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https://www.readbyqxmd.com/read/29149145/endoscopic-epidural-laser-decompression-versus-transforaminal-epiduroscopic-laser-annuloplasty-for-lumbar-disc-herniation-a-prospective-randomized-trial
#1
Chang Hong Park, Sang Ho Lee
BACKGROUND: Lumbar radicular pain often results from lumbar disc herniation, spinal stenosis, or degenerative spondylolisthesis. Minimally invasive disc decompression procedures, such as nucleo-annuloplasty or epiduroscopic neural decompression by laser, have been devised to treat such pain. OBJECTIVE: The short-term outcomes of disc decompression by endoscopic epidural laser decompression (EELD) or transforaminal epiduroscopic laser annuloplasty (TELA) were compared in patients with lumbar radicular pain due to disc herniation...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29135692/ultrasound-with-neurostimulation-compared-with-ultrasound-guidance-alone-for-lumbar-plexus-block-a-randomised-single-blinded-equivalence-trial
#2
Vanlapa Arnuntasupakul, Theerawat Chalachewa, Prangmalee Leurcharusmee, Worakamol Tiyaprasertkul, Roderick J Finlayson, De Q Tran
BACKGROUND: Ultrasound-guided lumbar plexus blocks usually require confirmatory neurostimulation. A simpler alternative is to inject local anaesthetic inside the posteromedial quadrant of the psoas muscle under ultrasound guidance. OBJECTIVE: We hypothesised that both techniques would result in similar total anaesthesia time, defined as the sum of performance and onset time. DESIGN: A randomised, observer-blinded, equivalence trial (equivalence margin = 7...
November 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29125031/a-rapidly-expanding-calvarial-langerhans-cell-histiocytosis-with-low-ki-67-in-an-adult-a-challenging-diagnosis-on-magnetic-resonance-imaging
#3
Mustafa Kemal Demir, Ozlem Yapıcıer, Teyyub Hasanov, Deniz Kilic, Turker Kilic
Langerhans cell histiocytosis may have a wide variety of clinical presentations. The growth of localised form is usually slow and it mainly involves bones such as the skull, femur, spine, ribs, mandible and pelvis in children. The spectrum of clinical manifestations and magnetic resonance imaging findings of the disease may sometimes mimic infections as well as benign and malignant tumours. In this report, we describe an unusual case of rapidly progressive calvarial Langerhans cell histiocytosis with a painful and tender mass in a 27-year-old man that created diagnostic and therapeutic challenges...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/29122701/predictors-of-quality-of-life-improvement-after-surgery-for-metastatic-tumors-of-the-spine-prospective-cohort-study
#4
Ori Barzilai, Lily McLaughlin, Mary-Kate Amato, Anne S Reiner, Shahiba Q Ogilvie, Eric Lis, Yoshiya Yamada, Mark H Bilsky, Ilya Laufer
BACKGROUND CONTEXT: Surgical decompression and stabilization followed by radiosurgery represents an effective method for local tumor control and neurologic preservation for patients with metastatic epidural spinal cord compression. We have previously demonstrated improvement in HrQOL after this combined modality treatment ("hybrid therapy"). PURPOSE: The current analysis focuses on delineation of patient-specific prognostic factors predictive of HrQOL change after combined surgery-SRS treatment of MESCC...
November 6, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29108403/epidemiology-of-septic-meningitis-associated-with-neuraxial-anesthesia-a-historical-review-and-meta-analysis
#5
Andres Zorrilla-Vaca, Ryan J Healy, Lucia Rivera-Lara, Michael C Grant, Lisa L Maragakis, Kevin Escandón-Vargas, Marek A Mirski
BACKGROUND: Neuraxial anesthesia in the form of spinal and epidural are two of the most frequent forms of regional anesthesia. We aimed to describe and compare the relevant epidemiological, clinical and microbiological characteristics of all reported cases of septic meningitis associated with the use of spinal and epidural anesthetics. METHODS: We performed a systematic review of septic meningitis associated with neuraxial anesthesia. We included all relevant case-reports and observational studies in which authors described septic meningitis in association with spinal, epidural or combined neuraxial anesthesia using local anesthetics...
November 6, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29099886/risk-of-osteoporotic-fracture-after-steroid-injections-in-patients-with-medicare
#6
Leah Y Carreon, Kevin L Ong, Edmund Lau, Steven M Kurtz, Steven D Glassman
To further evaluate the relationship between steroid injections and osteoporotic fracture risk, we analyzed Medicare administrative claims data on both large-joint steroid injections (LJSIs) into knee and hip and transforaminal steroid injections (TSIs), as well as osteoporotic hip and wrist fractures. Our hypothesis was that a systemic effect of steroid injections would increase fracture risk in all skeletal locations regardless of injection site, whereas a local effect would produce a disproportionate increased risk of spine fracture with spine injection...
September 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29095263/ed50-of-intrathecal-ropivacaine-for-cesarean-section-under-prophylactic-infusion-of-phenylephrine-a-consort-study
#7
Wangping Zhang, Hanbin Wu
BACKGROUND: Studies have reported that prophylactic continuous infusion of phenylephrine during spinal anesthesia for cesarean section can decrease the spread of local anesthetics. We investigated the ED50 of intrathecal hyperbaric ropivacaine in parturient women undergoing cesarean section under prophylactic infusion of phenylephrine. METHODS: Sixty parturient women were allocated into 2 groups in this prospective study. Group P received 0.5 mL kg h of phenylephrine (5 mg/50 mL) at the start of intrathecal injection, and Group C (control group) received the same volume of saline...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29084192/transient-left-ventricular-dysfunction-due-to-coronary-spasm-after-spinal-anesthesia-with-bupivacaine-a-case-report
#8
Waldemar Elikowski, Małgorzata Małek-Elikowska, Marek Słomczyński, Karolina Horbacka, Jarosław Bartkowski, Bartosz Kalawski
Bupivacaine is a long-acting local anesthetic (LA) used for cutaneous infiltration, peripheral nerve blocks, epidural and spinal anesthesia. However, its application may result in cardiovascular complications such as: hypotension, bradycardia, cardiac arrest and toxic myocardial injury. The authors describe a 53-year-old male with a history of cigarette smoking, admitted for an elective inguinal hernia surgery. Before surgery, the patient received subarachnoid injection of bupivacaine (20 mg). After the operation, he developed transient hypotension...
October 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29081513/localization-of-the-primary-sites-of-involvement-in-the-spinal-sensory-and-motor-pathways-for-multilevel-mri-abnormalities-in-degenerative-cervical-myelopathy
#9
Nobuaki Tadokoro, Toshikazu Tani, Kazunobu Kida, Katsuhito Kiyasu, Yusuke Kasai, Masashi Kumon, Ryuichi Takemasa, Masahiko Ikeuchi
STUDY DESIGN: Exploratory clinical study. OBJECTIVES: To localize the sites of conduction block in the spinal sensory and motor pathways for minimizing the level of surgical intervention despite MRI evidence of compression at several levels in degenerative cervical myelopathy (DCM). SETTING: Kochi Medical School Hospital, Japan. METHODS: We analyzed 83 DCM patients (69 ± 12 years) who underwent serial intervertebral recording of both ascending (A-SCEPs) and descending spinal cord-evoked potentials (D-SCEPs) after epidural and transcranial stimulation, respectively, during surgery before decompression procedures...
October 30, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29077667/ultrasound-pulsed-wave-doppler-detects-an-intrathecal-location-of-an-epidural-catheter-tip-a-case-report
#10
Hesham Elsharkawy, Wael Saasouh, Bimal Patel, Rovnat Babazade
Currently, no gold standard method exists for localization of an epidural catheter after placement. The technique described in this report uses pulsed-wave Doppler (PWD) ultrasound to identify intrathecal location of an epidural catheter. A thoracic epidural catheter was inserted after multiple trials with inconclusive aspiration and test dose. Ultrasound PWD confirmed no flow in the epidural space and positive flow in the intrathecal space. A fluid aspirate was positive for glucose, reconfirming intrathecal placement...
October 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29062440/the-feasibility-and-safety-of-thoracoscopic-surgery-under-epidural-and-or-local-anesthesia-for-spontaneous-pneumothorax-a-meta-analysis
#11
Wei Chen, Chenlei Zhang, Gebang Wang, Zhengjun Li, Hailong Wang, Hongxu Liu
The aim of this study was to compare thoracoscopic surgery for spontaneous pneumothorax under epidural and/or local anesthesia (ELA) with that under general anesthesia and prove the feasibility and safety of thoracoscopic surgery under ELA for spontaneous pneumothorax. Relevant studies were searched in five databases from their date of publication to June 2016. We collected and analyzed the data concerning operative time, hospital stay, complications, air leak, recurrence and perioperative mortality. A forest plot was performed to compare the differences between the two groups...
September 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29037478/five-hundred-seventy-six-cases-of-video-assisted-thoracic-surgery-utilizing-local-anesthesia-and-sedation-lessons-learned
#12
Mark R Katlic
BACKGROUND: General anesthesia and endotracheal intubation are a luxury rather than a necessity for many video-assisted thoracic surgery (VATS) operations. Twenty-three years ago the author began utilizing local anesthesia and sedation for pleural disease and subsequently for pericardial and lung disease. STUDY DESIGN: The records of all patients undergoing VATS utilizing local anesthesia and sedation at hospitals of the Geisinger Health System (Danville and Wilkes-Barre, PA) June 1, 2002 to June 30, 2011 and the Lifebridge Health System (Baltimore, MD) July 1, 2011 to March 1, 2017 were retrospectively reviewed...
October 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29034961/a-randomized-trial-of-automated-intermittent-ropivacaine-administration-vs-continuous-infusion-in-an-interscalene-catheter
#13
J Oxlund, A H Clausen, S Venø, M D Nielsen, M Pall, T Strøm, P Toft
BACKGROUND: Ultrasound-guided interscalene nerve block with ropivacaine as local anesthetic agent given as boluses or continuous infusion is the preferred pain management after major shoulder surgery. The use of automated intermittent boluses has been shown to be superior to continuous infusion in sciatic and epidural nerve block. HYPOTHESIS: Automated intermittent boluses reduce pain after major shoulder surgery. METHODS: Seventy patients aged 18-75 years, scheduled for major shoulder surgery under general anesthesia with interscalene nerve block were included in this randomized controlled trial...
October 16, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29033722/effect-of-intravenous-phenylephrine-infusion-on-dose-requirement-of-intrathecal-plain-levobupivacaine-for-cesarean-section-a-placebo-controlled-preliminary-study
#14
Asha Tyagi, Aanchal Kakkar, Namrata Niwal, Medha Mohta, Ashok Kumar Sethi
BACKGROUND: Phenylephrine infusion has been shown to decrease rostral spread of plain and hyperbaric local anesthetic (LA) when compared to ephedrine infusion. However, it does not result in higher dose requirement of hyperbaric LA for cesarean section. There is no trial evaluating the effect of phenylephrine infusion on ED50 of a plain intrathecal LA. METHODS: Pregnant patients with term uncomplicated singleton pregnancy undergoing elective cesarean section were given combined spinal-epidural anesthesia...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29022129/the-utility-of-local-anesthesia-for-neurosurgical-interventions-in-a-low-resource-setting-a-case-series
#15
Jessica Eaton, Asma Bilal Hanif, Suzgisam Mzumara, Anthony Charles
INTRODUCTION: Trauma is a major contributor to global morbidity and mortality, and injury to the central nervous system is the most common cause of death in these patients. While the provision of surgical services is being recognized as essential to global public health efforts, specialty areas such as neurosurgery remain overlooked. METHOD: This is a retrospective case review of patients with operable lesions, such as extra-axial hematomas and unstable depressed skull fractures that underwent neurosurgical interventions under local anesthesia...
October 11, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29017311/posterior-epidural-herniation-of-a-lumbar-disk-fragment-at-l2-3-that-mimicked-an-epidural-hematoma
#16
Jin-Sang Kil, Jong-Tae Park
Lumbar disk herniation is common. Because of the posterior longitudinal ligament, migration usually occurs into the ventral epidural space. Rarely, fragments migrate into the dorsal epidural space. A 57-year-old man presented with lower back pain and weakness on right hip flexion and right knee flexion. He had lower back pain 1 day previously and received a transforaminal epidural block at a local hospital. The next day, he reported weakness of the right lower extremity. Lumbar spine magnetic resonance imaging revealed a dorsal epidural lesion with compression of the thecal sac at L2-3...
September 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/29016499/epidural-analgesia-during-the-second-stage-of-labor-a-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
XiaoFeng Shen, Yunping Li, ShiQin Xu, Nan Wang, Sheng Fan, Xiang Qin, Chunxiu Zhou, Philip E Hess
OBJECTIVE: To evaluate whether maintaining a motor-sparing epidural analgesia infusion affects the duration of the second stage of labor in nulliparous parturients compared with a placebo control. METHODS: We conducted a double-blind, randomized, placebo-controlled trial involving nulliparous women with term cephalic singleton pregnancies who requested epidural analgesia. All women received epidural analgesia for the first stage of labor using 0.08% ropivacaine with 0...
November 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28991063/dose-response-curves-for-intrathecal-bupivacaine-levobupivacaine-and-ropivacaine-given-for-labor-analgesia-in-nulliparous-women
#18
Warwick D Ngan Kee, Floria F Ng, Kim S Khaw, Shannon P Y Tang, Alison G P Koo
BACKGROUND AND OBJECTIVES: Bupivacaine, levobupivacaine, and ropivacaine are often given intrathecally for labor analgesia, but limited data are available for their dose-response properties in this context. The objective of this study was to describe the dose-response curves of these local anesthetics when given intrathecally for labor analgesia, to determine values for D50 (dose producing a 50% response) and to compare the calculated values of D50 for levobupivacaine and ropivacaine with those for bupivacaine...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28980554/-the-possibilities-for-the-expert-diagnostics-of-the-injuries-for-the-purpose-of-examination-of-the-remains-of-the-strongly-burnt-and-carbonized-corpses
#19
V A Fetisov, I Yu Makarov, A V Kovalev, A A Gusarov, B A Sarkisyan, V E Yankovsky
The objective of the present study was the analysis of the publications in the domestic and foreign literature containing the reports concerning the experience with forensic medical expertise of the strongly burnt and carbonized human corpses. Flame is known to sometimes cause injuries simulating the intravital wounds. Such injuries are categorized into the following types. Thermal ruptures reminiscent of the classical stab and slash wounds unaccompanied by swelling and hemorrhage in the surrounding tissues...
2017: Sudebno-meditsinskaia Ekspertiza
https://www.readbyqxmd.com/read/28968538/local-infiltration-of-the-surgical-wound-with-levobupivacaine-ibuprofen-and-epinephrine-in-postoperative-pain-an-experimental-study
#20
Prashant S Korat, Pankaj P Kapupara
The body areas from where sutures are removed later, where wound healing is delayed. Epidural analgesia is the most effective method but could not be used for postoperative pain. Peripheral nerve blockers also provided excellent analgesia but are not effective in postoperative pain. Infiltration of the surgical wound with local anesthetics is decreased postoperative pain by inhibiting transmission of noxious impulses at the site. The objective of the study was to explore the effect of the local infiltration of the surgical wounds with low-dose of levobupivacaine, ibuprofen, and epinephrine over the sutured muscle wound in postoperative pain...
September 29, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
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