Regarding the CNS-HLH prognosis, current views generally consider that
intrathecal injection does not have a significantly active function on the final outcome of CNS-HLH and that more often allo-HSCT is required.[4],[20] Even though in our study, the P value is not significant, which may be related to the limited number of cases, it is also very clear in the survival curve that allo-HSCT significantly improved the prognosis of CNS-HLH patients and effectively prolonged their survival times.
Serum and CSF were collected at baseline and each time of
intrathecal injection. Anti-NMDAR antibodies were evaluated using the indirect immunofluorescence test kit autoimmune encephalitis mosaic 1 (catalog no.
Morphine, which is a hydrophilic opioid, has a longer residence time in the cerebrospinal fluid and therefore has long-lasting analgesia with
intrathecal injection. [4,8] In our study, we compared efficacy and adverse effects of intrathecal ketorolac, intrathecal morphine, combination of both and normal saline with bupivacaine in lower limb inflammatory orthopaedic and general surgeries.
The patients were kept warm by insulating both lower limbs, upper limbs, chest and head-neck region with clean PVC sheets immediately after completion of
intrathecal injection and urinary catheterisation.
* Numerical rating scale pain scores at rest and movement (pressure care turning) were collected at four, eight, 12, 16 and 20 hours post
intrathecal injection and averaged to give a first 24-hour pain 'score' with a denominator of 10.
(27.) Balestrieri PJ, Hamza MS, Ting PH, Blank RS, Grubb CT Inadvertent
intrathecal injection of labetalol in a patient undergoing post-partum tubal ligation.
Its use however is limited by its short duration of action and its implication in transient neurologic symptoms and cauda equina syndrome following
intrathecal injection. Bupivacaine is three to four times more potent than lidocaine and has longer duration of action.
Our findings highlight the potential inaccuracy of anaesthetists preparing their own solutions of morphine for
intrathecal injection. The current commercial availability of a specific intrathecal preparation of morphine adds weight to its preferential use in all clinical settings in view of the likely benefits of patient safety and efficacy.
Heart rate and NIBP were recorded before
intrathecal injection, 3, 5, 15, 30 minutes after the intrathecal drug administration, and thereafter every 30 minutes till the end of the surgery and one hour after the end of the surgery, at the ward.
Data collection included years of training and specialist status, previous experience with
intrathecal injection of morphine, usual method of dilution of intrathecal morphine and typical intrathecal morphine dose administered.
* The duration of effective analgesia was considered as time from
intrathecal injection to administration of rescue analgesia.
In this case we believe erroneous judgment and inappropriate management led to
intrathecal injection of autologous blood.