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https://www.readbyqxmd.com/read/28934797/percutaneous-endoscopic-debridement-and-drainage-with-four-different-approach-methods-for-the-treatment-of-spinal-infection
#1
Eun-Ji Choi, Su-Young Kim, Hyuck-Goo Kim, Hong-Sik Shon, Tae-Kyun Kim, Kyung-Hoon Kim
BACKGROUND: The incidence of spinal infection seems to be increasing in recent years. Percutaneous endoscopic debridement and drainage (PEDD) has become an effective alternative to extensive open surgery. OBJECTIVE: This study reviewed the charter of patients who received PEDD using 4 different approach methods to evaluate the clinical results. STUDY DESIGN: An Institutional Review Board (IRB)-approved retrospective chart review. SETTING: University hospital inpatient referred to our pain clinic...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934781/posture-influences-the-extent-of-spread-of-contrast-medium-during-thoracic-epidurography-a-prospective-randomized-trial
#2
Ji Hee Hong, Sung Won Jung, Ji Hoon Park
BACKGROUND: Various factors influencing the distribution of sensory blockade in epidural anesthesia have been identified; however, reports on the effects of gravity and different postures in thoracic epidural anesthesia have been rare. Medications may be injected with the lateral decubitus or the neutral position; however, it is unclear whether the distribution range of medication is similar or significantly different between these 2 postures. OBJECTIVE: We focused on identifying the effect of different postures on the distribution of local anesthetics using epidurography at the thoracic level...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28928573/a-comparative-study-for-the-analgesic-efficacy-and-safety-profile-of-fentanyl-versus-clonidine-as-an-adjuvant-to-epidural-ropivacaine-0-75-in-lower-abdominal-surgeries
#3
Shuchi Nigam, Shivani Rastogi, Amit Tyagi, Rajlakshmi Bhandari
CONTEXT: Different adjuvants are coadministered with local anesthetics to improve the speed of onset and duration of analgesia, and to reduce the dose, the selection of which is often left to the choice of an anesthesiologist. AIM: The aim of this study was to compare the analgesic efficacy and safety profile of fentanyl and clonidine as an adjuvant to epidural ropivacaine anesthesia. SETTING AND DESIGN: With institutional ethical committee clearance, a prospective, randomized, placebo-controlled double-blind clinical study was conducted at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928552/comparative-efficacy-of-minimal-concentration-of-racemic-bupivacaine-0-0625-with-fentanyl-and-ropivacaine-0-1-with-fentanyl-for-epidural-labor-analgesia
#4
T N Chethanananda, M R Shashank, N Madhu, J Achyutha, Karna Venkata Siva Kumar
BACKGROUND AND AIMS: This study aims to compare the minimum effective concentration of local anesthetic (LA) bupivacaine and ropivacaine with highly lipid soluble opioids fentanyl for providing optimal labor epidural analgesia. SETTINGS AND DESIGN: The objective of this study was to evaluate the efficacy of racemic bupivacaine 0.0625% and 0.1% of ropivacaine both mixed with 2 μg/ml of fentanyl for epidural labor analgesia in parturients with spontaneous labor and normal fetal heart rate tracing...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28917280/a-novel-use-of-the-intraoperative-mri-for-metastatic-spine-tumors-laser-interstitial-thermal-therapy-for-percutaneous-treatment-of-epidural-metastatic-spine-disease
#5
REVIEW
Jonathan G Thomas, Wajd N Al-Holou, Dhiego Chaves de Almeida Bastos, Amol J Ghia, Jing Li, Andrew J Bishop, Behrang Amini, Laurence D Rhines, Claudio E Tatsui
Spinal laser interstitial thermal therapy (LITT) appears to be a promising novel modality for treatment of epidural metastatic spine disease in patients who are poor candidates for larger-scale oncologic spinal surgery and can act synergetically with spinal stereotactic radiosurgery to maximize local control and palliate pain. This technique is ideally suited for the intraoperative MRI suite to monitor the extent of the ablation in the epidural space. As percutaneous navigation, imaging, and LITT technology improve, broader applicability of this minimally invasive technique in spinal oncology is foreseen...
October 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28917256/postoperative-stereotactic-body-radiotherapy-for-spinal-metastases
#6
Majed Alghamdi, Chia-Lin Tseng, Sten Myrehaug, Pejman Maralani, Chris Heyn, Hany Soliman, Young Lee, Mark Ruschin, Leodante Da Costa, Victor Yang, Mikki Campbell, Arjun Sahgal
Spine is a common site of metastases in cancer patients. Spine surgery is indicated for select patients, typically those with mechanical instability and/or malignant epidural spinal cord (or cauda equina) compression. Although post-operative conventional palliative external beam radiation therapy has been the standard of care, technical improvements in radiation planning and image-guided radiotherapy have allowed for the application of stereotactic body radiotherapy (SBRT) to the spine. Spine SBRT is intended to ablate residual tumor and optimize local control by delivering several fold greater biologically effective doses...
September 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28891203/effects-of-epidural-volume-extension-by-saline-injection-on-the-efficacy-and-safety-of-intrathecal-local-anaesthetics-systematic-review-with-meta-analysis-meta-regression-and-trial-sequential-analysis
#7
REVIEW
M Heesen, S Weibel, M Klimek, R Rossaint, L R Arends, P Kranke
Epidural volume extension, a modification of combined spinal-epidural anaesthesia, involves the epidural injection of saline in order to increase the spread of drugs given intrathecally. Results from individual studies have so far been contradictory and we aimed to gather the available evidence for this technique. We performed a systematic literature search for randomised, controlled trials comparing epidural volume extension after spinal injection with a control group without epidural injection in patients undergoing surgery...
September 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28881335/the-great-mimicker-at-thoracolumbar-spine-non-hodgkin-s-lymphoma
#8
Turgut Akgül, Yücel Bilgin, Gökhan Karademir
PURPOSE: To report two cases with Non-Hodgkin's Lymphoma (NHL) in thoracolumbar spine with very different presentation. METHODS: Case 1; An 84-year-old female patient was admitted to our emergency clinic with paraparesis in both lower extremities. Magnetic resonance imaging (MRI) revealed an epidural mass at the level of the T12 vertebrae. She was operated immediately with wide laminectomy and posterior instrumentation because of the paraparesis of both lower extremities...
August 24, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28878918/development-of-harlequin-syndrome-following-placement-of-thoracic-epidural-anesthesia-in-a-pediatric-patient-undergoing-nuss-procedure
#9
Ashley Lefevre, Gregory Schnepper
We report the development of Harlequin Syndrome following thoracic epidural placement in a pediatric patient. Unilateral facial flushing with contralateral pallor and anhidrosis is the clinical presentation. This syndrome is typically benign. When related to regional anesthesia, treatment involves reducing the local anesthetic infusion or stopping it altogether.
September 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28875709/continuous-epidural-infusion-versus-programmed-intermittent-epidural-bolus-for-labor-analgesia-optimal-configuration-of-parameters-to-reduce-physician-administered-top-ups
#10
Carlos Delgado, Christopher Ciliberto, Laurent Bollag, Margaret Sedensky, Ruth Landau
BACKGROUND AND OBJECTIVES: Programmed intermittent epidural bolus (PIEB) is a delivery mode associated with decreased local analgesia dosing, motor block, and physician-administered top-ups (PATU) during labor analgesia. We hypothesized that PIEB delivery at different settings will result in fewer PATU for labor analgesia than the same hourly volume of a continuous epidural infusion (CEI). METHODS: 'Before and after' study design of combined-spinal epidural (CSE) for labor, with bupivacaine 0...
September 6, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28860857/preventing-nausea-and-vomiting-in-women-undergoing-regional-anesthesia-for-cesarean-section-challenges-and-solutions
#11
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/28858781/epidermal-electrode-technology-for-detecting-ultrasonic-perturbation-of-sensory-brain-activity
#12
Stanley Huang, Jonathan A N Fisher, Meijun Ye, Yun-Soung Kim, Rui Ma, Marjan Nabili, Victor Krauthamer, Matthew R Myers, Todd P Coleman, Cristin G Welle
OBJECTIVE: We aim to demonstrate the in vivo capability of a wearable sensor technology to detect localized perturbations of sensory-evoked brain activity. METHODS: Cortical somatosensory evoked potentials (SSEPs) were recorded in mice via wearable, flexible epidermal electrode arrays. We then utilized the sensors to explore the effects of transcranial focused ultrasound, which noninvasively induced neural perturbation. SSEPs recorded with flexible epidermal sensors were quantified and benchmarked against those recorded with invasive epidural electrodes...
August 29, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28846539/catheterization-in-an-ultrasound-guided-thoracic-paravertebral-block%C3%A2-using-thoracoscopy
#13
T Fujii, Y Shibata, Y Ban, A Shitaokoshi, K Nishiwaki
Thoracic paravertebral block (TPVB) is an efficient alternative to epidural anesthesia. The location of a catheter within the thoracic paravertebral space (TPVS) has been examined in the human cadaver studies, but it is unclear how it goes into the TPVS during catheterization. In this report, thoracoscopy was used to observe the thoracic cavity in real-time during a parasagittal in-plane approach of ultrasound-guided TPVB. During thoracoscopy, we observed whether a paravertebral catheter could be advanced caudally beyond the ribs into the neighboring TPVS...
March 2017: Asian J Anesthesiol
https://www.readbyqxmd.com/read/28844617/spinal-extradural-arteriovenous-fistulas-with-retrograde-intradural-venous-drainage-diagnostic-features-in-digital-subtraction-angiography-and-time-resolved-magnetic-resonance-angiography
#14
Satoshi Koizumi, Keisuke Takai, Masaaki Shojima, Akira Kunimatsu, Kazuhiko Ishii, Hideaki Imai, Hirofumi Nakatomi, Nobuhito Saito
Spinal extradural arteriovenous fistulas (AVFs) may be more difficult to prospectively identify than dural AVFs because they are less common than dural AVFs. The primary purpose was to further characterize the diagnostic imaging of spinal extradural AVFs with intradural retrograde venous drainage. The magnetic resonance (MR) imaging and angiographic results of 23 patients with suspected spinal dural AVFs were analyzed in order to distinguish dural and extradural AVFs. The diagnostic accuracy of MR angiography was retrospectively compared between dural and extradural AVFs...
August 24, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28841343/effect-of-methyl-palmitate-on-the-formation-of-epidural-fibrosis-in-an-experimental-epidural-fibrosis-model
#15
Zahir Kizilay, Nesibe Kahraman Cetin
AIM: To investigate the effects of local and systemic administration of methyl palmitate on the formation of epidural fibrosis. MATERIAL AND METHODS: Twenty-eight rats were randomly divided into four equal groups (control, Spongostan, local methyl palmitate and orally methyl palmitate) and laminectomy was performed between T11 and L1 in all rats. Local methyl palmitate (300 mg/kg) was applied with Spongostan; methyl palmitate (300 mg/kg) was given orally three times per week on different days for a total period of 4 weeks...
August 25, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28836257/-efficacy-comparison-of-the-laparoscopic-total-extraperitoneal-prosthetic-and-the-lichtenstein-herniorrhaphy-for-inguinal-hernia
#16
Yiliang Li, Zhi Wang, Lemu Ke, Fuzeng Su, Cheng Zhang, Huiling Li, Zhi Du, Zhikai Zhu, Song Li
OBJECTIVE: To compare the efficacy and safety between laparoscopic total extraperitoneal prosthetic (TEP) and Lichtenstein herniorrhaphy in the treatment of inguinal hernia (IH). METHODS: Clinical data of 158 IH patients at our hospital from October 2015 to October 2016 were retrospectively analyzed. Among 158 patients, 85 patients underwent TEP (TEP group), and 73 underwent Lichtenstein herniorrhaphy(Lichtenstein group). Patients of TEP group received general anesthesia...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28828882/medication-equipment-and-supply-costs-for-common-interventions-providing-extended-post-surgical-analgesia-following-total-knee-arthroplasty-in-us-hospitals
#17
Shelby Corman, Nishant Shah, Simon Dagenais
AIMS: To estimate the cost to hospitals of materials (i.e. medications, equipment, and supplies) required to administer common interventions for post-surgical analgesia after total knee arthroplasty (TKA), including single-injection peripheral nerve block (sPNB), continuous peripheral nerve block (cPNB), periarticular infiltration of multi-drug cocktails, continuous epidural analgesia, intravenous patient-controlled analgesia (IV PCA), and local infiltration of bupivacaine liposome injectable suspension (BLIS)...
September 18, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28816240/rodent-mismatch-negativity-mmn-theta-neuro-oscillatory-response-as-a-translational-neurophysiological-biomarker-for-n-methyl-d-aspartate-receptor-based-new-treatment-development-in-schizophrenia
#18
Migyung Lee, Andrea Balla, Henry Sershen, Pejman Sehatpour, Peter Lakatos, Daniel C Javitt
Deficits in the generation of auditory mismatch negativity (MMN) generation are among the most widely replicated neurophysiological abnormalities in schizophrenia and linked to underlying dysfunction of N-methyl-D-aspartate receptor (NMDAR)-mediated neurotransmission. Here, we evaluate physiological properties of rodent MMN, along with sensitivity to NMDAR agonist and antagonist treatment, relative to known patterns of dysfunction in schizophrenia. Epidural neurophysiological responses to frequency- and duration-deviants, along with responses to standard stimuli, were obtained at baseline and following 2 and 4 weeks treatment from rats treated with saline, phencyclidine (PCP, 15 mg/kg/d by osmotic minipump), or PCP+glycine (16% by weight diet) interventions...
August 17, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28815798/infant-spinal-anesthesia-do-girls-need-a-larger-dose-of-local-anesthetic
#19
Geoff Frawley, Md Hamidul Huque
BACKGROUND: Gender differences in absorption, distribution, and metabolism of a number of anesthetic agents have been identified in adults. Clinically, adult studies suggest women demonstrate slower onset of opioid analgesic effects, lower spinal and epidural dose requirements, and greater sensitivity to neuromuscular blocking agents. Sex-related differences in the pharmacokinetics and pharmacodynamics of local anesthetics in neonates and infants, however, have not been well documented...
October 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28812113/-pathophysiology-of-intracranial-injuries
#20
REVIEW
D Lahner, G Fritsch
Traumatic brain injury (TBI) constitutes a heterogeneous condition that affects the most complex organ of the human body. It is commonly classified by its location as focal injury (e.g. epidural hematoma) and diffuse injury (e.g. diffuse axonal shearing injury) as well as by primary and secondary tissue injury. Accordingly, direct mechanical force causes the primary insult. The tissue damage occurring afterwards is subsumed under the term secondary brain damage. Some of these processes are overlapping and include in the early phase local cerebral ischemia resulting in excitotoxicity, which together with the triggered neuroinflammatory cascade causes the formation of cerebral edema and ultimately increased intracranial pressure once the intracranial compliance is exhausted...
August 15, 2017: Der Unfallchirurg
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