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https://www.readbyqxmd.com/read/27917806/comparison-of-intrathecal-plain-articaine-and-levobupivacaine-with-fentanyl-for-caesarean-section
#1
Rüveyda I Demircioglua, Muhammet Gozdemira, Burhanettin Ustaa, Hüseyin Serta, Safinaz Karabayirlia, Bünyamin Muslua, Esra A Keskinb
PURPOSE: Articaine is used as a local anesthetic for outpatient surgery because it offers rapid onset of anesthesia and short duration motor block. Levobupivacaine is often preferred for Caesarean section. We evaluated the anesthetic characteristics of fentanyl-supplemented plain articaine and levobupivacaine for Caesarean section under combine spinal epidural anesthesia. METHODS: Patients undergoing Caesarean section received in random order plain articaine 40 mg (Group A, n=50) or plain levobupivacaine 10 mg (Group L, n=50) mixed with fentanyl 20 µg intrathecally...
December 1, 2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/27914160/infectious-postpartum-sacroiliitis-the-importance-and-difficulty-of-early-diagnosis
#2
Emídio Vale-Fernandes, Fedra Rodrigues, Carla Monteiro, Luís Carvalho
The sacroiliitis accounts for about 1.5% - 10% of all cases of septic arthritis and it is strongly associated with gynaecological infections, pelvic trauma or drug abuse (3.4% - 12.8% of cases occur during the postpartum period). Early diagnosis is difficult because the symptoms are nonspecific in pregnancy and in the postpartum period, making the delay of treatment a serious risk of irreversible damage to the joint and development of post-infectious complications. The authors describe the case of a 37-year-old puerperal woman presented to hospital, weeks after urgent caesarean section, with endometritis, post-anesthetic epidural hematoma and secondary infectious postpartum sacroiliitis...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27904723/why-cannot-suction-drains-prevent-postoperative-spinal-epidural-hematoma
#3
Dong Ki Ahn, Won Shik Shin, Jin Woo Kim, Seong Min Yi
BACKGROUND: Postoperative spinal epidural hematoma (POSEH) is different from spontaneous or post-spinal procedure hematoma because of the application of suction drains. However, it appeared that suction drains were not effective for prevention of POSEH in previous studies. The purpose of this study was to test our hypothesis that POSEH can be caused by hypercoagulability. METHODS: This was an experimental study. One hundred fifty milliliters of blood was donated from each of the 12 consecutive patients who underwent spine surgery and infused into 3 saline bags of 50 mL each...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27903338/-ultrasound-imaging-increases-first-attempt-success-rate-of-neuraxial-block-in-elderly-patients
#4
J Geng, X L Chen, X D Wang, X Y Guo, M Li
Objective: To verify whether preprocedural ultrasound of the lumbar spine could improve first-attempt success rate (defined as a successful neuraxial anesthesia with only one skin puncture) of neuraxial block in elderly patients. Methods: From septemble 2015 to February 2016, 200 elderly patients undergoing lower-limb surgery with neuraxial block at the Peking Universty Third Hospital were enrolled in this study.RandA 1.0 software was used to randomize patients into two groups: conventional surface landmark-guided group (group LM) and ultrasound-assisted group (group US)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27900415/-management-of-anesthesia-in-endovascular-interventions
#5
T Rössel, R Paul, T Richter, S Ludwig, T Hofmockel, A R Heller, T Koch
Cardiovascular diseases are one of the leading causes of morbidity and mortality in Germany. In these patients, the high-risk profile necessitates an interdisciplinary and multimodal approach to treatment. Endovascular interventions and vascular surgery have become established as an important element of this strategy in the past; however, the different anatomical localizations of pathological vascular alterations make it necessary to use a wide spectrum of procedural options and methods; therefore, the requirements for management of anesthesia are variable and necessitate a differentiated approach...
November 29, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27896193/multidisciplinary-approach-to-an-extended-pressure-sore-at-the-lumbosacral-area
#6
Sehoon Yoon, Euicheol Jeong, Hudson Alex Lázaro
A pressure sore wound is often extensive or complicated by local infection involving adjacent soft tissue and bone. In this case, a regional flap after simple debridement is not adequate. Here, we present a case of an extensive pressure sore in the sacral area with deep tissue infection. A 43-year-old female patient with a complicated sore with deep tissue infection had a presacral abscess, an iliopsoas abscess, and an epidural abscess in the lumbar spine. After a multidisciplinary approach performed in stages, the infection had subsided and removal of the devitalized tissue was possible...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27891040/inadvertent-injection-of-potassium-chloride-instead-of-sodium-chloride-during-treatment-of-chronic-low-back-ache-with-epidural-injection-leading-to-paraplegia
#7
Rahul Ranjan, Naiyer Asif, Sohail Ahmad, Syed Ifthekar
Epidural injection of steroid is given for back pain resistant to other conservative management. Normal saline (NS) is used as diluent in 80 mg methylprednisolone and a local anesthetic. Due to a similar looking ampoule of NS and potassium chloride (KCl), there is a probability of accidental use of KCl instead of NS. We present a case of a 50-year-old male patient having low back ache refractory to other conservative treatments. Epidural injection of steroid was given, but accidently KCl was mixed with methylprednisolone instead of NS...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27884880/first-pass-contrast-enhanced-mra-for-pretherapeutic-diagnosis-of-spinal-epidural-arteriovenous-fistulas-with-intradural-venous-reflux
#8
S Mathur, S P Symons, T J Huynh, P Muthusami, W Montanera, A Bharatha
BACKGROUND AND PURPOSE: Spinal epidural AVFs are rare spinal vascular malformations. When there is associated intradural venous reflux, they may mimic the more common spinal dural AVFs. Correct diagnosis and localization before conventional angiography is beneficial to facilitate treatment. We hypothesize that first-pass contrast-enhanced MRA can diagnose and localize spinal epidural AVFs with intradural venous reflux and distinguish them from other spinal AVFs. MATERIALS AND METHODS: Forty-two consecutive patients with a clinical and/or radiologic suspicion of spinal AVF underwent MR imaging, first-pass contrast-enhanced MRA, and DSA at a single institute (2000-2015)...
November 24, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27871585/optimal-epidural-analgesia-for-patients-diagnosed-as-having-gynecologic-cancer-undergoing-interstitial-brachytherapy
#9
Ashley K Amsbaugh, Mark J Amsbaugh, Moataz N El-Ghamry, Brian M Derhake
STUDY OBJECTIVE: To determine the optimal epidural analgesia for patients receiving interstitial brachytherapy (ISBT) for gynecologic cancers. DESIGN: Retrospective analysis. SETTING: Operating room and hospital ward. PATIENTS: Seventy-three patients diagnosed as having gynecologic cancer and undergoing ISBT. INTERVENTIONS: Twelve patients received ropivacaine alone, 14 patients received ropivacaine with fentanyl, and 45 patients received ropivacaine with hydromorphone by epidural infusion...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871526/risk-factors-for-failed-reactivation-of-a-labor-epidural-for-postpartum-tubal-ligation-a-prospective-observational-study
#10
Mark F Powell, Douglas D Wellons, Steve F Tran, John M Zimmerman, Michael A Frölich
STUDY OBJECTIVE: To determine specific risk factors that increase the failure rate of labor epidurals reactivated for use as a surgical block for postpartum tubal ligation. DESIGN: Prospective, observational study. SETTING: Labor and delivery suite and operating rooms at the Women and Infants Center. PATIENTS: One hundred patients undergoing postpartum tubal ligation with an existing labor epidural that is documented to be within 2 cm of initial placement...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870743/epidural-local-anesthetics-versus-opioid-based-analgesic-regimens-for-postoperative-gastrointestinal-paralysis-vomiting-and-pain-after-abdominal-surgery-a-cochrane-review
#11
Joanne Guay, Mina Nishimori, Sandra L Kopp
BACKGROUND: The aim of this review was to compare the effects of postoperative epidural analgesia with local anesthetics to postoperative systemic or epidural opioids in terms of return of gastrointestinal transit, postoperative pain control, postoperative vomiting, incidence of gastrointestinal anastomotic leak, hospital length of stay, and cost after abdominal surgery. METHODS: Trials were identified by computerized searches of the Cochrane Central Register of Controlled Trials (CENTRAL) (2014, Issue 12), Medical Literature Analysis and Retrieval System Online (MEDLINE) (from 1950 to December, 2014) and Excerpta Medica dataBASE (EMBASE) (from 1974 to December 2014) and by checking the reference lists of trials retained...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27860187/autophagy-activated-by-tuberin-mtor-p70s6k-suppression-is-a-protective-mechanism-against-local-anaesthetics-neurotoxicity
#12
Jingwei Xiong, Qiuyue Kong, Leyang Dai, He Ma, Xiaofei Cao, Li Liu, Zhengnian Ding
The local anaesthetics (LAs) are widely used for peripheral nerve blocks, epidural anaesthesia, spinal anaesthesia and pain management. However, exposure to LAs for long duration or at high dosage can provoke potential neuronal damages. Autophagy is an intracellular bulk degradation process for proteins and organelles. However, both the effects of LAs on autophagy in neuronal cells and the effects of autophagy on LAs neurotoxicity are not clear. To answer these questions, both lipid LAs (procaine and tetracaine) and amide LAs (bupivacaine, lidocaine and ropivacaine) were administrated to human neuroblastoma SH-SY5Y cells...
November 15, 2016: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/27858380/effect-of-etanercept-on-the-formation-of-epidural-fibrosis-in-an-experimental-model
#13
Zahir Kizilay, Nesibe Kahraman Çetin, Abdullah Topcu, Özgür Ismailoğlu, İmran Kurt Ömürlü, Serdar Aktaş, Ali Yilmaz
AIM: To investigate the effects of local and systemic administration of etanercept on the formation of epidural fibrosis. MATERIAL AND METHODS: Twenty-eight rats were randomly divided into four equal groups (control, Spongostan, local etanercept and systemic etanercept) and laminectomy was performed between T11 and L1 in all rats. Spongostan was soaked with saline (0.1 mg/kg), local etanercept (300 µg/kg) was applied with Spongostan and systemic etanercept (300 µg/kg/week) was applied subcutaneously...
October 17, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27847694/contribution-of-low-dose-computerized-tomography-with-digital-multiplanar-reconstructions-in-thoracic-epidurography-and-correlation-with-sensory-block-in-postoperative-analgesia
#14
Cyrus Motamed, Karin Chedevergne, Frederic Deschamps, Lambros Tselikas, Christian Jayr
BACKGROUND: The level of sensory block in postoperative epidural analgesia has been correlated with conventional contrast epidurography in only one study, while low-dose CT scan epidurography with multiplanar reconstruction may be a better tool for this purpose. OBJECTIVES: The primary objective of this study was to evaluate, by CT imaging and digital multiplanar reconstruction, the spread and distribution of contrast medium injected into the epidural space through a catheter inserted in a low thoracic position for postoperative analgesia...
October 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27843682/large-spontaneous-spinal-subdural-epidural-hematoma-after-epidural-anesthesia-for-caesarean-section-conservative-management-with-excellent-outcome
#15
Ioannis D Siasios, Kunal Vakharia, Kevin J Gibbons, Vassilios G Dimopoulos
BACKGROUND: Iatrogenic or spontaneous spinal hematomas are rarely seen and present with multiple symptoms that can be difficult to localize. Most spontaneous spinal hematomas are multifactorial, and the pathophysiology is varied. Here, we present a case of a scattered, multicomponent, combined subdural and epidural spinal hematoma that was managed conservatively. CASE DESCRIPTION: A 38-year-old woman came to the emergency department (ED) complaining of severe neck and back pain...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27833479/efficacy-of-dexmedetomidine-as-an-adjuvant-to-ropivacaine-in-pediatric-caudal-epidural-block
#16
Manoj Kamal, Sadik Mohammed, Saroj Meena, Geeta Singariya, Rakesh Kumar, Dilip Singh Chauhan
CONTEXT: Caudal analgesia is a reliable and an easy method to provide intraoperative and postoperative analgesia for infraumbilical surgeries in pediatric population but with the disadvantage of short duration of action after single injection. Many additives were used in combination with local anesthetics in the caudal block to prolong the postoperative analgesia. AIM: We compared the analgesic effects and side effects of dexmedetomidine added to ropivacaine in pediatric patients undergoing lower abdominal surgeries...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27828798/effects-of-epidural-labor-analgesia-with-low-concentrations-of-local-anesthetics-on-obstetric-outcomes-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#17
Ting-Ting Wang, Shen Sun, Shao-Qiang Huang
BACKGROUND: Low concentrations of local anesthetics (LCLAs) are increasingly popular for epidural labor analgesia. The effects of epidural analgesia with low concentrations of anesthetics on the duration of the second stage of labor and the instrumental birth rate, however, remain controversial. A systematic review was conducted to compare the effects of epidural analgesia with LCLAs with those of nonepidural analgesia on obstetric outcomes. METHODS: The databases of PubMed, Embase, and the Cochrane controlled trials register were independently searched by 2 researchers, and randomized controlled trials that compared epidural labor analgesia utilizing LCLAs with nonepidural analgesia were retrieved...
November 8, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27803576/continuous-cervical-epidural-analgesia-in-metastatic-spinal-cord-compression
#18
Mahesh Menon, Nafisa Taha, Navita Purohit, Vatsal Kothari, Shweta Singh
Metastatic spinal cord compression is a devastating complication of cancer. Patients may often require high doses of opioids that may cause side effects, myoclonus being one such. A 63-year-old male suffering from malignant spinal cord compression was admitted to our institution. The primary team managed him conservatively with pharmacotherapy with no relief of pain, and he experienced myoclonus and sedation as adverse effects. A continuous cervical epidural catheter with local anesthetic infusion was inserted for 5 days to control his pain...
October 2016: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/27800076/-the-contribution-of-mri-in-the-management-of-slowly-progressive-nontraumatic-spinal-cord-compression
#19
Nfally Badji, Hamidou Deme, Geraud Akpo, Boucar Ndong, Mouhamadou Hamine Toure, Sokhna Ba Diop, El Hadji Niang
Slow spinal cord compressions are due to the development of an expansive lesion within the medullary canal. This is a very common condition whose diagnosis is primarily clinical. The magnetic resonance imaging occupies a central and currently irreplaceable position in diagnosis and localization as well as in etiological research. Etiology of cancer is predominant in Europe. This study aims to describe the MRI features of slow spinal cord compressions and to determine its etiologic profile. This is a retrospective study of 97 cases whose data were collected at the Department of Radiology, National University Hospital Centre (CHUN) of Fann, over a period of 30 months (from March 8, 2010 to September 29 2012)...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27791828/spine-stereotactic-radiosurgery-for-the-treatment-of-multiple-myeloma
#20
Jacob A Miller, Ehsan H Balagamwala, Samuel T Chao, Todd Emch, John H Suh, Toufik Djemil, Lilyana Angelov
OBJECTIVE The objective of this study was to define symptomatic and radiographic outcomes following spine stereotactic radiosurgery (SRS) for the treatment of multiple myeloma. METHODS All patients with pathological diagnoses of myeloma undergoing spine SRS at a single institution were included. Patients with less than 1 month of follow-up were excluded. The primary outcome measure was the cumulative incidence of pain relief after spine SRS, while secondary outcomes included the cumulative incidences of radiographic failure and vertebral fracture...
October 28, 2016: Journal of Neurosurgery. Spine
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