Adverse effects of beta adrenergic blockers during spinal anesthesia with 0.5% bupivacaine

J Vukelić,M Rakarić Poznanović

doi:10.1186/cc8712

Abstract

Protocol for perioperative usage of beta blockers was used in only 9% of major clinics in the USA. It is a very common practice to discontinue beta blockers during the perioperative period or to maximally reduce their doses. The main purpose of this paper is to investigate the incidence of adverse effects of beta blockers during large-scale trauma and orthopedic surgeries in spinal anesthesia.

Highlights

We previously showed that erythropoietin (EPO) attenuates the morphological signs of spinal cord ischemia/reperfusion (I/R) injury in swine [1] without, improving neurological function
The clinical use of EPO has been cautioned most recently due to serious safety concerns arising from an increased mortality in acute stroke patients treated with EPO and simultaneously receiving systemic thrombolysis [2]
In awake, spontaneously breathing mice, inhaling hydrogen sulfide (H2S) induced a hibernation-like metabolic state characterised by reduced energy expenditure and hypothermia [1], which protected against otherwise lethal hypoxia [2] and hemorrhage [3]

Summary

Introduction

We previously showed that erythropoietin (EPO) attenuates the morphological signs of spinal cord ischemia/reperfusion (I/R) injury in swine [1] without, improving neurological function. Methods We studied 90 patients affected by severe sepsis or septic shock previously enrolled in a prospective trial regarding the impact of glycemic control on inflammation and coagulation. In a retrospective analysis of the data from the SBITS-trial [1] we investigated whether the initial level of serum IgG on admission to the hospital in patients with sepsis and septic shock (before the first administration of the first dose of intravenous immunoglobulins) could be seen as a prognostic parameter for the primary outcome, lethality on day 28, or the secondary endpoints, lethality on day 7 or on the ICU. The aim of this analysis was to assess the impact of real-time continuous glucose monitoring (CGM) on glucose variability in critically ill patients receiving intensive insulin therapy (IIT) Methods This is the post hoc analysis of a prospective, randomized, controlled trial [2]. Respecting anonymity we have statistically evaluated 103 replies (response rate was 13.8%) and compared with data from other European countries

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