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neuroaxial block

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https://www.readbyqxmd.com/read/27871553/fascia-iliaca-block-associated-only-with-deep-sedation-in-high-risk-patients-taking-p2y12-receptor-inhibitors-for-intramedullary-femoral-fixation-in-intertrochanteric-hip-fracture-a-series-of-3-cases
#1
Carlos Rodrigues Almeida, Emília Milheiro Francisco, Vítor Pinho-Oliveira, José Pedro Assunção
OBJECTIVE: We present a series of 3 cases in which the impact in outcome was, first of all, related to the capacity to offer early and safer treatment to some hip fracture high-risk patients using a fascia iliaca block (FIB; ropivacaine 0,5% 20 cc and mepivacaine 1,3% 15 cc, given 30 minutes before incision) associated only with deep sedation, contributing to better practice and outcome. CASE REPORTS: All elderly patients were American Society of Anesthesiologists IV patients, under P2Y12 receptor inhibitors, suffering from an intertrochanteric fracture, and purposed for intramedullary femoral fixation (IMF)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27608657/palmitoylethanolamide-reverses-paclitaxel-induced-allodynia-in-mice
#2
Giulia Donvito, Jenny L Wilkerson, M Imad Damaj, Aron H Lichtman
Chemotherapy-induced peripheral neuropathy (CIPN) represents a serious complication associated with antineoplastic drugs. Although there are no medications available that effectively prevent CIPN, many classes of drugs have been used to treat this condition, including anticonvulsants, serotonin and noradrenaline reuptake inhibitors, and opioids. However, these therapeutic options yielded inconclusive results in CIPN clinical trials and produced assorted side effects with their prolonged use. Thus, there is an urgent need to develop efficacious and safe treatments for CIPN...
November 2016: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/27594753/anesthetic-management-of-urgent-cesarean-section-with-undiagnosed-transposition-of-great-arteries
#3
Nurullah Yilmaz, Ersin Koksal, Gokce Ultan Ozgen, Ersan Ozen, Ahmet Dilek, Deniz Karakaya, Fatma Ulger
We consider that general anesthesia will be an appropriate and safe method as regional methods could lead to significant time loss in the prevention or minimization of complications. High blockage required for regional anesthetic methods in pregnant women with TGA and the maintenance of hemodynamic stability may become difficult due to neuroaxial sympathectomy even if a successful neuroaxial block has been provided. Agents with minimal effect on cardiovascular functions should be preferred for anesthesia induction and maintenance and close hemodynamic monitoring should be done during intraoperative and postoperative periods...
June 2016: Medical Archives
https://www.readbyqxmd.com/read/27591456/bilateral-greater-occipital-nerve-block-for-treatment-of-post-dural-puncture-headache-after-caesarean-operations
#4
Esra Uyar Türkyilmaz, Nuray Camgöz Eryilmaz, Nihan Aydin Güzey, Özlem Moraloğlu
BACKGROUND: Post-dural puncture headache (PDPH) is an important complication of neuroaxial anesthesia and more frequently noted in pregnant women. The pain is described as severe, disturbing and its location is usually fronto-occipital. The conservative treatment of PDPH consists of bed rest, fluid theraphy, analgesics and caffeine. Epidural blood patch is gold standard theraphy but it is an invasive method. The greater occipital nerve (GON) is formed of sensory fibers that originate in the C2 and C3 segments of the spinal cord and it is the main sensory nerve of the occipital region...
September 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27445257/-bilateral-greater-occipital-nerve-block-for-treatment-of-post-dural-puncture-headache-after-caesarean-operations
#5
Esra Uyar Türkyilmaz, Nuray Camgöz Eryilmaz, Nihan Aydin Güzey, Özlem Moraloğlu
BACKGROUND: Post-dural puncture headache (PDPH) is an important complication of neuroaxial anesthesia and more frequently noted in pregnant women. The pain is described as severe, disturbing and its location is usually fronto-occipital. The conservative treatment of PDPH consists of bed rest, fluid theraphy, analgesics and caffeine. Epidural blood patch is gold standard theraphy but it is an invasive method. The greater occipital nerve (GON) is formed of sensory fibers that originate in the C2 and C3 segments of the spinal cord and it is the main sensory nerve of the occipital region...
September 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27410754/-management-of-acute-postoperative-pain-following-thoracotomy-state-of-the-art
#6
J Matek, P Michálek, S Trča, Z Krška
UNLABELLED: Postoperative pain management is an important part of complex perioperative care in patients undergoing thoracotomy, irrespective of the procedure type. Adequate pain relief leads to early mobilisation, improves respiratory functions and decreases global stress response. Thus, good perioperative pain management significantly reduces postoperative complications. Currently, numerous analgesic methods are available for the management of acute postthoracotomy pain including patient- or nurse-controlled systemic administration of analgesics, infiltration with local anaesthetics, intrapleural or intercostal nerve blockades and neuroaxial blocks (paravertebral, intrathecal, epidural)...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/27388793/adjunct-analgesic-drugs-to-local-anaesthetics-for-neuroaxial-blocks-in-children
#7
Märit Lundblad, Per-Arne Lönnqvist
PURPOSE OF REVIEW: This article reviews various adjunct drugs used in the context of neuroaxial blocks in children and to provide a literature and evidence-based suggestion for the rational use of such adjuncts. RECENT FINDINGS: Contrary to plain local anaesthetics, preservative-free morphine and clonidine, ketamine in neonatal rodents has been found to enhance apoptosis in the spinal cord. Dexmedetomidine has been shown to be equally effective as clonidine as an adjunct to caudal blocks...
October 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27385940/the-effect-of-regional-analgesia-on-vascular-tone-in-hip-arthroplasty-patients
#8
Enrique A Goytizolo, Ottokar Stundner, Sandra Hurtado Rúa, Dorothy Marcello, Valeria Buschiazzo, Ansara M Vaz, Stavros G Memtsoudis
BACKGROUND: While it is assumed that neuraxial analgesia and pain management may beneficially influence perioperative hemodynamics, few studies provided data quantifying such effects and none have assessed the potential contribution of the addition of a nerve block. QUESTIONS/PURPOSES: This clinical trial compared the visual analog scale (VAS) scores and measurement of arterial tone using augmentation index of patients who received combined spinal-epidural (CSE) only to patients who received both CSE and lumbar plexus block...
July 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/27225734/ultrasound-guided-chronic-pain-interventions-part-ii
#9
Taylan Akkaya, Alp Alptekin, Derya Özkan
Henceforth, ultrasonography (US) is an indispensible imaging technique in regional anesthesia practice. With the guidance of US, various invasive interventions in chronic pain pathologies of the musculoskeletal system, peripheral and neuroaxial pathologies has become possible. The management includes diagnostic blocks as weel as radiofrequency ablation and institution of neurolythic agents. During these algologic interventions we are able to see the target tissue, the dispersion of the drug and all nearby vascular structures...
April 2016: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
https://www.readbyqxmd.com/read/27225606/ultrasound-guided-chronic-pain-interventions-part-i
#10
Taylan Akkaya, Alp Alptekin, Derya Özkan
Recently, ultrasonography (US) is an indispensible imaging technique in regional anesthesia practice. With the guidance of US, various invasive interventions in chronic pain pathologies of the musculoskeletal system, peripheral and neuroaxial pathologies has become possible. The management includes diagnostic blocks as weel as radiofrequency ablation and institution of neurolythic agents. During these algologic interventions we are able to see the target tissue, the dispersion of the drug and all nearby vascular structures...
January 2016: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
https://www.readbyqxmd.com/read/26922685/ephedrine-requirements-during-spinal-anesthesia-for-cesarean-delivery-in-jordanian-parturients-association-with-b2-adrenoceptor-gene-variants
#11
Mahmoud M Almustafa, Abdelkareem S Al-Oweidi, Khaled R Al-Zaben, Ibraheem Y Qudaisat, Sami Abu-Halaweh, Subhi M Alghanem, Islam M Massad, Walid Samarah, Reem A Al-Shaer, Said Ismail, Fawaz Khazawla
BACKGROUND: Maternal hypotension after spinal anesthesia for cesarean delivery is common. Many studies performed on the b2-adrenoceptor (b2AR) gene variants and their association with vasopressor requirements during and after neuroaxial block have contradictory conclusions. OBJECTIVES: The aim of the study was to evaluate the influence of the b2AR in codons 16 and 27 on the incidence of maternal hypotension and ephedrine consumption after spinal anesthesia for cesarean delivery in an Arab ethnic group...
January 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/26446688/anesthetic-considerations-in-hellp-syndrome
#12
REVIEW
M del-Rio-Vellosillo, J J Garcia-Medina
BACKGROUND: HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) is an obstetric complication with heterogonous presentation and multisystemic involvement. It is characterized by microangiopathic hemolytic anemia, elevated liver enzymes by intravascular breakdown of fibrin in hepatic sinusoids and reduction of platelet circulation by its increased consumption. METHODS: In terms of these patients' anesthetic management, it is essential to consider some details: (1) effective, safe perioperative management by a multidisciplinary approach, and quick, good communication among clinical specialists to achieve correct patient management; (2) neuroaxial block, particularly spinal anesthesia, is the first choice to do the cesarean if there is only moderate, but not progressive thrombocytopenia; (3) if a general anesthesia is required, it is necessary to control the response to stress produced by intubation, especially in patients with either severe high blood pressure or neurological signs, or to prevent major cerebral complications; (4) invasive techniques, e...
February 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/26357836/spinal-anaesthesia-at-low-and-moderately-high-altitudes-a-comparison-of-anaesthetic-parameters-and-hemodynamic-changes
#13
MULTICENTER STUDY
Mehmet Aksoy, Ilker Ince, Ali Ahıskalıoglu, Omer Karaca, Fikret Bayar, Ali Fuat Erdem
BACKGROUND: Hypoxemia caused high altitude leads to an increase and variability in CSF volume. The purpose of this prospective study was to detect the differences, if any, between moderately highlanders and lowlanders in terms of anaesthetic parameters under neuroaxial anaesthesia. METHODS: Consecutive patients living at moderately high altitude (Erzurum, 1890 m above the sea level) and sea level (Sakarya, 31 m above the sea level) scheduled for elective lower extremity surgery with spinal anaesthesia were enrolled in this study (n = 70, for each group)...
2015: BMC Anesthesiology
https://www.readbyqxmd.com/read/26310089/the-rise-of-remifentanil-and-the-decline-of-midwifery-autonomy
#14
REVIEW
Carol Tiffin, Moira Broadhead
Since the 1980s epidural analgesia has been considered the gold standard for pain relief in labour. Over the past decade there has been a growing trend in UK maternity units to offer remifentanil PCA as a fast, safe alternative for women where epidural analgesia is contraindicated. Increasingly more obstetric units and anaesthetists are extending the use of remifentanil and in many units it is now preferred over central neuroaxial blocks (Stocki et al 2014). It would appear that remifentanil is being hailed as the panacea for labour pain...
January 2015: Practising Midwife
https://www.readbyqxmd.com/read/26237236/new-oral-anticoagulants-and-neuraxial-regional-anesthesia
#15
REVIEW
Thomas Volk, Christine Kubulus
PURPOSE OF REVIEW: As the increased use of new oral anticoagulants may put patients at particular risk of bleeding, experts suggested strategies to perform neuraxial anesthesia as well tolerated as possible. This review summarizes different approaches. RECENT FINDINGS: Data from licensing studies, drug pharmacology, registries, authorities and expert opinions are available and covered by the article. Spinal epidural hematoma formation associated with neuraxial blocks is rare...
October 2015: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/25912739/posterior-intercostal-nerve-block-with-liposomal-bupivacaine-an-alternative-to-thoracic-epidural-analgesia
#16
David C Rice, Juan P Cata, Gabriel E Mena, Andrea Rodriguez-Restrepo, Arlene M Correa, Reza J Mehran
BACKGROUND: Pain relief using regional neuroaxial blockade is standard care for patients undergoing major thoracic surgery. Thoracic epidural analgesia (TEA) provides effective postoperative analgesia but has unwanted side effects, including hypotension, urinary retention, nausea, and vomiting, and is highly operator dependent. Single-shot intercostal nerve and paravertebral blockade have not been widely used because of the short duration of action of most local anesthetics; however, the recent availability of liposomal bupivacaine (LipoB) offers the potential to provide prolonged blockade of intercostal nerves (72 to 96 hours)...
June 2015: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/25567394/-analgesic-techniques-for-labour-alternatives-in-case-of-epidural-failure
#17
J R Ortiz-Gómez, F J Palacio-Abizanda, I Fornet-Ruiz
Epidural analgesia is now the method of choice for the treatment of pain in labour and delivery. However, this technique may fail and provide inadequate or null alleviation to the mother. This paper reviews the risk factors, possible causes and possible therapeutic alternatives to inadequate analgesia, whether pharmacological therapies (neuroaxial, peripheral blocks or analgesic administration via intravenous or inhalational routes) or non-pharmacological ones (relaxation techniques, psychological or mechanical)...
September 2014: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/25422602/comparative-evaluation-of-ropivacaine-versus-dexmedetomidine-and-ropivacaine-in-epidural-anesthesia-in-lower-limb-orthopedic-surgeries
#18
Sarabjit Kaur, Joginder Pal Attri, Gagandeep Kaur, Tejinder Pal Singh
BACKGROUND: Various adjuvant are being used with local anesthetics for prolongation of intra operative and postoperative analgesia in epidural block for lower limb surgeries. Dexmedetomidine, the highly selective α2 adrenergic agonist is a new neuroaxial adjuvant gaining popularity. The aim of the present study was to compare the hemodynamic, sedative and analgesia potentiating effects of epidurally administered dexmedetomidine when combined with ropivacaine. MATERIALS AND METHODS: The study was conducted in prospective, randomized double-blind manner in which 100 patients of American Society of Anesthesiologist Grade I and II in the age group of 20-65 years of either sex under going lower limb surgeries were included after taking informed consent...
October 2014: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/25320659/a-review-of-current-analgesic-techniques-in-cardiac-surgery-is-epidural-worth-it
#19
REVIEW
Mohsen Ziyaeifard, Rasoul Azarfarin, Samad Ej Golzari
In this review we addressed the various analgesic techniques in cardiac surgery, especially regional methods such as thoracic epidural anesthesia (TEA). There are many techniques available for management of postoperative pain after cardiac operation including intravenous administration of analgesic drugs, infiltration of local anesthetics, nerve blocks, and neuroaxial techniques. Although there are many evidences declaring the benefits of neuroaxial blockade in improving postoperative well-being and quality of care in these patients, some studies have revealed limited effect of TEA on overall morbidity and mortality after cardiac surgery...
2014: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/25205412/-changing-trends-and-regional-anesthesia-practices-in-turkey
#20
Yavuz Gürkan, Alparslan Kuş, Can Aksu, Ciğdem Ohtaroğlu, Mine Solak, Kamil Toker
OBJECTIVES: Introduction of ultrasound into regional anesthesia (RA) practice has resulted in important changes and developments in RA. These developments have had a major influence on the way of practice and choice of blocks. The purpose of this study was to present the most recent instruments used in RA and clinical applications in our country. METHODS: A questionnaire consisting of 10 questions were distributed to the participants of the National RA Congress in 2011...
2014: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
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