peridural ultrasonography

BACKGROUND: Neuraxial anesthesia in obese parturients can be challenging due to anatomical and physiological modifications secondary to pregnancy; this led to growing popularity of spine ultrasound in this population for easing landmark identification and procedure execution. Integration of Artificial Intelligence with ultrasound (AI-US) for image enhancement and analysis has increased clinicians' ability to localize vertebral structures in patients with challenging anatomical conformation...

HISTORY AND PHYSICAL FINDINGS: A 67-years-old man suffered from relapsing moderate fever and back pain after arthroscopy of the knee under peridural anaesthesia. Antibiotics given for suspected iatrogenic infection was started, but was without improvement. After 4 months under several antibiotic regimes his condition rapidly deteriorated with high fever, excruciating lumbar back pain associated with elevated ESR/WBC (ESR = erythrocyte sedimentation rate, WBC = white blood cell count) along with arthritis of the shoulders, wrists, knees and ankles...

BACKGROUND: Classic breast reduction and mastopexy techniques leave a vertical scar, but are difficult to apply in cases requiring a large amount of breast tissue removal. This report describes a new breast reduction technique using a vertical incision for resections involving less than 600 g of tissue removal and an inverted T incision for larger resections. Results for the new technique are reported. METHODS: For 800 women, the reported technique was used for reduction mammaplasty (n=640) and mastopexy (n=160)...

Nikolai Alekseevich Lopatkin, Academician of the Russian Academy of Medical Sciences, has contributed much to development of prostatic cancer (PC) diagnosis and treatment in the Russian Federation. N. A. Lopatkin headed specialists from the Research Institute of Urology who were the first in Russia to introduce into clinical practice the method of interstitial radiotherapy (brachitherapy) of local prostatic cancer (PC). A total of 58 PC patients 42 to 76 years of age were treated. They had stages T1bN0M0 (n = 5), T2aN0M0 (n = 36), T2bN0M0 (n = 11), T3aN0M0 (n = 6)...

The use of ultrasound as a diagnostic tool for the visualisation of the epidural space has effects on the quality and the performance of epidural anesthesia. This work presents an overview of the recent experiences with ultrasound for epidural anesthesia and on the possibilities for ultrasound imaging techniques. The results of visualisation of the epidural space and its limiting structures obtained by various working groups are presented. We review all presently available data on the prediction of the puncture depth...

OBJECTIVE: To evaluate the effectiveness of uterine artery embolization in women with uterine myomas in terms of the clinical results for the relief of related symptoms. DESIGN: A pilot study on 26 women affected by uterine single myoma. SETTING: Tertiary level care in an university hospital. PATIENT(S): Twenty-six patients, aged 32 to 54 years, suffering of menorrhagia, pelvic pain, and abdominal mass for single myoma, intramural localization...

Epidural anaesthesia (EA) is the most important analgesia technique in obstetrics for delivery. In pregnancy, hormonal adjustments lead to an alteration of tissue consistency, which often causes an early, untimely loss of resistance. Apart from mere inspection and palpation, no useful diagnostic method prior to EA performance has been established yet. In this prospective study, we examined 100 pregnant women, who had been admitted for childbirth and were undergoing epidural block (level L3-L4) for delivery...

Ergot's derivatives are widely used in the treatment of migraine and in the prophylaxy of deep venous thrombosis in association with heparin. Clinical ergotism is rarely observed and can affect all the arteries, especially of the inferior limbs. Vasospasm of the peripheral arteries and collateral formation are specific findings on angiography. We report the illustrative case of a 38 years old woman hospitalized for a small bowel occlusion. She suffers from chronic migraine treated by ergotamine tartrate. During her hospitalization, she develops an acute ischemia of the lower limbs...

Using bidirectional CW Doppler flowmetry, transcutaneous recordings of flow velocity pulses were performed on the femoral artery of 11 patients before and during peridural anaesthesia. Compared to those obtained before peridural injection of bupivacaine the pulse contours exhibited characteristic changes 10 min after the injection. The backward flow wave during diastole decreased or disappeared. There was a marked increase in the steady flow at the expense of the pulsatile flow peaks. 20 min after injection these changes were slightly more pronounced...

The authors report on the case of a 28-year old married woman who was treated according to their IVF-programme after both Fallopian tubes had been removed Three embryo transfers after follicular aspiration by laparoscopy and IVF did not lead pregnancy. In a fourth attempt in May 1984 ovarian stimulation was effected via hMG (Pergonal); 10,000 IU hCG were administered on day 12 of the menstrual cycle. 35 hours later 7 oocytes were recovered via ultrasonically guided percutaneous follicular aspiration under epidural anaesthesia...

26 women with an uneventful singleton pregnancy near term underwent scheduled Caesarean section with lumbar epidural anaesthesia (PDA). Doppler-flow measurements of the foetal umbilical artery and the maternal hypogastric artery were taken before and after sympathicolysis was established. The mean arterial blood pressure was maintained unchanged between the measurements. Both measurements were performed by the same examiner. Three patients received additional general anaesthesia during the operation because of inadequate analgesia...