Continuous lumbosacral block using a Tuohy needle and catheter technique

Three cases are reported where continuous lumbosacral block was performed using a catheter through an epidural needle technique. Good unilateral lower limb surgical anaesthesia was achieved in all three cases with successful blockade of the lumbar and sacral plexuses. A 17-gauge Tuohy needle was positioned between the transverse processes of L4 and L5 and an epidural catheter inserted into the space between the quadratus lumborum and psoas muscles. Forty to seventy millilitres of local anaesthetic were injected and resulted in good surgical anaesthesia within 12-20 min. Radiographic studies in these patients confirmed placement of the catheter in close proximity to the lumbosacral plexus. Experience in a further 12 cases is also reported. There were no side-effects. The technique is successful and is recommended when unilateral lower limb anaesthetic is required and when spinal and epidural anaesthesia are contraindicated.     

Role of computed tomography (CT) in identifying foreign body ingestion in an individual with autism – A case report

Foreign body ingestions are quite common and most often will uneventfully pass in stool, however, some ingestions, can lead to complications such as obstruction. If left untreated, this can lead to perforation and fistula formation. Hence, threshold for intervention should be low and diagnostic imaging can assist with treatment decisions. We present to you a case of 17-year-old male with non-verbal autism with an unusual hollow foreign body ingestion leading to small bowel obstruction.     

Effects of exposure to cotton dust on energy expenditure in the textile industry

Summary An assessment of energy expenditure has been made in 50 male textile workers and 30 male office cleaners. There was a statistically significant difference (P < 0.001) in energy expenditure between textile workers and office cleaners amounting to 12 to 16%. While 33.3% of the textile group complained of chest disorders, none of the cleaners had such a complaint. FEV₁ and FVC values of the textile workers were significantly lower (P < 0.01) compared to those of the controls. There were no differences in body weight, lean body mass and socio-economic conditions of the two groups, however, the textile workers were younger and taller than the unexposed group. Exposure to cotton dust and respiratory and ventilatory impairments are suspected of causing a reduction in the energy expenditure of the textile workers     

Efeito da inclinação da mesa e flexão da coluna sobre a janela acústica da coluna lombar em mulheres grávidas

Study objective

The purpose of this study was to assess whether application of dorsal table tilt and body rotation to a parturient seated for neuraxial anesthesia increased the size of the paramedian target area for neuraxial needle insertion.