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Recent HBOT News
Clinical Trial – Intrathecal Magnesium for Same-day-surgery
5% hyperbaric lidocaine has lost its usefulness for same-day-surgery (SDS) anaesthesia
because it has been blamed responsible for the so-called transitory neurological syndrome
(TNS). This entity appears particularly in patients operated on lithotomy and knee
arthroscopy position and obese patients. It is a benign, moderately painful (grade 3-4 out of
10) and self-limited in time, but disturbing enough to be avoided in same-day-surgery cases.
Other local anesthetics are not competitive with general anesthesia in time to be discharged
home from the SDS unit. The magnesium ion is well-known for its protective properties on
cells with electrical activity. The objective is to confirm that the magnesium ion added as
adjuvant to intrathecal (IT) lidocaine may antagonize TNS incidence. If this hypothesis could
be confirmed, the practical and theoretical consequences would be far-reaching.
The method to achieve our objective would be a double-blinded randomized clinical trial
considering two groups of intrathecal lidocaine: with and without added IT magnesium.
Clinical Trial – Safety of Spinal Anesthesia in Patients With Tibial Shaft Fracture
There is a elevated risk of acute compartment syndrome (ACS) related to tibial shaft
fractures due to oedema and reduced blood flow in traumatised tissues. This may lead to lack
of oxygen and even necrosis. Symptoms of ACS are severe pain, hypoaesthesia, pain during
flexion of the ankle and swollen leg in clinical examination. Paralysis and lack of distal
pulses are late symptoms of ACS.
Many experts think that effective relief of pain caused by regional anaesthesia (RA) may hide
the symptoms of the ACS. This may be incorrect. The evidence of dangers related to RA is
based on old patient-series and single case-reports. Some of these studies report the
symptoms of ACS (hypaesthesia and even pain) being caused by RA. Majority of the conclusions
in these studies cannot be confirmed by an expert of RA. It is also possible that there are
more hemodynamic changes related to general anaesthesia (GA) which may predispose to ACS.
There are no modern, randomized and controlled studies of the safety of RA in patients with
tibial shaft fracture.
Late rectal and bladder toxicity following radiation therapy for prostate cancer: Predictive factors and treatment results.
Abstract: This study aimed at investigating factors associated to late rectal and bladder toxicity following radiation therapy and the effectiveness of Hyperbaric Oxygen Therapy (HBOT) when toxicity is grade ≥2. Radiation is frequently used for prostate cancer, but a...