A rare case of delayed subarachnoid anesthetic blockade effects in a 103-year-old female patient
Identifieur interne : 007482 ( Ncbi/Merge ); précédent : 007481; suivant : 007483A rare case of delayed subarachnoid anesthetic blockade effects in a 103-year-old female patient
Auteurs : Ramsis F. Ghaly [États-Unis] ; Utchariya Anantamongkol [États-Unis] ; Kenneth D. Candido [États-Unis] ; Nebojsa Nick Knezevic [États-Unis]Source :
- Surgical Neurology International [ 2229-5097 ] ; 2015.
Abstract
The elderly represent a unique challenge for the effects of regional anesthesia, and very few cases of block onset delay have been described. Their delayed response is attributed to a number of factors that include: Physiologic deterioration, musculoskeletal contractures, degenerative joint disease, autonomic regulatory dysfunction, cognitive dysfunction, altered pharmacokinetics, and pharmacodynamics of local anesthetics and adjuvants.
In this report we present the rare case of 45-min delay between the administration and onset of action of a subarachnoid blockade in a 103-year-old female, who was scheduled for left hip pinning, for repair of a femoral neck fracture. Patient received an injection of hyperbaric bupivacaine, 1.5 ml of 0.75% (11.25 mg), with 15 mcg of fentanyl into the subarachnoidal space and underwent the surgical procedure without complications.
Delayed responses to subarachnoid anesthesia can be expected in extremely elderly patients. Anesthetic procedures should be monitored and managed on a case-by-case basis.
Url:
DOI: 10.4103/2152-7806.157658
PubMed: 26060597
PubMed Central: 4448518
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Ghaly</name><affiliation wicri:level="2"><nlm:aff id="aff1">Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="aff2">Department of Anesthesiology, JHS Hospital of Cook County, Chicago, IL 60612</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Department of Anesthesiology, JHS Hospital of Cook County, Chicago</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="aff3">Ghaly Neurosurgical Associates, Aurora, IL 60504</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Ghaly Neurosurgical Associates, Aurora</wicri:cityArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4">Department of Anesthesiology, University of Illinois, Chicago, IL 60612, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Anesthesiology, University of Illinois, Chicago, IL 60612</wicri:regionArea><wicri:noRegion>IL 60612</wicri:noRegion></affiliation></author><author><name sortKey="Anantamongkol, Utchariya" sort="Anantamongkol, Utchariya" uniqKey="Anantamongkol U" first="Utchariya" last="Anantamongkol">Utchariya Anantamongkol</name><affiliation wicri:level="2"><nlm:aff id="aff1">Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago</wicri:cityArea></affiliation></author><author><name sortKey="Candido, Kenneth D" sort="Candido, Kenneth D" uniqKey="Candido K" first="Kenneth D." last="Candido">Kenneth D. 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Ghaly</name><affiliation><nlm:aff id="aff1">Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657</nlm:aff><wicri:noCountry code="subfield">IL 60657</wicri:noCountry></affiliation><affiliation wicri:level="2"><nlm:aff id="aff2">Department of Anesthesiology, JHS Hospital of Cook County, Chicago, IL 60612</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Department of Anesthesiology, JHS Hospital of Cook County, Chicago</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="aff3">Ghaly Neurosurgical Associates, Aurora, IL 60504</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Ghaly Neurosurgical Associates, Aurora</wicri:cityArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4">Department of Anesthesiology, University of Illinois, Chicago, IL 60612, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Anesthesiology, University of Illinois, Chicago, IL 60612</wicri:regionArea><wicri:noRegion>IL 60612</wicri:noRegion></affiliation></author><author><name sortKey="Anantamongkol, Utchariya" sort="Anantamongkol, Utchariya" uniqKey="Anantamongkol U" first="Utchariya" last="Anantamongkol">Utchariya Anantamongkol</name><affiliation wicri:level="2"><nlm:aff id="aff1">Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago</wicri:cityArea></affiliation></author><author><name sortKey="Candido, Kenneth D" sort="Candido, Kenneth D" uniqKey="Candido K" first="Kenneth D." last="Candido">Kenneth D. Candido</name><affiliation wicri:level="2"><nlm:aff id="aff1">Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago</wicri:cityArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4">Department of Anesthesiology, University of Illinois, Chicago, IL 60612, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Anesthesiology, University of Illinois, Chicago, IL 60612</wicri:regionArea><wicri:noRegion>IL 60612</wicri:noRegion></affiliation></author><author><name sortKey="Knezevic, Nebojsa Nick" sort="Knezevic, Nebojsa Nick" uniqKey="Knezevic N" first="Nebojsa Nick" last="Knezevic">Nebojsa Nick Knezevic</name><affiliation wicri:level="2"><nlm:aff id="aff1">Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago</wicri:cityArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff4">Department of Anesthesiology, University of Illinois, Chicago, IL 60612, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Anesthesiology, University of Illinois, Chicago, IL 60612</wicri:regionArea><wicri:noRegion>IL 60612</wicri:noRegion></affiliation></author></analytic><series><title level="j">Surgical Neurology International</title><idno type="ISSN">2229-5097</idno><idno type="eISSN">2152-7806</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background:</title><p>The elderly represent a unique challenge for the effects of regional anesthesia, and very few cases of block onset delay have been described. Their delayed response is attributed to a number of factors that include: Physiologic deterioration, musculoskeletal contractures, degenerative joint disease, autonomic regulatory dysfunction, cognitive dysfunction, altered pharmacokinetics, and pharmacodynamics of local anesthetics and adjuvants.</p></sec><sec id="st2"><title>Case Description:</title><p>In this report we present the rare case of 45-min delay between the administration and onset of action of a subarachnoid blockade in a 103-year-old female, who was scheduled for left hip pinning, for repair of a femoral neck fracture. Patient received an injection of hyperbaric bupivacaine, 1.5 ml of 0.75% (11.25 mg), with 15 mcg of fentanyl into the subarachnoidal space and underwent the surgical procedure without complications.</p></sec><sec id="st3"><title>Conclusions:</title><p>Delayed responses to subarachnoid anesthesia can be expected in extremely elderly patients. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Surg Neurol Int</journal-id><journal-id journal-id-type="iso-abbrev">Surg Neurol Int</journal-id><journal-id journal-id-type="publisher-id">SNI</journal-id><journal-title-group><journal-title>Surgical Neurology International</journal-title></journal-title-group><issn pub-type="ppub">2229-5097</issn><issn pub-type="epub">2152-7806</issn><publisher><publisher-name>Medknow Publications & Media Pvt Ltd</publisher-name><publisher-loc>India</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26060597</article-id><article-id pub-id-type="pmc">4448518</article-id><article-id pub-id-type="publisher-id">SNI-6-88</article-id><article-id pub-id-type="doi">10.4103/2152-7806.157658</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>A rare case of delayed subarachnoid anesthetic blockade effects in a 103-year-old female patient</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Ghaly</surname><given-names>Ramsis F.</given-names></name><email xlink:href="rfghaly@aol.com">rfghaly@aol.com</email><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff3">3</xref><xref ref-type="aff" rid="aff4">4</xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Anantamongkol</surname><given-names>Utchariya</given-names></name><email xlink:href="utchariya.anan@gmail.com">utchariya.anan@gmail.com</email><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Candido</surname><given-names>Kenneth D.</given-names></name><email xlink:href="kdcandido1@gmail.com">kdcandido1@gmail.com</email><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Knezevic</surname><given-names>Nebojsa Nick</given-names></name><email xlink:href="nick.knezevic@gmail.com">nick.knezevic@gmail.com</email><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff4">4</xref></contrib></contrib-group><aff id="aff1"><label>1</label>Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657</aff><aff id="aff2"><label>2</label>Department of Anesthesiology, JHS Hospital of Cook County, Chicago, IL 60612</aff><aff id="aff3"><label>3</label>Ghaly Neurosurgical Associates, Aurora, IL 60504</aff><aff id="aff4"><label>4</label>Department of Anesthesiology, University of Illinois, Chicago, IL 60612, USA</aff><author-notes><corresp id="cor1"><label>*</label>Corresponding author
</corresp></author-notes><pub-date pub-type="collection"><year>2015</year></pub-date><pub-date pub-type="epub"><day>26</day><month>5</month><year>2015</year></pub-date><volume>6</volume><elocation-id>88</elocation-id><history><date date-type="received"><day>27</day><month>2</month><year>2015</year></date><date date-type="accepted"><day>17</day><month>3</month><year>2015</year></date></history><permissions><copyright-statement>Copyright: © 2015 Ghaly RF.</copyright-statement><copyright-year>2015</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-sa/3.0"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec id="st1"><title>Background:</title><p>The elderly represent a unique challenge for the effects of regional anesthesia, and very few cases of block onset delay have been described. Their delayed response is attributed to a number of factors that include: Physiologic deterioration, musculoskeletal contractures, degenerative joint disease, autonomic regulatory dysfunction, cognitive dysfunction, altered pharmacokinetics, and pharmacodynamics of local anesthetics and adjuvants.</p></sec><sec id="st2"><title>Case Description:</title><p>In this report we present the rare case of 45-min delay between the administration and onset of action of a subarachnoid blockade in a 103-year-old female, who was scheduled for left hip pinning, for repair of a femoral neck fracture. Patient received an injection of hyperbaric bupivacaine, 1.5 ml of 0.75% (11.25 mg), with 15 mcg of fentanyl into the subarachnoidal space and underwent the surgical procedure without complications.</p></sec><sec id="st3"><title>Conclusions:</title><p>Delayed responses to subarachnoid anesthesia can be expected in extremely elderly patients. Anesthetic procedures should be monitored and managed on a case-by-case basis.</p></sec></abstract><kwd-group><kwd>Delayed response</kwd><kwd>elderly patients</kwd><kwd>subarachnoid anesthetic blockade</kwd></kwd-group></article-meta></front></pmc><affiliations><list><country><li>États-Unis</li></country><region><li>Illinois</li></region></list><tree><country name="États-Unis"><region name="Illinois"><name sortKey="Ghaly, Ramsis F" sort="Ghaly, Ramsis F" uniqKey="Ghaly R" first="Ramsis F." last="Ghaly">Ramsis F. Ghaly</name></region><name sortKey="Anantamongkol, Utchariya" sort="Anantamongkol, Utchariya" uniqKey="Anantamongkol U" first="Utchariya" last="Anantamongkol">Utchariya Anantamongkol</name><name sortKey="Candido, Kenneth D" sort="Candido, Kenneth D" uniqKey="Candido K" first="Kenneth D." last="Candido">Kenneth D. Candido</name><name sortKey="Candido, Kenneth D" sort="Candido, Kenneth D" uniqKey="Candido K" first="Kenneth D." last="Candido">Kenneth D. Candido</name><name sortKey="Ghaly, Ramsis F" sort="Ghaly, Ramsis F" uniqKey="Ghaly R" first="Ramsis F." last="Ghaly">Ramsis F. Ghaly</name><name sortKey="Ghaly, Ramsis F" sort="Ghaly, Ramsis F" uniqKey="Ghaly R" first="Ramsis F." last="Ghaly">Ramsis F. Ghaly</name><name sortKey="Knezevic, Nebojsa Nick" sort="Knezevic, Nebojsa Nick" uniqKey="Knezevic N" first="Nebojsa Nick" last="Knezevic">Nebojsa Nick Knezevic</name><name sortKey="Knezevic, Nebojsa Nick" sort="Knezevic, Nebojsa Nick" uniqKey="Knezevic N" first="Nebojsa Nick" last="Knezevic">Nebojsa Nick Knezevic</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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HfdIndexSelect -h $EXPLOR_AREA/Data/Ncbi/Merge/RBID.i -Sk "pubmed:26060597" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Ncbi/Merge/biblio.hfd \
| NlmPubMed2Wicri -a LymphedemaV1
| This area was generated with Dilib version V0.6.31. |  |