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https://www.readbyqxmd.com/read/28607343/failed-epidural-for-labour-what-now
#1
Emilia Guasch, Fabrizio Iannuccelli, Nicolas Brogly, Fernando Gilsanz
Labour epidural failure is a challenging situation for the obstetric anaesthetist, especially when associated to high risk of caesarean delivery, obesity, and difficult airway predictors. Labour epidural failure is still not standardly defined, consequently its incidence is uncertain: improving the knowledge of risk factors related to failure will increase epidural block success rate. Prolonged labours, previous history of epidural failure, and repeated topups needed during labour are recognized risk factors for failure...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28551063/-superior-gluteal-nerve-a-new-block-on-the-block
#2
Miguel Sá, Rita Graça, Hugo Reis, José Miguel Cardoso, José Sampaio, Célia Pinheiro, Duarte Machado
BACKGROUND AND OBJECTIVES: The superior gluteal nerve is responsible for innervating the gluteus medius, gluteus minimus and tensor fascia latae muscles, all of which can be injured during surgical procedures. We describe an ultrasound-guided approach to block the superior gluteal nerve which allowed us to provide efficient analgesia and anesthesia for two orthopedic procedures, in a patient who had significant risk factors for neuraxial techniques and deep peripheral nerve blocks. CLINICAL REPORT: An 84-year-old female whose regular use of clopidogrel contraindicated neuraxial techniques or deep peripheral nerve blocks presented for urgent bipolar hemiarthroplasty in our hospital...
May 24, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28504988/the-labor-analgesia-requirements-in-nulliparous-women-randomized-to-epidural-catheter-placement-in-a-high-or-low-intervertebral-space
#3
Albert Moore, Valerie Villeneuve, Bruno Bravim, Aly El-Bahrawy, Eva El-Mouallem, Ian Kaufman, Roupen Hatzakorzian, William Li Pi Shan
BACKGROUND: We hypothesized that an epidural catheter placed in a lower vertebral interspace will require less medication for labor analgesia. METHODS: Nulliparous women requesting neuraxial labor analgesia were randomized to epidural catheter placement at the ultrasound-confirmed L1-2 or L4-5 interspace. Patient-controlled epidural analgesia and breakthrough manual epidural boluses of 10 mL of 0.125% bupivacaine with 50 µg of fentanyl or 8 mL of 2% lidocaine were utilized...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28413286/transversus-abdominis-plane-catheters-for-postoperative-pain-relief-in-pediatric-patients
#4
Sumitra G Bakshi, Jeson R Doctor, Bhakti D Trivedi, Sajid S Qureshi
Regional techniques provides excellent post operative pain relief in pediatric patients. Transversus abdominis plane (TAP) block is a newer regional technique available. Though there is emerging evidence proving the efficacy of TAP blocks, there is limited literature on use of TAP catheters in pediatric patients. TAP catheters were placed in two children following laparotomy with transverse incisions and in both epidural was avoided, with good post operative pain relief. Ultrasound guidance was used in one child, while in the other the catheter was placed under direct vision after dissection of the plane between transversus abdominis and internal oblique...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28339540/interventional-pain-management-for-sacroiliac-tumors-in-the-oncologic-population-a-case-series-and-paradigm-approach
#5
Nathan Hutson, Joseph C Hung, Vinay Puttanniah, Eric Lis, Ilya Laufer, Amitabh Gulati
Introduction: Tumors invading the sacrum and/or ilium often represent incurable metastatic disease, and treatment is targeted toward palliation of symptoms and control of pain. As systemic opioid therapy is frequently inadequate and limited by side effects, a variety of interventional techniques are available to better optimize analgesia. Using six patients as a paradigm for interventional approaches to pain relief, we present a therapeutic algorithm for treating sacroiliac tumor-related pain in the oncologic population...
May 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28291128/the-use-of-ultrasound-in-obstetric-anesthesia
#6
Carolyn F Weiniger, Limor Sharoni
PURPOSE OF REVIEW: The current review considers an array of recent applications for point-of-care ultrasound in clinical practice including diagnostic and therapeutic procedures that may be relevant for the obstetric anesthesiologist. The rapid advancement of technology and clinical applications for bedside ultrasound in obstetric anesthesiology requires an appraisal of the limitations and uses. RECENT FINDINGS: The review presents the most recent literature describing ultrasound-guided airway assessments, airway management, cricothyroidotomy, transthoracic echocardiography, gastric volume assessments, point-of-care lung ultrasound diagnoses, intracranial pressure assessments, vascular access, neuraxial blocks, and transversus abdominis plane blocks...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28230717/imaging-performance-of-a-handheld-ultrasound-system-with-real-time-computer-aided-detection-of-lumbar-spine-anatomy-a-feasibility-study
#7
Mohamed Tiouririne, Adam J Dixon, F William Mauldin, David Scalzo, Arun Krishnaraj
OBJECTIVES: The aim of this study was to evaluate the imaging performance of a handheld ultrasound system and the accuracy of an automated lumbar spine computer-aided detection (CAD) algorithm in the spines of human subjects. MATERIALS AND METHODS: This study was approved by the institutional review board of the University of Virginia. The authors designed a handheld ultrasound system with enhanced bone image quality and fully automated CAD of lumbar spine anatomy...
February 22, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28217069/can-ultrasound-guided-subcostal-transverse-abdominis-plane-block-be-used-as-sole-anesthetic-technique
#8
Pooja Bihani, Pradeep Bhatia, Swati Chhabra, Pradeepika Gangwar
Subcostal transverse abdominis plane (TAP) block anesthetizes area of the abdomen with cutaneous innervation of T6-T10 dermatomes. These abdominal field blocks become very advantageous when cardiac patient presents for noncardiac surgeries as sole anesthetic or as a part of multimodal anesthesia. A 58-year-male came for open surgical repair of subxiphoid incisional hernia developed post coronary artery bypass grafting (CABG). Echocardiography showed hypokinesia of left ventricle (LV) in the left anterior descending (LAD) artery territory, dilated LV, and ejection fraction of 30%, and coronary angiography after 6 months of CABG showed 70% stenosis of LAD...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28217056/preprocedural-ultrasound-examination-versus-manual-palpation-for-thoracic-epidural-catheter-insertion
#9
Ahmed M Hasanin, Ali M Mokhtar, Shereen M Amin, Ahmed A Sayed
BACKGROUND AND AIMS: Ultrasound imaging before neuraxial blocks was reported to improve the ease of insertion and minimize the traumatic trials. However, the data about the use of ultrasound in thoracic epidural block are scanty. In this study, pre-insertion ultrasound scanning was compared to traditional manual palpation technique for insertion of the thoracic epidural catheter in abdominal operations. SUBJECTS AND METHODS: Forty-eight patients scheduled to midline laparotomy under combined general anesthesia with thoracic epidural analgesia were included in the study...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28118226/intraoperative-placement-of-pectoral-nerve-block-catheters-description-of-a-novel-technique-and-review-of-the-literature
#10
Katharine M Hinchcliff, Jared R Hylton, Hakan Orbay, Michael S Wong
Regional and neuraxial anesthesia for pain management after breast surgery is not widely used despite data showing improved postoperative pain control and patient satisfaction scores. We report a case of a 61-year-old woman who underwent bilateral mastectomies, and received postoperative analgesia via pectoral nerves 1 and 2 nerve blocks. This case highlights a previously undescribed technique of prolonged postoperative pain control by intraoperative placement of pectoral nerves 1 and 2 regional anesthesia catheters under direct visualization...
May 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28094482/real-time-ultrasound-guided-spinal-anesthesia-in-patients-with-predicted-difficult-anatomy
#11
Hesham Elsharkawy, Ankit Maheshwari, Rovnat Babazade, Anahi Perlas, Sherif Zaky, Loran M Soliman
BACKGROUND: There are limited reports of lumbar neuraxial blocks using real-time ultrasound in patients with predicted difficulties. We compared the number of attempts to perform spinal anesthesia using real time ultrasound guidance versus landmark technique in patients meeting predefined criteria for difficult spinal anesthesia. We also compared procedure time, block success, patient satisfaction and difficulty scores between groups. METHODS: Following institutional review board approval patients scheduled for total hip or knee arthroplasty with expected difficulty to perform spinal anesthesia were included...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28045758/a-virtual-reality-simulation-model-of-spinal-ultrasound-role-in-teaching-spinal-sonoanatomy
#12
Reva Ramlogan, Ahtsham U Niazi, Rongyu Jin, James Johnson, Vincent W Chan, Anahi Perlas
BACKGROUND AND OBJECTIVES: Ultrasound assessment of the lumbar spine improves the success of spinal and epidural anesthesia, especially for patients with underlying difficult anatomy. To assist with the teaching and learning of ultrasound-guided neuraxial anesthesia, we have created an online interactive educational model (http://www.usra.ca/vspine.php and http://pie.med.utoronto.ca/vspine). The aim of the current study was to determine whether the virtual spine model improved the knowledge of neuraxial anatomy and sonoanatomy...
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28002229/evaluation-of-ultrasound-assisted-thoracic-epidural-placement-in-patients-undergoing-upper-abdominal-and-thoracic-surgery-a-randomized-double-blind-study
#13
David B Auyong, Lucy Hostetter, Stanley C Yuan, April E Slee, Neil A Hanson
BACKGROUND AND OBJECTIVES: The placement of thoracic epidurals can be technically challenging and requires a thorough understanding of neuraxial anatomy. Although ultrasound imaging of the thoracic spine has been described, no outcome studies on the use of this imaging have been performed. We evaluated whether preprocedural ultrasound of the thoracic spine would facilitate the process of epidural catheterization. METHODS: Subjects undergoing thoracic or upper abdominal surgery with planned thoracic epidural placement at T10 or higher were enrolled in this randomized double-blind study...
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27903338/-ultrasound-imaging-increases-first-attempt-success-rate-of-neuraxial-block-in-elderly-patients
#14
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/27836523/-why-and-how-to-perform-an-ultrasound-guided-transversus-abdominis-plane-block-a-step-by-step-approach
#15
E Nohuz, B El Drayi, A Triki, K Grossmannova, B Boudier, K Koffi, M Albaut, C Dualé
Used in clinical practice as part of a multimodal analgesic regimen, the transversus abdominis plane block (TAP block) is a relative novel procedure in which local anaesthetic agents are injected into the anatomic neurofascial space between the internal oblique and the transversus abdominis muscle. It allows a significantly prolonged duration of analgesia during the early postoperative stage in abdominal surgery. This regional anesthesia technique provides analgesia to the skin, muscles of the anterior abdominal wall and parietal peritoneum in order to decrease the incision-related pain...
December 2016: Gynécologie, Obstétrique & Fertilité
https://www.readbyqxmd.com/read/27828783/transversus-abdominis-plane-block-for-inguinal-hernia-repair-in-a-premature-infant-a-case-report
#16
Rashmi Ramachandran, Sumit Bansal, Preeti Yadav, Vimi Rewari
In this report, we describe the case of a premature infant (36 weeks' postgestational age) who underwent left inguinal hernia repair under general anesthesia without the use of any airway device. Anesthesia was induced and maintained with sevoflurane in oxygen and nitrous oxide. An ultrasound-guided transversus abdominis plane block was performed that provided effective analgesia, obviating the need for opioids in the intraoperative period. The infant's hemodynamics remained stable throughout the surgery. This report also briefly explains the advantages of using a transversus abdominis plane block, compared with neuraxial blockade, for hernia repair surgery...
January 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/27827521/ultrasonography-for-neuraxial-blocks-a-review-of-the-evidence
#17
Maria F Elgueta, Silvia Duong, Roderick J Finlayson, De Q. Tran
INTRODUCTION: This narrative review summarizes the evidence derived from randomized controlled trials (RCTs) pertaining to the use of adjunctive ultrasonography (US) for neuraxial blocks. EVIDENCE ACQUISITION: The literature search was conducted using the MEDLINE, EMBASE and PUBMED databases. For the MEDLINE and EMBASE searches, the MESH terms "ultrasonography" and key word "ultrasound" were queried; using the operator "and", they were combined with the MESH terms "neuraxial block", "epidural anesthesia", "epidural analgesia", "spinal anesthesia", "spinal analgesia", "intrathecal anesthesia", "intrathecal analgesia", "caudal anesthesia", and "caudal analgesia"...
November 9, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27785357/perioperative-regional-anaesthesia-and-postoperative-longer-term-outcomes
#18
REVIEW
Jan Jakobsson, Mark Z Johnson
Regional anaesthesia provides effective anaesthesia and analgesia in the perioperative setting. Central neuraxial blocks-that is, spinal and epidural blocks-are well established as an alternative or adjunct to general anaesthesia. Peripheral blocks may be used as part of multimodal anaesthesia/analgesia in perioperative practice, reducing the need for opioid analgesics and enhancing early recovery. Furthermore, regional anaesthesia has increased in popularity and may be done with improved ease and safety with the introduction of ultrasound-guided techniques...
2016: F1000Research
https://www.readbyqxmd.com/read/27776105/smart-phone-angle-calculation-improves-success-of-neuraxial-ultrasound
#19
Raviraj Raveendran, William Mcllvaine
No abstract text is available yet for this article.
November 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27746528/lower-limb-surgeries-under-combined-femoral-and-sciatic-nerve-block
#20
Lipsy Bansal, Joginder Pal Attri, Pawan Verma
INTRODUCTION: Peripheral nerve blocks are gaining popularity for many infraumblical surgeries with the development of new techniques such as ultrasound and peripheral nerve stimulator. It provides stable hemodynamic, better, and prolonged postoperative analgesia. This study was carried out to see the effectiveness of combined femoral and sciatic nerve block with ropivacaine alone and by adding fentanyl. MATERIALS AND METHODS: The study was carried out on 100 patients scheduled for lower limb surgeries and were randomly divided into two groups of 50 each...
September 2016: Anesthesia, Essays and Researches
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