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Biomedical subjects

A Hadzic

Publications and source records attributed to A Hadzic.

12 recordsLinked to original sources
PubMed2006

Neurologic and histologic outcome after intraneural injections of lidocaine in canine sciatic nerves.

BACKGROUND: Inadvertent intraneural injection of local anesthetics may result in neurologic injury. We hypothesized that an intraneural injection may be associated with higher injection pressures and an increase in the risk of neurologic injury. METHODS: The study was conducted in accordance with the principles of laboratory animal care, and was approved by the Laboratory Animal Care and Use Committee. Fifteen dogs of mixed breed (16-21 kg) were studied. After general endotracheal anesthesia, the sciatic nerves (n= 30) were exposed bilaterally. Under direct vision, a 25-gauge, long-beveled needle (30 degrees) was placed either epineurally (n= 10) or intraneurally (n= 20), and 4 ml of preservative-free lidocaine 20 mg/ml was injected using an automated infusion pump (4 ml/min). Injection pressure data were acquired using an in-line manometer coupled to a computer via an analog-to-digital conversion board. After injection, the animals were awakened and subjected to serial neurologic examinations. One week later, the dogs were killed, the sciatic nerves excised and histologic examination was performed by pathologists blind to the purpose of the study. RESULTS: All perineural injections resulted in low pressures (< or = 5 psi). In contrast, eight of 20 intraneural injections resulted in high pressures (20-38 psi) at the beginning of the injection. Twelve intraneural injections, however, resulted in pressures of less than 12 psi. Neurologic function returned to baseline within 3 h after perineural injections and within 24 h after intraneural injections, when the measured injection pressures were less than 12 psi. Neurologic deficits persisted throughout the study period after all eight intraneural injections that resulted in high injection pressures. Histologic examination of the affected nerves revealed fascicular axonolysis and cellular infiltration. CONCLUSIONS: The data in our canine model of intraneural injection suggest that intraneural injections do not always lead to nerve injury. High injection pressures during intraneural injection may be indicative of intrafascicular injection and may predict the development of neurologic injury.

Anesthetics, Local↗
PubMed2000

Unilateral mydriasis after nasal reconstruction surgery.

PURPOSE: To present a case of iatrogenic, unilateral pupillary dilatation after general anesthesia for nasal surgery. Unilateral pupillary dilatation after general anesthesia has sinister implications, which might prompt further investigations. However, in patients undergoing nasal surgery, it might be caused by the action of drugs injected intranasally. Consideration of iatrogenic causes of pupillary dilatation might help clinicians to avoid time-consuming and costly investigations. CLINICAL FEATURES: A 24-yr-old healthy woman underwent a general anesthetic for septoplasty and bilateral turbinectomy. She was hemodynamically stable and did not suffer any hypoxia intraoperatively. At the end of the operation her right pupil was dilated (8 mm diameter). Her left pupil was normal. No other abnormality was detected. After she woke up, her vision was grossly normal. Neurological examination did not show any other abnormality. Six to eight hours later, both pupils were equal (2 mm in diameter) and reacting normally to light and accommodation. CONCLUSION: The patient was a healthy 24-yr-old who underwent an operation in which there was no incident of hypoxia or hemodynamic instability. Since the patient recovered completely within six to eight hours, the pupillary dilatation was probably caused by epinephrine, which could have entered the eye through the nasolacrimal duct. Although pupillary dilatation after general anesthesia has been described, this is the first case report where the most likely causative agent was epinephrine, injected into the nasal submucosa.

Adult↗
PubMed1997

Combined popliteal and posterior cutaneous nerve of the thigh blocks for short saphenous vein stripping in outpatients: an alternative to spinal anesthesia.

STUDY OBJECTIVE: To compare a combination of peripheral nerve blocks with spinal anesthesia in ambulatory patients undergoing short saphenous vein stripping. DESIGN: Prospective, randomized study. SETTING: University hospital. PATIENTS: 28 ASA physical status l and II ambulatory surgery patients undergoing short saphenous vein stripping. INTERVENTIONS: 14 patients received a popliteal block (sciatic nerve block at the popliteal fossa) using 30 ml of alkalinized 3% chloroprocaine and a posterior cutaneous nerve of the thigh block with 10 ml of 1% lidocaine. The 14 patients who were randomized to the spinal anesthesia group received 65 mg of 5% hyperbaric lidocaine. MEASUREMENTS AND MAIN RESULTS: There were no significant differences in age and gender between the two groups (mean age 53 +/- 13 years, 8 men and 20 women). Patients in the peripheral nerve block group recovered significantly faster in phase 1 of the postanesthesia care unit (PACU) (67 +/- 10 min vs. 122 +/- 50 min, p < 0.01) and were discharged home sooner (222 +/- 53 min vs. 294 +/- 69 min, p < 0.01) than the patients in the spinal anesthesia group. CONCLUSIONS: The combination of popliteal and posterior cutaneous nerve of the thigh blocks provided adequate anesthesia and a faster recovery profile with a similar subjective acceptance of both anesthetic techniques in ambulatory patients undergoing short saphenous vein stripping in the prone position.

Ambulatory Surgical Procedures↗
PubMedDate not supplied

Improvised purification methods for obtaining individual drinking water supply under war and extreme shortage conditions.

BACKGROUND: Supplying an adequate amount of drinking water to a population is a complex problem that becomes an extremely difficult task in war conditions. In this paper, several simple methods for obtaining individual supplies of drinking water by filtration of atmospheric water with common household items are reported. METHODS: Samples of atmospheric water (rain and snow) were collected, filtered, and analyzed for bacteriological and chemical content. The ability of commonly available household materials (newspaper, filter paper, gauze, cotton, and white cotton cloth) to filter water from the environmental sources was compared. RESULTS: According to chemical and biological analysis, the best results were obtained by filtering melted snow from the ground through white cotton cloth. CONCLUSIONS: Atmospheric water collected during war or in extreme shortage conditions can be purified with simple improvised filtering techniques and, if chlorinated, used as an emergency potable water source.

Bosnia and Herzegovina↗
PubMedDate not supplied

Hypertensive crisis after a successful placement of an epidural anesthetic in a hypertensive parturient. Case report.

BACKGROUND AND OBJECTIVES: The use of epinephrine-containing local anesthetic solutions in pre-eclampsia is controversial. While epinephrine in local anesthetic solutions has been used without complications in this setting, a hypertensive reaction remains a concern among many clinicians. METHODS: An epidural anesthetic containing epinephrine was administered to a hypertensive parturient for cesarean delivery. When a hypertensive crisis developed, the radial artery was cannulated and administration of sodium nitroprusside was initiated. Arterial blood samples were evaluated for plasma norepinephrine and serum lidocaine concentrations. RESULTS: The introduction of lumbar epidural anesthesia for cesarean delivery using 30 mL 2% lidocaine with 1:200,000 epinephrine resulted in a profound hypertensive reaction, in the patient with pre-eclampsia, despite an adequate level of epidural anesthesia. CONCLUSIONS: Epinephrine-containing local anesthetic solutions may place a hypertensive parturient at significant risk of an acute hypertensive reaction.

Adult↗