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101.
Subramanian Vaidyanathan Bakul Soni Fahed Selmi Gurpreet Singh Cristian Esanu Peter Hughes Tun Oo Kamesh Pulya 《Patient safety in surgery》2012,6(1):1-8
Background
Some tetraplegic patients may wish to undergo urological procedures without anaesthesia, but these patients can develop autonomic dysreflexia if cystoscopy and vesical lithotripsy are performed without anaesthesia.Case presentation
We describe three tetraplegic patients, who developed autonomic dysreflexia when cystoscopy and laser lithotripsy were carried out without anesthesia. In two patients, who declined anaesthesia, blood pressure increased to more than 200/110 mmHg during cystoscopy. One of these patients developed severe bleeding from bladder mucosa and lithotripsy was abandoned. Laser lithotripsy was carried out under subarachnoid block a week later in this patient, and this patient did not develop autonomic dysreflexia. The third patient with C-3 tetraplegia had undergone correction of kyphoscoliotic deformity of spine with spinal rods and pedicular screws from the level of T-2 to S-2. Pulmonary function test revealed moderate to severe restricted curve. This patient developed vesical calculus and did not wish to have general anaesthesia because of possible need for respiratory support post-operatively. Subarachnoid block was not considered in view of previous spinal fixation. When cystoscopy and laser lithotripsy were carried out under sedation, blood pressure increased from 110/50 mmHg to 160/80 mmHg.Conclusion
These cases show that tetraplegic patients are likely to develop autonomic dysreflexia during cystoscopy and vesical lithotripsy, performed without anaesthesia. Health professionals should educate spinal cord injury patients regarding risks of autonomic dysreflexia, when urological procedures are carried out without anaesthesia. If spinal cord injury patients are made aware of potentially life-threatening complications of autonomic dysreflexia, they are less likely to decline anaesthesia for urological procedures. Subrachnoid block or epidural meperidine blocks nociceptive impulses from urinary bladder and prevents occurrence of autonomic dysreflexia. If spinal cord injury patients with lesions above T-6 decline anaesthesia, nifedipine 10 mg should be given sublingually prior to cystoscopy to prevent increase in blood pressure due to autonomic dysreflexia. 相似文献102.
103.
Heng Chi Pauline Arends Jurriën G P Reijnders Ivana Carey Ashley Brown Massimo Fasano David Mutimer Katja Deterding Ye H Oo Jrg Petersen Florian van Bommel Robert J de Knegt Teresa A Santantonio Thomas Berg Tania M Welzel Heiner Wedemeyer Maria Buti Pierre Pradat Fabien Zoulim Bettina E Hansen Harry L A Janssen 《Journal of gastroenterology and hepatology》2016,31(11):1882-1887
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109.
Young-Sam Keum Tin Oo Khor Wen Lin Guoxiang Shen Ki Han Kwon Avantika Barve Wenge Li Ah-Ng Kong 《Pharmaceutical research》2009,26(10):2324-2331
Purpose
In the present study, we have evaluated the pharmacokinetics and the in vivo prostate chemopreventive activity of broccoli sprouts. 相似文献110.