Hypotension following combined spinal epidural anaesthesia

Abstract

Syringe labellingI was interested to read in the March 2003 edition of Anaesthesia News that the four Councils have decided to adopt what has become known as the International Colour Coding System for Syringe Labelling as is used in North America and Australasia. Manufacturers have already started circulating samples for anaesthetists to use. I have noticed that the colour labelling of the antagonists of commonly used drugs (for example flumazenil, neostigmine, labetolol, naloxone) are clearly identified by a striped diagonal border. The sample labels being circulated are predominantly white with a striped diagonal border alternating with that of the corresponding agonist colour. It is my experience from working in Australia that the same labels are predominantly coloured with the same striped border -that is the background label colour is the same as the agonist and not white. Having read the Australian and New Zealand Standard for User Applied Drug Labels in Anaesthesia it is understandable how its wording could be misinterpreted. Furthermore, I notice that some of the manufacturers are putting out labels with drug combinationsfor example propofol with lidocaine. If manufacturers are marketing this as the standard that complies with Australasia then this would appear to be incorrect.

Epidural analgesia compared with femoral nerve block for postoperative pain therapy after total knee arthroplasty – a matched pair analysis

“…Thoracic and lumbar epidural anesthesia induce sympathetic blockade and vasodilation in lower extremities. In patients with pre-existing hypertension, compensatory mechanisms are less efficient and may result in severe hypotension [22,23]. FNB plus PCA is associated with less adverse events such as urinary retention, muscle blockade and pruritus.…”