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B Dennison

Publications and source records attributed to B Dennison.

9 recordsLinked to original sources

Mechanism of extension of spinal anaesthesia by extradural injection of local anaesthetic.

We have examined the effect of extradual injection of 0.5% bupivacaine or normal saline on the progression of spinal anaesthesia in 28 patients undergoing Caesearean section. Three groups were studied. Subarachnoid anaesthesia was established in all patients. Group A (n = 10), the control, received no extradural injection for 20 min. Group B (n = 9) received extradural bupivacaine 10 ml and group C (n = 9) received extradual saline 10 ml 5 min after the subarachnoid injection. Sensory levels were compared at 5-min intervals and extension of the block was found to be similar in groups B and C and significantly faster than the control (P < 0.05). The quality of anaesthesia and incidence of adverse effects was similar for all three groups. We conclude that the mechanism of extension of spinal anaesthesia by extradural injection of local anaesthesia is largely a volume effect.

Adult

Epidural test dose.

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Anesthesia, Epidural

Excessive dose requirements of local anaesthetic for epidural analgesia. How far should an epidural catheter be inserted?

On two separate occasions, a 78-year-old obese man suffering from congestive cardiac failure and peripheral vascular disease, required epidural anaesthesia for surgery to his leg. The dosage requirement on the first occasion was large and much greater than on the second occasion. Reasons for the difference in dosage are discussed. We suggest an epidural catheter should be inserted 3 cm into the epidural space.

Aged

Complications associated with a narrow bore nasogastric tube.

The use of a new narrow bore nasogastric feeding tube with stylet has resulted in two cases of misplacement with traumatic laceration of the visceral pleura. Diagnoses were made by chest x-ray film, one case immediately and the other 24 hours later. In both cases, the narrow bore tube was inserted asymptomatically by a graduate physician. Detailed case reports of both patients are presented, those patients at risk for abnormal placement of this nasogastric tube are discussed, and new guidelines for safer use are proposed.

Aged