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Epidural analgesia

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https://www.readbyqxmd.com/read/29933246/cerebrospinal-fluid-cutaneous-fistula-after-neuraxial-anesthesia-an-effective-treatment-approach
#1
Ramiro Marinho, Mara Sousa, Filipa Machado, Sara Fonseca, Luísa Guedes
Cerebrospinal fluid cutaneous fistula is a rare but potentially serious complication of epidural analgesia. We report the case of a patient submitted to total knee arthroplasty under subarachnoid block and placement of lumbar epidural catheter for post-operative analgesia. The epidural catheter was found exteriorised on the fourth post-operative day, and the patient presented with a moderate fluid leak from the puncture site that was confirmed to be cerebrospinal fluid by cytological and chemical analysis. The initial therapeutic approach consisted of bed rest, hydration and prophylactic antibiotic therapy for 3 days, but it was ineffective as the leak persisted...
June 22, 2018: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29926477/local-anaesthetics-and-regional-anaesthesia-versus-conventional-analgesia-for-preventing-persistent-postoperative-pain-in-adults-and-children
#2
REVIEW
Erica J Weinstein, Jacob L Levene, Marc S Cohen, Doerthe A Andreae, Jerry Y Chao, Matthew Johnson, Charles B Hall, Michael H Andreae
BACKGROUND: Regional anaesthesia may reduce the rate of persistent postoperative pain (PPP), a frequent and debilitating condition. This review was originally published in 2012 and updated in 2017. OBJECTIVES: To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of PPP beyond three months in adults and children undergoing elective surgery. SEARCH METHODS: We searched CENTRAL, MEDLINE, and Embase to December 2016 without any language restriction...
June 20, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29924051/consort-epidural-dexmedetomidine-improves-gastrointestinal-motility-after-laparoscopic-colonic-resection-compared-with-morphine
#3
Qiuxia Wan, Wengang Ding, Xiaoguang Cui, Xianzhang Zeng
BACKGROUND: We have previously shown that epidural dexmedetomidine, when used as an adjunct to levobupivacaine for control of postoperative pain after open colonic resection, improves recovery of gastrointestinal motility compared with morphine. METHODS: Sixty patients undergoing laparoscopic colonic resection were enrolled and allocated randomly to treatment with dexmedetomidine (group D) or morphine (group M). Group D received an epidural loading dose of dexmedetomidine (5 mL, 0...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29924010/effect-of-led-photobiomodulation-on-analgesia-during-labor-study-protocol-for-a-randomized-clinical-trial
#4
Maria Aparecida Dos Santos Traverzim, Sergio Makabe, Daniela Fátima Teixeira Silva, Christiane Pavani, Sandra Kalil Bussadori, Kristianne Santos Porta Fernandes, Lara Jansiski Motta
BACKGROUND: Labor pain is one of the most intense pains experienced by women, which leads to an increase in the number of women opting to undergo a cesarean delivery. Pharmacological and nonpharmacological analgesia methods are used to control labor pain. Epidural analgesia is the most commonly used pharmacological analgesia method. However, it may have side effects on the fetus and the mother. Light-emitting diode (LED) photobiomodulation is an effective and noninvasive alternative to pharmacological methods...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29923954/is-a-retrolaminar-approach-to-the-thoracic-paravertebral-space-possible-a-human-cadaveric-study
#5
A Sassan Sabouri, Lane Crawford, Sarah K Bick, Ala Nozari, Thomas A Anderson
BACKGROUND AND OBJECTIVES: The retrolaminar block (RB) is used for truncal analgesia, but its mechanism of neural blockade remains obscure. We sought to learn the pattern of local anesthetic spread after thoracic RB using cadaveric models. METHODS: In 8 fresh cadavers, an ultrasound-guided T4 RB was performed with 20 mL of methylene blue 1% and bupivacaine 0.5%. For comparison, an RB at T9 in 1 cadaver and a T4 thoracic paravertebral block in another cadaver were performed...
June 19, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29914785/the-optimal-concentration-of-bupivacaine-and-levobupivacaine-for-labor-pain-management-using-patient-controlled-epidural-analgesia-a-double-blind-randomized-controlled-trial
#6
V Baliuliene, A Macas, K Rimaitis
BACKGROUND: The study aim was to evaluate the efficacy and safety of different low concentrations of two local anesthetics for labor analgesia using patient-controlled epidural analgesia. METHODS: A double-blind, randomized controlled trial recruiting healthy nulliparous women was conducted from 2014 to 2016. Epidural analgesia was provided using local anesthetic and fentanyl. Patients were allocated to six groups, according to the concentration of bupivacaine or levobupivacaine (0...
May 18, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29914784/experimental-validation-of-the-compuflo%C3%A2-epidural-controlled-system-to-identify-the-epidural-space-and-its-clinical-use-in-difficult-obstetric-cases
#7
G Capogna, M Camorcia, A Coccoluto, M Micaglio, M Velardo
BACKGROUND: This prospective study was designed to validate the CompuFlo® device and to assess its use in difficult epidural placement. METHODS: In the first part of the study, 30 parturients requesting labor epidural analgesia were recruited. The block was performed by an expert anesthesiologist, with the Tuohy needle connected to the CompuFlo® device to evaluate the agreement between the anesthesiologist's reported sensation and the variation of pressure recorded by the CompuFlo®...
May 4, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29914232/current-practice-in-obstetric-anesthesia-and-analgesia-in-public-hospitals-of-greece-a-2016-national-survey
#8
Chryssoula Staikou, Alexandros Μakris, Kassiani Theodoraki, Athanasia Τsaroucha, Amalia Doumax, Eleni Μoka, Eleni Αrnaoutoglou, Tilemahos Paraskevopoulos, Ioanna Siafaka, Efi Stavropoulou, Eriphili Αrgyra
Aims: The aim of this nationwide descriptive survey was to assess the use of regional anesthesia in obstetrics in Greek public hospitals. Methods: The survey was conducted between March and August, 2016. A structured questionnaire was sent to 50 Anesthesia Departments in Greek Public Hospitals with obstetric units. Results: The response rate was 94%. Data corresponded to 9475 cesarean and 8155 vaginal deliveries. Regional anesthesia was used in 69...
June 19, 2018: Balkan Medical Journal
https://www.readbyqxmd.com/read/29913937/paravertebral-block-is-not-safer-nor-superior-to-thoracic-epidural-analgesia
#9
Gísli Vigfusson
No abstract text is available yet for this article.
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913936/a-systematic-review-of-comparative-studies-indicates-that-paravertebral-block-is-neither-superior-nor-safer-than-epidural-analgesia-for-pain-after-thoracotomy
#10
Hilde M Norum, Harald Breivik
Background The "gold standard" for pain relief after thoracotomy has been thoracic epidural analgesia (TEA). The studies comparing TEA with paravertebral block (PVB) and recent reviews recommend PVB as a novel, safer method than TEA. Methods A systematic search of the Cochrane and PubMed databases for prospective, randomized trials (RCTs) comparing TEA and PVB for post-thoracotomy analgesia was done. We assessed how TEA and PVB were performed, methods of randomization, assessment of pain relief, and complications...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913924/pain-relief-with-paravertebral-blocks-or-epidural-analgesia-those-who-do-not-know-the-history-of-paravertebral-blocks-are-condemned-to-rediscover-the-complications
#11
Geir Niemi, Harald Breivik
No abstract text is available yet for this article.
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913779/optimal-thoracic-epidural-analgesia-again
#12
Harald Breivik, Geir Niemi
No abstract text is available yet for this article.
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29911573/managing-post-thoracotomy-pain-epidural-or-systemic-analgesia-and-extended-care-a-randomized-study-with-an-as-usual-control-group
#13
Elina Tiippana, Kaisa Nelskylä, Eija Nilsson, Eero Sihvo, Matti Kataja, Eija Kalso
Background and aims Thoracotomies can cause severe pain, which persists in 21-67% of patients. We investigated whether NSAID + intravenous patient-controlled analgesia (IV-PCA) with morphine is an efficacious alternative to thoracic epidural analgesia (TEA). We also wanted to find out whether an extended controlled pain management protocol within a clinical study can decrease the incidence of persistent post-thoracotomy pain. Methods Thirty thoracotomy patients were randomized into 3 intervention groups with 10 patients in each...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29908407/antenatal-education-for-childbirth-epidural-analgesia
#14
Lisa Cutajar, Allan M Cyna
The language structures used by antenatal educators have not been previously researched in the context of antenatal childbirth classes. Epidural analgesia for labour is a common, and a frequently asked about, component of antenatal education for parents in hospitals providing maternity care. AIM OF THE STUDY: We aimed to identify the way information is described and presented by childbirth educators to assess content and determine which language structures such as metaphor, suggestion, information and storytelling are utilized...
May 7, 2018: Midwifery
https://www.readbyqxmd.com/read/29894394/improving-clinical-proficiency-using-a-3-dimensionally-printed-and-patient-specific-thoracic-spine-model-as-a-haptic-task-trainer
#15
Jeffrey Bortman, Yanick Baribeau, Jelliffe Jeganathan, Yannis Amador, Faraz Mahmood, Marc Shnider, Muneeb Ahmed, Philip Hess, Robina Matyal
BACKGROUND AND OBJECTIVES: Advanced haptic simulators for neuraxial training are expensive, have a finite life, and are not patient specific. We sought to demonstrate the feasibility of developing a custom-made, low-cost, 3-dimensionally printed thoracic spine simulator model from patient computed tomographic scan data. This study assessed the model's practicality, efficiency as a teaching tool, and the transfer of skill set into patient care. METHODS: A high-fidelity, patient-specific thoracic spine model was used for the study...
June 11, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29890381/postoperative-continuous-adductor-canal-block-for-total-knee-arthroplasty-improves-pain-and-functional-recovery-a-randomized-controlled-clinical-trial
#16
Patrick Leung, David M Dickerson, Sahitya K Denduluri, Maryam K Mohammed, Min Lu, Magdalena Anitescu, Hue H Luu
STUDY OBJECTIVE: Investigate the use of a postoperative continuous adductor canal block (cACB) after epidural analgesia to decreases opioid consumption and improve visual analog scale (VAS) scores compared to a sham catheter. DESIGN: Double-blinded randomized placebo-controlled trial. SETTING: Inpatient setting in tertiary care teaching hospital with outpatient follow-up. PATIENTS: One-hundred and sixty-five subjects (cACB n = 82 and sham catheter n = 83) with end-stage degenerative joint disease undergoing elective unilateral total knee arthroplasty...
June 8, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29888832/perinatal-outcome-of-vaginal-delivery-with-epidural-analgesia-initiated-at-the-early-or-late-phase-of-labor-period-a-retrospective-cohort-study-in-the-japanese-population
#17
Michihisa Shiro, Katsutoshi Nakahata, Sawako Minami, Tomoyuki Kawamata, Kazuhiko Ino
AIM: We compared the perinatal outcomes of vaginal delivery with epidural analgesia initiated at the early versus late phase in a Japanese population. METHODS: Women enrolled in this retrospective cohort study received intrapartum analgesia via combined spinal epidural analgesia after labor onset between May 2010 and August 2015. We compared the perinatal outcomes between two different timings of epidural analgesia: at the early phase (≤3 cm cervical dilatation) and the late phase (≥4 cm) or at the new definition-based early phase (≤5 cm) and late phase (≥6 cm)...
June 11, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29887886/anesthesiologists-preferences-regarding-visitor-presence-during-placement-of-neuraxial-labor-analgesia
#18
Sangeeta Kumaraswami, Suryanarayana Pothula, Mario Anthony Inchiosa, Keshar Paul Kubal, Micah Alexander Burns
Introduction: Neuraxial labor analgesia has become an integral part of modern obstetric anesthetic practice. Presence of a familiar person during its placement may be beneficial to the patient. A survey was sent to anesthesiologists practicing obstetric anesthesia in the USA to determine their views. Methods: The survey queried the following: existence of a written policy; would they allow a visitor; visitor's view, sitting or standing; reasons to allow or not allow a visitor; and influence by other staff on the decision...
2018: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/29887239/effect-of-multimodal-analgesia-with-paravertebral-blocks-on-biochemical-recurrence-in-men-undergoing-open-radical-prostatectomy
#19
Liam C Macleod, Robert M Turner, Samia Lopa, Lee A Hugar, Benjamin J Davies, Bruce Ben-David, Jacques E Chelly, Bruce L Jacobs, Joel B Nelson
BACKGROUND: Recent studies suggest that anesthetic technique during radical prostatectomy for prostate cancer may affect recurrence or progression. This association has previously been investigated in series that employ epidural analgesia. The objective of this study is to determine the association between the use of a multimodal analgesic approach incorporating paravertebral blocks and risk of biochemical recurrence following open radical prostatectomy. PATIENTS AND METHODS: Using a prospective database of 3,029 men undergoing open radical prostatectomy by a single surgeon, we identified 2,909 men who received no neoadjuvant androgen deprivation and had at least 1 year of follow up...
June 7, 2018: Urologic Oncology
https://www.readbyqxmd.com/read/29883521/formulating-and-answering-high-impact-causal-questions-in-physiologic-childbirth-science-concepts-and-assumptions
#20
REVIEW
Jonathan M Snowden, Ellen L Tilden, Michelle C Odden
In this article, we conclude our 3-part series by focusing on several concepts that have proven useful for formulating causal questions and inferring causal effects. The process of causal inference is of key importance for physiologic childbirth science, so each concept is grounded in content related to women at low risk for perinatal complications. A prerequisite to causal inference is determining that the question of interest is causal rather than descriptive or predictive. Another critical step in defining a high-impact causal question is assessing the state of existing research for evidence of causality...
June 8, 2018: Journal of Midwifery & Women's Health
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