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https://www.readbyqxmd.com/read/28549524/-quadratus-lumborum-block-are-we-aware-of-its-side-effects-a-report-of-2-cases
#1
Miguel Sá, José Miguel Cardoso, Hugo Reis, Marta Esteves, José Sampaio, Isabel Gouveia, Pilar Carballada, Célia Pinheiro, Duarte Machado
BACKGROUND AND OBJECTIVES: The quadratus lumborum block was initially described in 2007 and aims at blocking the same nerves as the ones involved on the Transverse Abdominis Plane block, while accomplishing some visceral enervation as well due to closer proximity with the neuroaxis and sympathetic trunk. Given its versatility, we have successfully used it in a wide range of procedures. We report two cases where we believe the dispersion of local anesthetic is likely to have led to a previously undescribed complication...
May 23, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28545491/treatment-of-acute-sciatica-with-transforaminal-epidural-corticosteroids-and-local-anesthetic-design-of-a-randomized-controlled-trial
#2
Bastiaan C Ter Meulen, Esther T Maas, Amrita Vyas, Marinus van der Vegt, Koo de Priester, Michiel R de Boer, Maurits W van Tulder, Henry C Weinstein, Raymond W J G Ostelo
BACKGROUND: Transforaminal epidural injections with steroids (TESI) are used increasingly for patients with sciatica. However there is much debate about their safety and effectiveness. It is important to identify patients that benefit most from TESI and only few trials have yet evaluated the effects in patients with acute sciatica. METHODS: We describe a prospective, randomized controlled trial (RCT), with the aim to evaluate the hypothesis that TESI plus Levobupivacaine (TESI-plus) added to oral pain medication is more effective compared to pain medication alone or compared to transforaminal injection with a local anesthetic of short duration among patients with acute sciatica...
May 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28535567/radiation-dose-and-procedure-time-for-994-ct-guided-spine-pain-control-procedures
#3
Matthew S Lazarus, Rebecca B Forman, Alan L Brook, Todd S Miller
BACKGROUND: Image guidance for spine pain control procedures, including epidural steroid injection, nerve root block, and facet block, can be performed with either computed tomography (CT) or conventional fluoroscopy. CT has the advantage of improved anatomic localization and use of air for contrast; however, there are concerns that CT leads to higher radiation dose and longer procedure time. OBJECTIVE: To evaluate procedure time and radiation dose for multiple types of spine pain control procedures performed under CT guidance...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28535556/feasibility-of-percutaneous-lumbar-discectomy-combined-with-percutaneous-cementoplasty-for-symptomatic-lumbar-disc-herniation-with-modic-type-i-endplate-changes
#4
Qing-Hua Tian, Ying-Ying Lu, Xi-Qi Sun, Tao Wang, Chun-Gen Wu, Ming-Hua Li, Sheng Cheng-Ying
BACKGROUND: Treatment of symptomatic lumbar disc herniation with Modic type I endplate changes is complex and challenging, requiring systemic and local therapies which include conservative therapy, epidural infiltrations, percutaneous therapeutic techniques, and surgical options. The clinical management of symptomatic lumbar disc herniation involving Modic type I endplate changes is uniquely challenging because it requires alleviating pain caused by both the herniated disc and the endplate osteochondritis...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28526462/-sudden-motor-and-sensorial-loss-due-to-retroperitoneal-hematoma-during-postoperative-periods-a-case-report
#5
Pelin Şen, Havva Gül Gültekin, İsmail Caymaz, Ömer Özel, Ayda Türköz
A 68 year-old male patient was hospitalized for radical prostatectomy. He had no abnormal medical history including neurological deficit before the operation. Prior to general anesthesia, an epidural catheter was inserted in the L3-4 interspace for intraoperative and postoperative analgesia. After surgery for nine hours, he developed confusion and flaccid paralysis of bilateral lower extremities occurred. No pathology was detected from cranial computed tomography and diffusion magnetic resonance imaging no pathology was detected...
May 16, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28524911/cancer-related-acute-pain-a-systematic-review-of-evidence-based-interventions-for-putting-evidence-into-practice
#6
Thiruppavai Sundaramurthi, Natalie Gallagher, Bethany Sterling
BACKGROUND: Identifying and implementing evidence-based interventions for cancer-related acute pain can decrease adverse effects and improve quality of life. 
. OBJECTIVES: This article presents current evidence supporting interventions to reduce cancer-related acute pain. 
. METHODS: PubMed and CINAHL® databases were searched to identify studies addressing interventions to manage acute pain in patients with cancer. The interventions are categorized according to the Putting Evidence Into Practice classification schema...
June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28515284/long-lasting-increase-in-axonal-excitability-following-epidurally-applied-dc
#7
Elzbieta Jankowska, Dominik Kaczmarek, Francesco Bolzoni, Ingela Hammar
Effects of direct current (DC) on nerve fibres have primarily been investigated during or just after DC application. However, locally applied cathodal DC was recently demonstrated to increase the excitability of intraspinal preterminal axonal branches for more than one hour. The aim of this study was, therefore, to investigate whether DC evokes a similarly long-lasting increase in the excitability of myelinated axons within the dorsal columns. The excitability of dorsal column fibres stimulated epidurally was monitored by recording compound action potentials in peripheral nerves in acute experiments in deeply anaesthetized rats...
May 17, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28512617/vertebral-artery-injury-in-c2-3-epidural-schwannoma-resection-a-case-report-and-literature-review
#8
Su Bum Lee, Chae Hong Rhim, Sung Woo Roh, Sang Ryong Jeon, Seung Chul Rhim
The incidence of vertebral artery (VA) injury (VAI) in posterior approach tumor resection surgery is extremely rare, but it can lead to serious complication. In this case, a 57-year-old man underwent surgery for resection of the tumor involving left epidural space and neural foramen at C2-3 level. Iatrogenic VAI occurred suddenly during tumor resection procedure using pituitary forceps. Immediate local hemostasis and maintaining of perfusion for reducing the risk of posterior circulation ischemia were performed...
April 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/28508148/thermographic-skin-temperature-measurement-compared-with-cold-sensation-in-predicting-the-efficacy-and-distribution-of-epidural-anesthesia
#9
Arnoud A Bruins, Kay R J Kistemaker, Annemieke Boom, John H G M Klaessens, Rudolf M Verdaasdonk, Christa Boer
Due to the high rates of epidural failure (3-32%), novel techniques are required to objectively assess the successfulness of an epidural block. In this study we therefore investigated whether thermographic temperature measurements have a higher predictive value for a successful epidural block when compared to the cold sensation test as gold standard. Epidural anesthesia was induced in 61 patients undergoing elective abdominal, thoracic or orthopedic surgery. A thermographic picture was recorded at 5, 10 and 15 min following epidural anesthesia induction...
May 15, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28492436/continuous-regional-anesthesia-and-inpatient-rehabilitation-for-pediatric-complex-regional-pain-syndrome
#10
Carolina Donado, Kimberly Lobo, María Fe Velarde-Álvarez, Joseph Kim, Anne Kenney, Deirdre Logan, Charles B Berde
BACKGROUND: Evidence supports treatment of pediatric complex regional pain syndromes (CRPS) with physical and occupational therapy and cognitive-behavioral therapy. Some patients have persistent pain and/or limb dysfunction despite these treatments. We performed a retrospective study of pediatric patients with CRPS treated by continuous epidural or peripheral perineural local anesthetic infusions along with inpatient rehabilitation at Boston Children's Hospital. METHODS: After approval from the institutional review board, electronic medical records were reviewed for patients treated between September 2003 and September 2014...
May 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28476692/oxytocin-administration-during-spontaneous-labor-guidelines-for-clinical-practice-chapter-7-epidural-analgesia-and-use-of-oxytocin-during-spontaneous-labor
#11
Catherine Fischer
OBJECTIVES: To evaluate the association between epidural analgesia and oxytocin use during spontaneous labor. MATERIAL AND METHODS: A systematic review of the literature via the Medline and Cochrane databases. The key words used for this analysis included oxytocin and epidural. The articles selected related only to spontaneous labor. RESULTS: Based on data reflecting at least in part older practices of epidural analgesia that used high quantities of local anesthetic, studies of the effects of epidural analgesia suggest that those epidural methods had little effect on the first stage of labor but prolonged the second stage and increased the rate of instrumental but not cesarean delivery...
May 2, 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28475555/epidural-neostigmine-versus-fentanyl-to-decrease-bupivacaine-use-in-patient-controlled-epidural-analgesia-during-labor-a-randomized-double-blind-controlled-study
#12
Jessica L Booth, Vernon H Ross, Kenneth E Nelson, Lynnette Harris, James C Eisenach, Peter H Pan
BACKGROUND: The addition of opioids to epidural local anesthetic reduces local anesthetic consumption by 20% but at the expense of side effects and time spent for regulatory compliance paperwork. Epidural neostigmine also reduces local anesthetic use. The authors hypothesized that epidural bupivacaine with neostigmine would decrease total hourly bupivacaine use compared with epidural bupivacaine with fentanyl for patient-controlled epidural analgesia. METHODS: A total of 215 American Society of Anesthesiologists physical status II, laboring parturients requesting labor epidural analgesia consented to the study and were randomized to receive 0...
May 5, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28474974/primary-spinal-epidural-cic-dux4-undifferentiated-sarcoma-in-a-child
#13
John E Donahue, Evgeny Yakirevich, Shan Zhong, Diana O Treaba, Nelli S Lakis, Siraj M Ali, Suzanne M de la Monte, Shamlal Mangray
Primitive round- or spindle-cell EWSR1-negative undifferentiated sarcomas harboring CIC-DUX4 gene fusion are the most common form of Ewing-like sarcomas. These tumors primarily occur in peripheral soft tissues, but examples have been described within viscera and the brain. As far as we are aware, CIC-DUX4 positive primary epidural spinal sarcoma has not been reported. Herein, we describe a T5-T6 epidural tumor in a 15-year-old girl in which many neoplastic cells had moderate and focally abundant cytoplasm, including plasmacytoid or rhabdoid cells, rather than the more common Ewing-like morphology described in the majority of such tumors...
January 1, 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28450153/epidural-focal-brain-cooling-abolishes-neocortical-seizures-in-cats-and-non-human-primates
#14
Takao Inoue, Masami Fujii, Hiroyuki Kida, Toshitaka Yamakawa, Yuichi Maruta, Tatsuji Tokiwa, Yeting He, Sadahiro Nomura, Yuji Owada, Takeshi Yamakawa, Michiyasu Suzuki
Focal brain cooling (FBC) is under investigation in preclinical trials of intractable epilepsy (IE), including status epilepticus (SE). This method has been studied in rodents as a possible treatment for epileptic disorders, but more evidence from large animal studies is required. To provide evidence that FBC is a safe and effective therapy for IE, we investigated if FBC using a titanium cooling plate can reduce or terminate focal neocortical seizures without having a significant impact on brain tissue. Two cats and two macaque monkeys were chronically implanted with an epidural FBC device over the somatosensory and motor cortex...
April 24, 2017: Neuroscience Research
https://www.readbyqxmd.com/read/28448325/combined-spinal-epidural-anesthesia-with-dexmedetomidine-based-sedation-for-multiple-corrective-osteotomies-in-a-child-with-osteogenesis-imperfecta-type-iii-a-case-report
#15
Anju Gupta, Geeta Kamal, Nishkarsh Gupta, Anil Aggarwal
Osteogenesis imperfecta (OI) is a rare disabling genetic connective tissue disorder. General anesthesia in these patients is associated with increased risks. Regional anesthesia is favored wherever feasible, but there are limited reports of use of a sole regional technique in OI in pediatric patients. Moreover, combined spinal-epidural anesthesia has never been described previously. We are reporting the use of combined spinal-epidural anesthesia for a prolonged surgery (multiple osteotomies) of lower limbs in a 10-year-old wheelchair-bound child with OI type III...
April 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28448320/difficult-airway-management-resulting-from-local-anesthetic-allergy-during-emergent-cesarean-delivery-a-case-report
#16
Courtney L Maxey-Jones, Alec Palmerton, Jocelyn R Farmer, Brian T Bateman
Difficult airway management in the gravid patient is a well-described phenomenon. We present a case of emergent cesarean delivery complicated by a "cannot intubate, cannot ventilate" scenario that was later determined to be secondary to an allergic, IgE-mediated reaction to epidurally administered local anesthetic.
April 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28425307/epidural-fentanyl-does-not-affect-cervical-dilation-and-progress-of-first-stage-of-vaginal-delivery-a-randomized-double-blind-study
#17
Chryssoula Staikou, Theodoros Kalampokas, Emmanouil Kalampokas, Sophia Vassiloglou, Anteia Paraskeva
OBJECTIVE: Local anesthetics combined with opioids are commonly used in labor epidural analgesic schemes. We investigated if the addition of fentanyl to epidural ropivacaine can affect cervical dilation and progress of vaginal delivery. METHODS: Sixty-two nulliparous parturients were randomized to receive epidurally 8ml ropivacaine 0.2% combined with fentanyl 20μg (F/R-group, n = 31) or with normal saline 0.4ml (R-group, n = 31), every hour. Rescue doses of 5ml ropivacaine 0...
April 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28419420/reliability-of-pressure-waveform-analysis-to-determine-correct-epidural-needle-placement-in-labouring-women
#18
I Al-Aamri, S H Derzi, A Moore, M F Elgueta, M Moustafa, T Schricker, D Q Tran
Pressure waveform analysis provides a reliable confirmatory adjunct to the loss-of-resistance technique to identify the epidural space during thoracic epidural anaesthesia, but its role remains controversial in lumbar epidural analgesia during labour. We performed an observational study in 100 labouring women of the sensitivity and specificity of waveform analysis to determine the correct location of the epidural needle. After obtaining loss-of-resistance, the anaesthetist injected 5 ml saline through the epidural needle (accounting for the volume already used in the loss-of-resistance)...
April 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28417614/spinal-epidural-abscess-caused-by-brucella-species-a-review-of-17-cases
#19
Qin Zhang, Xiaohui Yang, Honglin Yu, Benrang Jia, Bin Meng
BACKGROUND: Spinal epidural abscess (SEA) is a rarely encountered clinical entity during the course of Brucella infection. METHODS: We reported 17 patients diagnosed with Brucellar SEA for a mean follow-up of 15 months. Spinal epidural abscess was detected by magnetic resonance imaging in all cases. Brucella diagnosis was established by serological tests. Patients were administered antibiotics for duration of 6 to 16 weeks. RESULTS: SEA was localized in lumbar region in 9 patients, thoracic in 4 patients, cervical in 3 patients, both thoracic and lumbar in 1 patient...
June 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28417354/perioperative-epidural-analgesia-is-not-associated-with-increased-survival-from-renal-cell-cancer-but-overall-survival-may-be-improved-a-retrospective-chart-review
#20
Evan Kovac, Farhad Firoozbakhsh, Homayoun Zargar, Amr Fergany, Hesham Elsharkawy
PURPOSE: We investigated the possible association between perioperative epidural and both cancer-specific survival (CSS) and overall survival (OS) in patients undergoing partial or radical nephrectomy for localized renal cell carcinoma (RCC). METHODS: A retrospective chart review was performed on patients who underwent complete surgical resection of localized RCC from 1994-2008 at our institution. Baseline demographics and pathological and survival data were collected...
April 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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