The caudal approach to the epidural space involves the use of a Tuohy needle, an intravenous catheter, or a hypodermic needle to puncture the sacrococcygeal membrane . Injecting local anaesthetic at this level can result in analgesia and/or anaesthesia of the perineum and groin areas. The caudal epidural technique is often used in infants and children undergoing surgery involving the groin, pelvis or lower extremities. In this population, caudal epidural analgesia is usually combined with general anaesthesia since most children do not tolerate surgery when regional anaesthesia is employed as the sole modality.
Sentara Healthcare , based in Norfolk, VA, celebrates more than 125 years in pursuit of its mission to improve health every day. Sentara is an integrated not-for-profit system of 12 hospitals in Virginia and North Carolina, including a Level I trauma center with Nightingale Regional Air Ambulance . The Sentara family also includes four medical groups, ambulatory campuses, post-acute care services, the physician-led Sentara Quality Care Network , the Sentara College of Health Sciences , Optima Health Plan members in Virginia, Alabama and Ohio, and a team of professionals nearly 28,000 strong. Sentara is strategically focused on continuous improvement in quality, safety, innovation and the patient experience.
A study in cloned human cardiac ion channels has shown that granisetron has the potential to affect cardiac repolarisation via blockade of HERG potassium channels. Granisetron has been shown to block both sodium and potassium channels, which potentially affects both depolarization and repolarization through prolongation of PR, QRS, and QT intervals. This data helps to clarify the molecular mechanisms by which some of the ECG changes (particularly QT and QRS prolongation) associated with this class of agents occur. However, there is no modification of the cardiac frequency, blood pressure or the ECG trace. If changes do occur, they are generally without clinical significance.