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Local and Regional Anesthesia

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https://www.readbyqxmd.com/read/30288098/plasma-ropivacaine-concentration-after-tap-block-in-a-patient-with-cardiac-and-renal-failure
#1
Takashi Ishida, Satoshi Tanaka, Akiyuki Sakamoto, Takanobu Hirabayashi, Mikito Kawamata
We report a successful ultrasound-guided transversus abdominis plane (TAP) block as an analgesic option for minor abdominal surgery in a 66-year-old patient with cardiac, respiratory, and renal dysfunction caused by primary systemic amyloidosis. Bilateral TAP blocks with 120 mg (1.8 mg/kg) of ropivacaine provided sufficient intra- and postoperative analgesia for insertion of a continuous ambulatory peritoneal dialysis catheter. However, the plasma concentration of ropivacaine reached a maximum of 2.5 µg/mL at 15 minutes after the TAP block, a concentration that was potentially neurotoxic...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/30214281/the-impact-of-fluoroscopic-confirmation-of-thoracic-imaging-on-accuracy-of-thoracic-epidural-catheter-placement-on-postoperative-pain-control
#2
Tabish Aijaz, Kenneth D Candido, Utchariya Anantamongkol, Gleb Gorelick, Nebojsa Nick Knezevic
Background: Thoracic epidural analgesia (TEA) provides superior postoperative pain control compared to parenteral opioids after major thoracic and abdominal surgeries. However, some studies with respect to benefits of continuous TEA have shown mixed results. The purpose of this study was to determine the rate of successful TEA catheter insertion into the epidural space using contrast fluoroscopy and the impact of placement location on postoperative analgesia and opioid use. Patients and methods: After Advocate health care institutional review board approval, we conducted a prospective, open-label, single intervention study on patients undergoing thoracic or upper abdominal surgery...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/30127636/foot-drop-after-spinal-anesthesia-for-cesarean-section-a-case-report
#3
Ali Dastkhosh, Majid Razavi, Mehryar Taghavi Gilani
Objective: Spinal anesthesia is the preferred anesthetic technique for cesarean section. Neurological complications are very rare and often transient after spinal anesthesia. Case report: In the present case, a 37-year-old woman was considered eligible for cesarean section due to fetal distress. She underwent spinal anesthesia with a 25-gauge pencil-point spinal needle. In the sitting position, 3 mL of 0.5% bupivacaine was injected following free flow of cerebrospinal fluid...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/30122981/local-anesthetic-systemic-toxicity-current-perspectives
#4
REVIEW
Kariem El-Boghdadly, Amit Pawa, Ki Jinn Chin
Local anesthetic systemic toxicity (LAST) is a life-threatening adverse event that may occur after the administration of local anesthetic drugs through a variety of routes. Increasing use of local anesthetic techniques in various healthcare settings makes contemporary understanding of LAST highly relevant. Recent data have demonstrated that the underlying mechanisms of LAST are multifactorial, with diverse cellular effects in the central nervous system and cardiovascular system. Although neurological presentation is most common, LAST often presents atypically, and one-fifth of the reported cases present with isolated cardiovascular disturbance...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/30046251/optimizing-the-securement-of-epidural-catheters-an-in-vitro-trial
#5
Mohammed Hakim, Alexander B Froyshteter, Hina Walia, Dmitry Tumin, Giorgio Veneziano, Tarun Bhalla, Joseph D Tobias
Introduction: Epidural anesthesia is frequently used to provide postoperative analgesia following major surgical procedures. Secure fixation of the epidural catheter is necessary to prevent premature dislodgment and loss of epidural analgesia. Using an in vitro model, the current prospective study evaluates different types of dressings for securement of an epidural catheter by quantifying the force in Newtons (N) required for dislodgment using a digital force gage. Methods: Four methods of epidural catheter securement were used on a simulator mannequin: 1) Suresite® Window Clear Dressing, 2) Op-Site Post-Op® Visible Dressing, 3) Steri-Strips® and Suresite Window Clear Dressing, and 4) Steri-Strips and Op-Site Post-Op Visible Dressing...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/29760560/spinal-anesthesia-instead-of-general-anesthesia-for-infants-undergoing-tendon-achilles-lengthening
#6
EDITORIAL
Mohammad AlSuhebani, David P Martin, Lance M Relland, Tarun Bhalla, Allan C Beebe, Amanda T Whitaker, Walter Samora, Joseph D Tobias
Spinal anesthesia (SA) has been used relatively sparingly in the pediatric population, as it is typically reserved for patients in whom the perceived risk of general anesthesia is high due to comorbid conditions. Recently, concern has been expressed regarding the potential long-term neurocognitive effects of general anesthesia during the early stages of life. In view of this, our center has developed a program in which SA may be used as the sole agent for applicable surgical procedures. While this approach in children is commonly used for urologic or abdominal surgical procedures, there have been a limited number of reports of its use for orthopedic procedures in this population...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/29670398/remifentanil-induced-postoperative-hyperalgesia-current-perspectives-on-mechanisms-and-therapeutic-strategies
#7
REVIEW
Cristina Santonocito, Alberto Noto, Claudia Crimi, Filippo Sanfilippo
The use of remifentanil in clinical practice offers several advantages and it is used for a wide range of procedures, ranging from day-surgery anesthesia to more complex procedures. Nonetheless, remifentanil has been consistently linked with development of opioid-induced hyperalgesia (OIH), which is described as a paradoxical increase in sensitivity to painful stimuli that develops after exposure to opioid treatment. The development of OIH may cause several issues, delaying recovery after surgery and preventing timely patient's discharge...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/29503582/effect-of-warming-anesthetic-on-pain-perception-during-dental-injection-a-split-mouth-randomized-clinical-trial
#8
Pedro Christian Aravena, Camila Barrientos, Catalina Troncoso, Cesar Coronado, Pamela Sotelo-Hitschfeld
Background: The purpose of this study is to determine the effectiveness of warming anesthesia on the control of the pain produced during the administration of dental anesthesia injection and to analyze the role of Transient Receptor Potential Vanilloid-1 nociceptor channels in this effect. Patients and methods: A double-blind, split-mouth randomized clinical trial was designed. Seventy-two volunteer students (22.1±2.45 years old; 51 men) from the School of Dentistry at the Universidad Austral de Chile (Valdivia, Chile) participated...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/29440926/local-anesthetics-for-brain-tumor-resection-current-perspectives
#9
REVIEW
Jan-Willem Potters, Markus Klimek
This review summarizes the added value of local anesthetics in patients undergoing craniotomy for brain tumor resection, which is a procedure that is carried out frequently in neurosurgical practice. The procedure can be carried out under general anesthesia, sedation with local anesthesia or under local anesthesia only. Literature shows a large variation in the postoperative pain intensity ranging from no postoperative analgesia requirement in two-thirds of the patients up to a rate of 96% of the patients suffering from severe postoperative pain...
2018: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/29184440/administration-of-epidural-labor-analgesia-is-not-associated-with-a-decreased-risk-of-postpartum-depression-in-an-urban-canadian-population-of-mothers-a-secondary-analysis-of-prospective-cohort-data
#10
Marissa Nahirney, Amy Metcalfe, Katie H Chaput
Background: Postpartum depression (PPD) is a common complication of pregnancy, affecting approximately 13% of mothers internationally. Previous research has examined whether epidural analgesia used for pain control during labor and birth is associated with a lower risk of PPD, but reports conflicting results and may have suffered from methodological shortcomings. Our study aimed to prospectively assess whether epidural analgesia is associated with a lower risk of PPD (at either 6 weeks or 6 months postpartum) after attempting to adequately adjust for selection bias and confounding variables...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/29066932/efficiency-of-spinal-anesthesia-versus-general-anesthesia-for-lumbar-spinal-surgery-a-retrospective-analysis-of-544-patients
#11
John T Pierce, Guy Kositratna, Mark A Attiah, Michael J Kallan, Rebecca Koenigsberg, Peter Syre, David Wyler, Paul J Marcotte, W Andrew Kofke, William C Welch
BACKGROUND: Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia to general in lumbar surgery. Some studies have shown reduced surgical time, postoperative pain, time in the postanesthesia care unit (PACU), incidence of urinary retention, postoperative nausea, and more favorable cost-effectiveness with spinal anesthesia. Despite these results, the current literature has also shown contradictory results in between-group comparisons...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28860857/preventing-nausea-and-vomiting-in-women-undergoing-regional-anesthesia-for-cesarean-section-challenges-and-solutions
#12
REVIEW
Yvonne Jelting, Christian Klein, Thomas Harlander, Leopold Eberhart, Norbert Roewer, Peter Kranke
BACKGROUND: Intraoperative nausea and vomiting (IONV) or postoperative nausea and vomiting (PONV) affecting women undergoing regional anesthesia for cesarean section is an important clinical problem since these techniques are used widely. There are burdens of literature about IONV/PONV and several in parturient and cesarean. However, it needs more attention. The underlying mechanisms of IONV and PONV in the obstetrical setting mainly include hypotension due to sympathicolysis during neuraxial anesthesia, bradycardia owing to an increased vagal tone, the visceral stimulation via the surgical procedure and intravenously administered opioids...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28790864/case-report-bilateral-tunneled-epidural-catheters-to-prevent-unilateral-analgesia-for-cancer-related-pain
#13
Raj B Padalia, Corey J Reeves, Neal Shah, Ankur A Patel, Devang M Padalia
OBJECTIVE: Unilateral analgesia often occurs with epidural analgesia. Traditional methods of troubleshooting this problem can be insufficient in obtaining adequate pain relief in a timely manner for terminal cancer patients. This case report demonstrates a safe and effective solution which can be utilized in these circumstances. CASE REPORT: A 55-year-old female with stage IV pancreatic cancer and life expectancy of a few weeks presented to the interventional pain clinic with intractable sacral pain...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28790863/great-auricular-neuropraxia-with-beach-chair-position
#14
Minal Joshi, Ruth Cheng, Hattiyangadi Kamath, Joel Yarmush
Shoulder arthroscopy has been shown to be the procedure of choice for many diagnostic and therapeutic interventions. Neuropraxia of the great auricular nerve (GAN) is an uncommon complication of shoulder surgery, with the patient in the beach chair position. We report a case of great auricular neuropraxia associated with direct compression by a horseshoe headrest, used in routine positioning for uncomplicated shoulder surgery. In this case, an arthroscopic approach was taken, under regional anesthesia with sedation in the beach chair position...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28744155/efficacy-of-single-injection-unilateral-thoracic-paravertebral-block-for-post-open-cholecystectomy-pain-relief-a-prospective-randomized-study-at-gondar-university-hospital
#15
Demeke Yilkal Fentie, Endale Gebreegziabher Gebremedhn, Zewditu Abdissa Denu, Amare Hailekiros Gebreegzi
BACKGROUND: Cholecystectomy can be associated with considerable postoperative pain. While the benefits of paravertebral block (PVB) on pain after thoracotomy and mastectomy have been demonstrated, not enough investigations on the effects of PVB on pain after open cholecystectomy have been conducted. We tested the hypothesis that a single-injection thoracic PVB reduces pain scores, decreases opioid consumption, and prolongs analgesic request time after cholecystectomy. METHODS: Of 52 patients recruited, 50 completed the study...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28740428/does-the-approach-influence-the-success-rate-for-ultrasound-guided-rectus-sheath-blocks-an-anatomical-case-series
#16
Ronald Seidel, Andreas Wree, Marko Schulze
The anterior cutaneous branches of the thoracolumbar spinal nerves enter the rectus sheath at its lateral border and perforate the muscle after travelling a short distance in the ventral direction. In this anatomical case series, we show that dye injection at the medial margin did not lead to reliable impregnation of the target nerves. The local anesthetic should therefore be injected at the lateral edge of the rectus sheath. Preceding surgical procedures to the ventral abdominal wall may affect the craniocaudal spread of local anesthetic...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28721094/spinal-anesthesia-the-holy-grail
#17
COMMENT
Marieke Voet, Cornelis Slagt
No abstract text is available yet for this article.
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28496360/epidural-anesthesia-for-labor-and-delivery-in-a-patient-with-may-hegglin-anomaly-a-case-report
#18
Annas Muhammad Muzannar, Mohammed Al Harbi, Raza Rathore, Nasser Tawfeeq, Freddie Wambi, Nasir Mahmood, Sonia Albrechtova, Vassilios Dimitriou
We report a case of May-Hegglin anomaly (MHA) in a woman who had a successful labor and delivery under epidural anesthesia. MHA is an inherited thrombocytopenia easily misdiagnosed as idiopathic (immune) thrombocytopenic purpura (ITP). Early and appropriate diagnosis of MHA during pregnancy is essential for optimal maternal and neonatal delivery outcome. Additionally, it can avoid unnecessary diagnostic studies, such as bone marrow aspiration and biopsy, and even harmful therapies with corticosteroids, immunosuppressive agents, and splenectomy...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28479859/the-smaller-the-better
#19
COMMENT
Cornelis Slagt
No abstract text is available yet for this article.
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28458577/ambulatory-anesthetic-care-in-children-undergoing-myringotomy-and-tube-placement-current-perspectives
#20
REVIEW
Hal Robinson, Thomas Engelhardt
PURPOSE: Myringotomy and tube placement is one of the most frequently performed ear, nose and throat (ENT) surgeries in the pediatric population. Effective anesthetic management is vital to ensuring successful ambulatory care and ensuring child and parental satisfaction. RECENT FINDINGS: This review summarizes recently published studies about the long-term effects of general anesthesia in young children, novel approaches to preoperative fasting and simplified approaches to the assessment and management of emergence delirium (ED) and emergence agitation (EA)...
2017: Local and Regional Anesthesia
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