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Epidural analgesia

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https://www.readbyqxmd.com/read/28821891/an-audit-of-829-paediatric-epidurals-in-a-tertiary-singapore-hospital-complications-and-conundrums
#1
Jolin Wong, Serene St Lim
INTRODUCTION: The incidence of complications related to epidural analgesia remains less well defined in the paediatric population as compared to adults. A retrospective review of prospectively collected data was performed to review and quantify risks of both adverse events and complications related to epidural analgesia in our Singaporean paediatric population. MATERIALS AND METHODS: Data from the Acute Pain Service (APS) was prospectively collected over 19 years...
July 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28820803/perioperative-breast-analgesia-a-qualitative-review-of-anatomy-and-regional-techniques
#2
Glenn E Woodworth, Ryan M J Ivie, Sylvia M Nelson, Cameron M Walker, Robert B Maniker
Breast surgery is exceedingly common and may result in significant acute as well as chronic pain. Numerous options exist for the control of perioperative breast pain, including several newly described regional anesthesia techniques, but anesthesiologists have an insufficient understanding of the anatomy of the breast, the anatomic structures disrupted by the various breast surgeries, and the theoretical and experimental evidence supporting the use of the various analgesic options. In this article, we review the anatomy of the breast, common breast surgeries and their potential anatomic sources of pain, and analgesic techniques for managing perioperative pain...
September 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28808868/effect-of-multimodal-analgesia-on-opioid-use-after-open-ventral-hernia-repair
#3
Jeremy A Warren, Caroline Stoddard, Ahan L Hunter, Anthony J Horton, Carlyn Atwood, Joseph A Ewing, Steven Pusker, Vito A Cancellaro, Kevin B Walker, William S Cobb, Alfredo M Carbonell, Robert R Morgan
BACKGROUND: There is limited data on enhanced recovery after surgery (ERAS) protocols after ventral hernia repair (VHR). This study reports the impact of multimodal analgesia on opioid use after open VHR. METHODS: Retrospective review of open VHR treated during the initial 6 months after ERAS implementation. Protocol focused on opioid sparing using intraoperative ketamine and/or lidocaine infusion, selective epidural anesthesia, and postoperative ketamine infusion, ketorolac, and acetaminophen...
August 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28806489/characteristics-of-spontaneous-births-attended-by-midwives-and-physicians-in-us-hospitals-in-2014
#4
Patrick Thornton
INTRODUCTION: This study compares characteristics and birth outcomes of women attended by certified nurse-midwives/certified midwives (midwives) and physicians in US hospitals in 2014. METHODS: Data reported in 2014 on the 2003 version of the US birth certificate were examined. Spontaneous vaginal births attributed to midwives and physicians and occurring in hospitals were included. Demographic and risk profiles and adjusted odds ratios for maternal and newborn outcomes were compared by provider type...
August 14, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28805780/-regional-and-peripheral-blockades-for-prevention-of-chronic-post-thoracotomy-pain-syndrome-in-oncosurgical-practice
#5
V E Khoronenko, A S Malanova, D S Baskakov, A B Ryabov, O V Pikin
AIM: To compare an effectiveness of thoracic epidural anesthesia/analgesia, paravertebral and intercostal blockades in prevention of chronic post-thoracotomy pain syndrome (CPTPS) in oncosurgery. MATERIAL AND METHODS: There were 300 patients who underwent open surgery including lobectomy or pneumonectomy. Patients were randomized into 3 groups depending on type of anesthesia: TEA (n=100) - combined general and epidural anesthesia; PVB (n=50) - combined general and paravertebral anesthesia; ICB (n=50) - general anesthesia was supplemented by intercostal blockade after removal of the drug...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28799128/the-influence-of-epidural-catheter-on-the-incidence-of-intravascular-injection-during-caudal-block
#6
Jin Young Lee, Sung Hyun Lee, Woo Seog Sim, Duk Kyung Kim, Sang Hoon Lee, Hyo Min Yun, Hue Jung Park
OBJECTIVE: The aim of this study was to analyze the influence of epidural catheters on the incidence of intravascular injection and to identify possible predictors of intravascular injection in patients undergoing a caudal block using fluoroscopy. METHODS: A total of 154 patients scheduled to receive a caudal block were randomized into group N (those without epidural catheter) or group C (those with epidural catheter). Demographic and clinical data were recorded and analyzed...
August 10, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28794836/comparing-epidural-surgical-anesthesia-and-spinal-anesthesia-following-epidural-labor-analgesia-for-intrapartum-cesarean-section-a-prospective-randomized-controlled-trial
#7
Hea-Jo Yoon, Sang-Hwan Do, Yeo Jin Yun
BACKGROUND: The conversion of epidural labor analgesia (ELA) to epidural surgical anesthesia (ESA) for intrapartum cesarean section (CS) often fails, resulting in intraoperative pain. Spinal anesthesia (SA) can provide a denser sensory block than ESA. The purpose of this prospective, non-blinded, parallel-arm, randomized trial was to compare the rate of pain-free surgery between ESA and SA following ELA for intrapartum CS. METHODS: Both groups received continuous epidural infusions for labor pain at a rate of 10 ml/h...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28794535/epidural-analgesia-information-card-averted-permanent-neurological-sequelae
#8
Sumitra G Bakshi, Gautham Rajan, Parmanand N Jain
No abstract text is available yet for this article.
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28794528/post-operative-effectiveness-of-continuous-wound-infiltration-continuous-epidural-infusion-and-intravenous-patient-controlled-analgesia-on-post-operative-pain-management-in-patients-undergoing-spinal-surgery
#9
Anshuman Singh, Parul Jindal, Gurjeet Khurana, Ranjeet Kumar
BACKGROUND AND AIMS: Very few studies have compared continuous wound infiltration (CWI), continuous epidural infusion (CEI) and intravenous Patient Controlled Analgesia (PCA) with morphine in spine surgery. This study compared these modalities in patients undergoing microdissectomy. METHODS: This prospective, randomized control trial was conducted on 75 patients of American Society of Anesthesiologists' physical status I or II undergoing microdiscectomy. Patients in all the three groups received morphine 1 mg IV, with a lockout period of 10 min after each bolus, and the maximum allowed dose was 15 mg/5 h postoperatively...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28794527/the-effect-of-addition-of-dexamethasone-to-levobupivacaine-in-parturients-receiving-combined-spinal-epidural-for-analgesia-for-vaginal-delivery
#10
Amr Samir Wahdan, Ahmed Ibrahim El-Sakka, Hassan Mostafa Ismail Gaafar
BACKGROUND AND AIMS: Regional analgesia is commonly used for the relief of labour pain, Prolongation of analgesia can be achieved by adjuvant medications. The aim of this randomised controlled trial was to evaluate the efficacy of intrathecal levobupivacaine with dexamethasone for labour analgesia. METHODS: A total of 80 females were included in this study, all were primigravidas undergoing vaginal delivery with cervical dilatation ≥4 cm and 50% or more effacement...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28790864/case-report-bilateral-tunneled-epidural-catheters-to-prevent-unilateral-analgesia-for-cancer-related-pain
#11
Raj B Padalia, Corey J Reeves, Neal Shah, Ankur A Patel, Devang M Padalia
OBJECTIVE: Unilateral analgesia often occurs with epidural analgesia. Traditional methods of troubleshooting this problem can be insufficient in obtaining adequate pain relief in a timely manner for terminal cancer patients. This case report demonstrates a safe and effective solution which can be utilized in these circumstances. CASE REPORT: A 55-year-old female with stage IV pancreatic cancer and life expectancy of a few weeks presented to the interventional pain clinic with intractable sacral pain...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28782603/randomized-clinical-trial-of-epidural-compared-to-conventional-analgesia-after-minimally-invasive-colorectal-surgery
#12
Mark H Hanna, Mehraneh D Jafari, Fariba Jafari, Michael J Phelan, Joseph Rinehart, Coral Sun, Joseph C Carmichael, Steven D Mills, Michael J Stamos, Alessio Pigazzi
OBJECTIVE: The effectiveness of thoracic epidural analgesia (EA) versus conventional intravenous analgesia (IV) after minimally invasive surgery (MIS) is still unproven. We designed a randomized controlled trial comparing EA versus IV after MIS colorectal surgery. METHODS: A total of 87 patients who underwent MIS colorectal procedures at a single institution between 2011 and 2014 were enrolled. 8 patients were excluded and 38 were randomized to EA and 41 to IV. Pain was assessed with the visual analogue scale (VAS) and quality of life with the Overall Benefit of Analgesia Score (OBAS) daily until discharge...
August 3, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28767472/intrathecal-migration-of-an-epidural-catheter-while-using-a-programmed-intermittent-epidural-bolus-technique-for-labor-analgesia-maintenance-a-case-report
#13
Francesca Betti, Brendan Carvalho, Edward T Riley
We describe a case of intrathecal migration of a wire-reinforced epidural catheter in a parturient who received epidural labor analgesia. Epidural analgesia was initiated with a combined-spinal epidural technique and maintained by programmed intermittent epidural boluses. Epidural catheter aspiration after insertion was negative for cerebrospinal fluid. The patient's response to the first four doses of local anesthetic was consistent with epidural drug delivery. After the fifth dose, she developed a complete lower extremity motor block, hypotension, and high sensory blockade...
August 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28767456/effects-of-anaesthesia-and-analgesia-on-long-term-outcome-after-total-knee-replacement-a-prospective-observational-multicentre-study
#14
Dario Bugada, Massimo Allegri, Marco Gemma, Andrea L Ambrosoli, Giuseppe Gazzerro, Fernando Chiumiento, Doriana Dongu, Fiorella Nobili, Andrea Fanelli, Paolo Ferrua, Massimo Berruto, Gianluca Cappelleri
BACKGROUND: Perioperative regional anaesthesia may protect from persistent postsurgical pain (PPSP) and improve outcome after total knee arthroplasty (TKA). OBJECTIVES: Aim of this study was to evaluate the impact of regional anaesthesia on PPSP and long-term functional outcome after TKA. DESIGN: A web-based prospective observational registry. SETTING: Five Italian Private and University Hospitals from 2012 to 2015. PATIENTS: Undergoing primary unilateral TKA, aged more than 18 years, informed consent, American Society of Anesthesiologists (ASA) physical status classes 1 to 3, no previous knee surgery...
August 1, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28763356/randomized-controlled-trial-of-the-clinical-efficacy-of-multiport-versus-uniport-wire-reinforced-flexible-catheters-for-labor-epidural-analgesia
#15
John Philip, Shiv K Sharma, Timothy J Sparks, Joan S Reisch
BACKGROUND: The purpose of this prospective, randomized, controlled trial was to determine whether multiple ports improve the analgesic efficacy of wire-reinforced flexible catheters used for labor epidural analgesia (LEA). METHODS: Six hundred fifty laboring patients were randomized to receive epidural analgesia using either a multiport or uniport wire-reinforced flexible catheter. The primary outcome was analgesic success, defined as the incidence of adequate analgesia following the initial bolus given to initiate LEA...
July 28, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28754057/risk-assessments-of-epidural-analgesia-during-labor-and-delivery
#16
Antonio Herrera-Gómez, Elvira De Luna-Bertos, Javier Ramos-Torrecillas, Francisco M Ocaña-Peinado, Concepción Ruiz, Olga García-Martínez
Epidural analgesia (EA) is one of the methods of choice for labor pain relief, but its adverse effects on the mother and child remain controversial. The objective of this study was to determine whether there is an association between the use of EA and different aspects of labor. The author(s) analyzed the effect of EA on different aspects of labor in a retrospective cohort observational study of deliveries in a public Spanish hospital during a 3-year period. Women with EA administration were found to increase the risk of stimulated labor, reduce the percentage of spontaneous deliveries, increase the risk of instrumental labor due to stalled labor or loss of fetal well-being, and increase the percentage of episiotomies...
July 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/28746153/a-randomized-controlled-trial-of-postoperative-thoracic-epidural-analgesia-versus-intravenous-patient-controlled-analgesia-after-major-hepatopancreatobiliary-surgery
#17
Thomas A Aloia, Bradford J Kim, Yun Shin Segraves-Chun, Juan P Cata, Mark J Truty, Qiuling Shi, Alexander Holmes, Jose M Soliz, Keyuri U Popat, Thomas F Rahlfs, Jeffrey E Lee, Xin Shelley Wang, Jeffrey S Morris, Vijaya N R Gottumukkala, Jean-Nicolas Vauthey
OBJECTIVES: The primary objective of this randomized trial was to compare thoracic epidural analgesia (TEA) to intravenous patient-controlled analgesia (IV-PCA) for pain control over the first 48 hours after hepatopancreatobiliary (HPB) surgery. Secondary endpoints were patient-reported outcomes, total narcotic utilization, and complications. BACKGROUND: Although adequate postoperative pain control is critical to patient and surgeon success, the optimal analgesia regimen in HPB surgery remains controversial...
September 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28744777/-recent-standards-in-management-of-obstetric-anesthesia
#18
REVIEW
Maximiliaan van Erp, Clemens Ortner, Stefan Jochberger, Klaus Ulrich Klein
The following article contains information not only for the clinical working anaesthesiologist, but also for other specialists involved in obstetric affairs. Besides a synopsis of a German translation of the current "Practice Guidelines for Obstetric Anaesthesia 2016" [1], written by the American Society of Anesthesiologists, the authors provide personal information regarding major topics of obstetric anaesthesia including pre-anaesthesia patient evaluation, equipment and staff at the delivery room, use of general anaesthesia, peridural analgesia, spinal anaesthesia, combined spinal-epidural anaesthesia, single shot spinal anaesthesia, and programmed intermittent epidural bolus...
July 25, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28742435/the-role-of-transversus-abdominis-plane-blocks-in-eras-pathways-for-open-and-laparoscopic-colorectal-surgery
#19
Alexander J Kim, Robert Jason Yong, Richard D Urman
INTRODUCTION: The concepts of Enhanced Recovery After Surgery (ERAS(®)) have steadily increased in usage, with benefits in patient outcomes and hospital length of stay. One important component of successful implementation of ERAS protocol is optimized pain control, via the multimodal approach, which includes neuraxial or regional anesthesia techniques and reduction of opioid use as the primary analgesic. Transversus abdominis plane (TAP) block is one such regional anesthesia technique, and it has been widely studied in abdominal surgery...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28742434/use-of-regional-anesthesia-techniques-analysis-of-institutional-enhanced-recovery-after-surgery-protocols-for-colorectal-surgery
#20
Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Principles of enhanced recovery after surgery (ERAS(®)) protocols are well established, with the primary goal of optimizing perioperative care and recovery. The use of multimodal analgesia is a key component of these protocols, including regional analgesia techniques such as thoracic epidural analgesia (TEA), transversus abdominis plane (TAP), rectus sheath blocks or continuous wound infiltration (CWI)/catheters, and spinal anesthesia. We compare and contrast regional anesthesia approaches in different institutional colorectal surgery ERAS protocols...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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