ABSTRACT
Scorpion bite has different manifestations in vital organs and may cause blindness secondary to involvement in the circulation of these vital organs. We report a case of abrupt vision loss and periorbital edema and redness due to scorpion bite in the eyebrow in an endemic region of southern Iran. A 45-year-old woman referred to the emergency room of our ophthalmology center due to abrupt vision loss and periorbital edema in her right eye. Involvement of ocular vasculature by localizing stroke due to the coagulative disorder caused by scorpion venom leads to retinal vein occlusion in this case. Management of BRVO was done with intravitreal injection of bevacizumab in the early phase. The outcome was complete vision recovery. To the best of our knowledge, this is the first case of macular branch retinal vein occlusion after scorpion bite
ABSTRACT
The disadvantages of intravenous regional anesthesia [IVRA] include slow onset, poor muscle relaxation, tourniquet pain, and rapid onset of pain after tourniquet deflation. In this randomized, double-blind study, we evaluated the effect of nitroglycerin [NTG] in quality improvement when added to lidocaine in IVRA. Forty-six patients [20?50 yrs], were randomly allocated in two equal groups. Under identical condition, the control group received a total dose of 3mg/kg of lidocaine 1% diluted with saline, and the study group received an additional 200 microg NTG. Vital signs and tourniquet pain, based on visual analog scale [VAS] score were measured and recorded before and 5, 10, 15, 20, and 30 min after anesthetic solution administration. The onset times of sensory and motor block were measured and recorded in all patients. After the tourniquet deflation, at 30 min and 2, 4, 6, 12 and 24h, VAS score, time to first analgesic requirement, total analgesic consumption in the first 24 h after operation, and side effects were noted. The sensory and motor block onset time were shortened in study group [2.61 vs. 5.09 and 4.22 vs. 7.04 min, respectively] [p <0.05]. The recovery time of sensory and motor block and onset of tourniquet pain were also prolonged [7.26 vs. 3.43, 9.70 vs. 3.74 and 25 vs. 16.65min., respectively] [p <0.05]. Analgesia time after tourniquet deflation was prolonged and tourniquet pain intensity was lowered in study group [p <0.05]. Intraoperative fentanyl and meperedine requirement during first postoperative day and pain intensity at 4, 6, 12 and 24 hr postoperatively were lower in the study group [p <0.05]. There were no significant side effects...The NTG adding to lidocaine in intravenous regional anesthesia shortens onset times of sensory and motor block and decreases the tourniquet and postoperative pain, without any side effect