ProvinceChina School of Graduates Dalian Medical UniversityWest SectionNo.8 South Lvshun RoadLvshun DistrictDalian 116000Liaoning ProvinceChina

BACKGROUND Intradural anesthesia caused by anesthetic drug leakage during percutaneous vertebroplasty(PVP)has rarely been *** here report a 71-year-old woman who suffered this rare and life-threatening complication during *** SUMMARY A 71-year-old woman,who suffered from 2 wk of severe back pain with a visual analog score of 8,came to our outpatient *** was later diagnosed with a newly compressed L1 fracture and was then admitted in our *** was initially attempted again under local ***,serendipitous intradural anesthesia leading to total spinal anesthesia ***,after successful resuscitation of the patient,PVP was safely and smoothly *** pain relief was achieved postoperatively,and she was safely discharged on postoperative day *** patient recovered normally at 3-mo *** Total spinal anesthesia secondary to PVP by anesthetic drug leakage rarely *** cases of inadvertent wrong puncture leading to drug leakage when performing it under local anesthesia,surgeons should be highly vigilant during the whole *** monitoring,oxygen inhalation,intravenous cannula set prior to surgery,regular checking of motor activity and a meticulous imaging monitoring with slower pushing of anesthetic drugs,*** be highly recommended.

关键词： Percutaneous vertebroplasty Intradural anesthesia Total spinal anesthesia Minimally invasive surgery Osteoporotic vertebral compression fracture Fracture spinal anesthesia Case report

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Varicella-zoster virus meningitis after spinal anesthesia:A case report

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World Journal of Clinical Cases 2022年第25期10卷 9127-9131页

作者： Ye-Won Lee Byunghoon Yoo Yun Hee Lim Department of Anesthesiology and Pain Medicine College of MedicineInje UniversitySanggye Paik HospitalSeoul 01757South Korea

BACKGROUND Headache is a common complication of regional *** treatment of post spinal anesthesia headache varies depending on the *** meningitis is rare,it can cause significant harm to the *** dural puncture headache and septic meningitis are the most commonly suspected causes of post spinal anesthesia headache;however,other causes should also be *** SUMMARY A 69-year-old woman was scheduled for varicose vein stripping surgery under spinal *** procedure was performed aseptically,and surgery was completed without any *** 4 d,the patient visited the emergency room with complaints of headache,nausea,and *** examination revealed that the patient was *** the history of spinal anesthesia,post dural puncture headache and septic meningitis was initially suspected,and the patient was treated with empirical ***,varicella-zoster virus PCR test result was positive,and all other test results were *** patient was diagnosed with meningitis caused by varicella-zoster virus and was treated with acyclovir for 5 *** headache improved,and the patient was discharged without any *** Viral meningitis due to virus reactivation may cause headache after regional ***,clinicians should consider multiple etiologies of headache.

关键词： Aseptic meningitis Headache Regional anesthesia spinal anesthesia Varicella zoster virus infection Case report

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Effectiveness of aromatherapy with lavender compared to progressive muscle relaxation on anxiety and vital signs in patients under spinal anesthesia:A randomized clinical trial

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Journal of Integrative Nursing 2024年第2期6卷 90-95页

作者： Nazanin AMINI Safoora OMIDVAR Masoomeh Noruzi ZAMENJANI Mehdi HARORANI Hesameddin MODIR Department of Paramedicine Arak University of Medical SciencesArakIran Department of Nursing Shazand School of NursingArak University of Medical SciencesArakIran Department of Anesthesiology Arak University of Medical SciencesArakIran

Objective:This study aimed to determine the effectiveness of aromatherapy with lavender essential oil compared to progressive muscle relaxation(PMR)on anxiety and vital signs of patients under spinal *** and Methods:This clinical trial was conducted on 120 spinal anesthesia candidates who were randomly assigned into three groups of 40 including control,PMR(Jacobsen group),and *** state-trait anxiety inventory was completed on surgery day and 15 min after the end of the intervention by the samples of all three groups,and at the same time as completing the questionnaire,vital signs were also measured and ***:The mean score of anxiety after intervention was lower than that before the intervention in the aromatherapy group(Pspinal *** to the high level of anxiety and its serious effects on the patient’s hemodynamics,aromatherapy with lavender can be used as an easy and cheap method to reduce anxiety in operation rooms.

关键词： Anxiety aromatherapy lavender essential oil massage progressive muscle relaxation spinal anesthesia vital signs

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spinal anesthesia in Infant with Ventriculoperitoneal Shunt: A Case Report of Inguinal Hernia Repair

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Open Journal of Anesthesiology 2016年第6期6卷 97-100页

作者： Gian Matteo Pedrazzi Gianfranco Montanari Vincenzo Domenichelli Department of Surgery Unit of Anesthesiology “Infermi” Hospital AUSL Romagna Rimini Italy Department of Woman Newborn Infants and Child Health Unit of Pediatric Urology “Infermi” Hospital AUSL Romagna Rimini Italy

We are describing a case of a female infant with ventriculoperitoneal shunt scheduled for inguinal hernia repair under spinal anesthesia. The child was a premature newborn who, in a recent past, underwent surgery in general anesthesia for retinopathy correction with subsequent difficult mechanical ventilation weaning. The benefit of spinal anesthesia in high-risk infant was described and the risks of spinal anesthesia in the presence of a ventricular shunt device-especially dural leakage and infections were briefly discussed.

关键词： spinal anesthesia Prematurity Ventriculoperitoneal Shunt Inguinal Hernia

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Comparison of two vasopressor protocols for preventing hypotension post-spinal anesthesia during cesarean section: a randomized controlled trial

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Chinese Medical Journal 2021年第7期134卷 792-799页

作者： Qian-Qian Fan Yong-Hui Wang Jing-Wen Fu Hai-Long Dong Man-Ping Yang Duo-Duo Liu Xiao-Fan Jiang Zhi-Xin Wu Li-Ze Xiong Zhi-Hong Lu Department of Anesthesiology and Perioperative Medicine Xijing HospitalFourth Military Medical UniversityXi’anShaanxi 710032China Department of Gynecology and Obstetrics Xijing HospitalFourth Military Medical UniversityXi’anShaanxi 710032China Department of Neurosurgery Xijing HospitalFourth Military Medical UniversityXi’anShaanxi 710032China Department of Anesthesiology and Translational Research Institute of Brain and Brain-like Intelligence Shanghai Fourth People’s Hospital Affiliated to Tongji University School of MedicineShanghai 200081China.

Background:Norepinephrine infusion decreases hypotension after spinal anesthesia during cesarean *** study aimed to compare the efficacy of norepinephrine infusion and ephedrine bolus against post-spinal hypotension in ***:In this double-blinded,randomized controlled clinical trial,parturients scheduled for elective cesarean section were randomly allocated to receive norepinephrine infusion(0.05μg·kg^(-1)·min^(-1))just before spinal anesthesia continuing for 30 min or ephedrine bolus(0.15 mg/kg)just before spinal anesthesia.A rescue bolus(5μg norepinephrine for the norepinephrine group,and 5 mg ephedrine for the ephedrine group)was administered whenever hypotension *** primary outcome was the incidence of hypotension within 30 min of spinal anesthesia *** outcomes included maternal and neonatal outcomes 30 min after spinal block,and neonatal cerebral oxygenation 10 min after ***:In total,190 patients were enrolled;of these patients,177 were included in the final *** patients suffered hypotension in the norepinephrine group than in the ephedrine group(29.5%vs.44.9%,odds ratio[OR]:0.51,95%confidence interval[CI]:0.28-0.95,P=0.034).Moreover,the tachycardia frequency was lower in the norepinephrine group than in the ephedrine group(OR:0.22,95%CI:0.11-0.44,Pspinal anesthesia,norepinephrine infusion compared to ephedrine bolus resulted in less hypotension and tachycardia,and exhibited potential neonatal benefits.

关键词： Hypotension spinal anesthesia Norepinephrine Ephedrine Cesarean section

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Effects of colloid preload on the incidence of hypotension in spinal anesthesia for cesarean section:a systematic review and meta-analysis

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Chinese Medical Journal 2021年第9期134卷 1043-1051页

作者： Rui-Song Gong Xiao_Wen Liu Wei-Xia Li Jing Zhao Department of anesthesia China-Japan Friendship HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijingChina Department of anesthesia China-Japan Friendship HospitalBeijingChina

Background:Hypotension is a common complication caused by spinal anesthesia(SA),which may have adverse impacts on the condition of the parturient and *** infusion was found to be relatively effective for reducing the incidence of ***,the question of whether colloid preload can optimize hemodynamic variables in the cesarean section remains *** study aims to determine the effects of colloid preload on the incidence of hypotension induced by SA in elective cesarean ***:Related keywords were searched on PubMed,EMBASE,and Cochrane Library from inception dates to May *** included were evaluated for eligibility and *** primary outcome was the intra-operative incidence of hypotension and severe *** secondary outcomes included the lowest intra-operative systolic blood pressure,the maximal intra-operative heart rate,the intra-operative needs of ephedrine and phenylephrine,the incidence of maternal nausea and/or vomiting,and neonatal outcomes(umbilical artery pH and Apgar scores).Apart from the above,RevMan 5.3 was used for the data ***:Altogether nine randomized controlled trials were included in the *** were no significant differences in the incidence of intra-operative hypotension,severe hypotension,or neonatal outcomes between the colloid preload group and control group,except for the umbilical artery ***:This meta-analysis suggests that colloid preload does not significantly reduce the incidence of hypotension associated with SA in elective cesarean section.

关键词： Colloid Preload spinal anesthesia Cesarean section

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Impact of Adding Midazolam to Bupivacaine 0.5% in Regional spinal anesthesia on Maternal Middle Cerebral Artery Velocimetry in Parturients with Severe Preeclampsia

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Open Journal of Anesthesiology 2020年第6期10卷 232-246页

作者： Mina Maher Raouf Hany Kamal Mikhail Mohammad Ameen Mohammed Awad Alsaeid Samar Magdy Department of anesthesia and ICU Faculty of Medicine El Minia University El Minia Egypt Departement of Radiodiagnosis Faculty of Medicine El Minia University El Minia Egypt Department of anesthesia and Pain Faculty of Medicine El Fayoum University El Fayoum Egypt

Severe preeclampsia is a challenging issue facing both intensivist and anesthetic team carrying both maternal and fetal morbidity and mortality. Termination of pregnancy after blood pressure control is the golden key in management. Cerebral complications due to diffuse cerebral vasospasm are most common and serious. Intrathecal midazolam with its gamma amino butyric action may antidote glutamate mediated sympathetic surge and decreasing cerebral vasospasm. Temporal view transcranial Doppler imaging maternal middle cerebral artery is used to examine blood flow indices namely pulsatility index and resistive index. One hundred ladies with severe preeclampsia scheduled for urgent caesarian section were recruited in 2 groups, both received 10 mg bupivacaine 0.5%, Midazolam group received 1 mg midazolam and the other group received 0.2 ml sterile saline 0.9% NaCl. All vascular indices were significantly better in midazolam group, less ICU stay.

关键词： Severe Preeclampsia Transcranial Doppler Midazolam spinal anesthesia

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A Comparison of spinal anesthesia with Levobupivacaine and Hyperbaric Bupivacaine for Cesarean Sections:A Randomized Trial

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Open Journal of Anesthesiology 2012年第3期2卷 84-89页

作者： Gulen Guler Gokhan Cakir Ayse Ulgey Fatih Ugur Cihangir Bicer Isin Gunes Adem Boyaci Department of Anesthesiology Medical FacultyErciyes UniversityKayseriTurkey

Purpose: Levobupivacaine showed a lower risk of cardiovascular and central nervous system (CNS) toxicity than bupivacaine which is the most popular local anesthetic agent in obstetric practice. The aim of this study was to investigate the clinical efficacy of levobupivacaine compared with hyperbaric bupivacaine for spinal anesthesia for cesarean section. Methods: 60 pregnant women in ASA I - II group scheduled to have elective cesarean operation were allocated into the study. Patients were randomly divided into two groups. The combinations 10 mg levobupivacaine (0.5%) + fentanyl (15 μcg) for Group LF (n = 30) patients, 10 mg hyperbaric bupivacaine (0.5%) + fentanyl (15 μcg) for BF (n = 30) patients were intrathecally administrated a total of 2.3 cc. Sensory and motor block characteristics of the groups were assessed with pinprick and Bromage scale;observed hemodynamic changes and side effects were recorded. Results: The time to reach maximum dermatome for the sensory block, time to regression by two dermatomes and time to regress to T12 dermatome was found to be significantly long in Group BF. It was observed that in Group BF, the evolution of the motor block was faster and lasted longer. Whereas hypotension, bradycardia and nausea were less in Group LF, the need for ephedrine was higher in Group BF (p < 0.05). Conclusion: Since motor block time is shorter, and side effects like hypotension, bradycardia and nausea are less, the combination of levobupivacaine + fentanyl can be a good alternative in cesarean sections.

关键词： spinal anesthesia Levobupivacaine Bupivacaine Fentanyl Cesarean Section

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