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Epidural analgesia

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https://www.readbyqxmd.com/read/29469195/postoperative-ileus-following-major-colorectal-surgery
#1
REVIEW
S J Chapman, A Pericleous, C Downey, D G Jayne
BACKGROUND: Postoperative ileus (POI) is characterized by delayed gastrointestinal recovery following surgery. Current knowledge of pathophysiology, clinical interventions and methodological challenges was reviewed to inform modern practice and future research. METHODS: A systematic search of MEDLINE and Embase databases was performed using search terms related to ileus and colorectal surgery. All RCTs involving an intervention to prevent or reduce POI published between 1990 and 2016 were identified...
February 22, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29464136/anesthetic-management-of-pheochromocytoma-resection-in-adults-with-single-ventricle-physiology
#2
Giancarlo Suffredini, Natalia Diaz-Rodriguez, Krishnan Chakravarthy, Aarti Mathur, Heather K Hayanga, Steve M Frank, Richard E Ringel, Stephen Freiberg, Viachaslau M Barodka, Jochen Steppan
Survival rates for patients with palliated congenital heart disease are increasing, and an increasing number of adults with cyanotic congenital heart disease (CCHD) might require surgical resection of pheochromocytoma-paraganglioma (PHEO-PGL). A recent study supports the idea that patients with a history of CCHD and current or historical cyanosis might be at increased risk for developing PHEO-PGL. We review the anesthetic management of two adults with single-ventricle physiology following Fontan palliation presenting for PHEO-PGL resection and review prior published case reports...
December 8, 2017: Curēus
https://www.readbyqxmd.com/read/29463947/randomized-controlled-trial-of-epidural-versus-patient-controlled-intravenous-analgesia-for-postoperative-pain-control-after-laparoscopic-gastrectomy
#3
Satoru Kikuchi, Shinji Kuroda, Masahiko Nishizaki, Takashi Matsusaki, Toshiharu Mitsuhashi, Kazuya Kuwada, Shunsuke Kagawa, Hiroshi Morimatsu, Toshiyoshi Fujiwara
Although epidural analgesia (EDA) is considered standard postoperative analgesia for open gastrectomy, it has been unclear whether EDA has benefits in laparoscopic gastrectomy (LG) because postoperative pain after a laparoscopic procedure is significantly reduced. We are conducting a two-arm, single-center, prospective randomized non-inferiority trial to evaluate the postoperative pain relief of patient-controlled intravenous analgesia (PCIA) compared to EDA. A total of 132 patients undergoing LG will be randomized to EDA and PCIA groups (n=64 each) for postoperative pain control...
February 2018: Acta Medica Okayama
https://www.readbyqxmd.com/read/29458911/pharmacogenetic-study-of-pruritus-induced-by-epidural-morphine-for-post-cesarean-section-analgesia
#4
Chia-Chi Kung, Shiou-Sheng Chen, Hong-Jyh Yang, Chih-Jun Lai, Li-Kuei Chen
OBJECTIVE: The mechanism through which neuroaxial morphine causes pruritus has not been elucidated clearly and thoroughly. MATERIALS AND METHODS: a study in 129 female parturients was conducted to investigate the effect of 14 single nucleotide polymorphisms (SNPs) on phenotype (pruritus) induced by neuroaxial (including intrathecal or epidural) morphine for cesarean section. Clinical phenotype, subjective complaints and objective observations were recorded. DNA from blood samples was used to record the SNPs...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29458228/efficacy-of-epidural-analgesia-after-laparotomy-in-children
#5
Klarieke Bravenboer-Monster, Claudia Keyzer-Dekker, Monique van Dijk, Lonneke Staals, Tom de Leeuw, Rene Wijnen
BACKGROUND: Epidural analgesia (EDA) is used as postoperative pain treatment in children, but little is known about its efficacy after laparotomy in children. This retrospective study investigated the efficacy of postoperative EDA after laparotomy in children and the frequencies of adverse effects and complications. MATERIALS AND METHODS: Data of all children aged 0 to 18 years undergoing laparotomy and treated with EDA in our hospital from January 2014 to December 2015 were collected...
February 19, 2018: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29457120/spread-of-injectate-in-ultrasound-guided-serratus-plane-block-a-cadaveric-study
#6
Tatsuya Kunigo, Takeshi Murouchi, Shuji Yamamoto, Michiaki Yamakage
Background: Serratus plane block is a thoracic truncal block that has been proposed as alternatives for analgesia such as epidural anesthesia and paravertebral block for the anterolateral chest wall. Previously, we performed the clinical study about optimal volume of the local anesthetic in serratus plane block. The primary aim of this study was to assess the pattern of distribution of dye into the serratus plane of cadavers after ultrasound-guided serratus plane injection. Findings: Ultrasound-guided serratus plane injection was performed at the level of the fourth rib on the mid-axillary line in nine adult Thiel-embalmed cadavers...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29457116/a-spinal-cord-infarction-that-occurred-after-laparoscopic-gastrectomy-performed-under-general-anesthesia-and-epidural-analgesia
#7
Kei Houri, Shinichi Hamasaki, Takatoshi Tsujimoto, Tomohisa Uchida, Tatsushige Iwamoto, Toru Shirai, Shinichi Nakao
Background: Spinal cord infarction (SCI) after epidural anesthesia is quite rare. Although most cases of perioperative SCI are associated with aortic, cardiac, or spinal surgery, and/or abnormal preoperative conditions, such as spinal stenosis or hypercoagulopathy, intraoperative events, such as severe hypotension or epidural puncture and catheterization, can be contributory factors. Case presentation: A 52-year-old male was underwent laparoscopic gastrectomy. Before induction of general anesthesia, an epidural catheter was placed without any problems...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29457112/anesthetic-management-during-a-cesarean-section-in-a-patient-with-cleidocranial-dysplasia-a-case-report
#8
Yumiko Nishio, Teruyuki Hiraki, Hiroko Taniguchi, Kazuo Ushijima
Background: Cleidocranial dysplasia is a type of skeletal dysplasia, which is primarily characterized by delayed ossification of skeletal structures. It causes facial and oral abnormalities, resulting in difficult airway management and neuraxial anesthesia. Case presentation: The patient was a 24-year-old primipara (height 138 cm, weight 42 kg) with a hypoplastic right clavicle, patent fontanelles, dental malalignment, and a high palate. She was diagnosed with cleidocranial dysplasia at birth, although gene examination has not been performed...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29455380/clinical-features-and-peripartum-outcomes-in-pregnant-women-with-cardiac-disease-a-nationwide-retrospective-cohort-study-in-japan
#9
Toshiaki Isogai, Hiroki Matsui, Hiroyuki Tanaka, Akira Kohyama, Kiyohide Fushimi, Hideo Yasunaga
Although the number of pregnancies in women with cardiac disease is increasing worldwide, there are few data concerning their clinical characteristics and peripartum outcomes. Using the Diagnosis Procedure Combination database between 2008 and 2014 in Japan, we retrospectively identified pregnant women who underwent high-risk delivery due to obstetric or non-obstetric comorbidities. We classified eligible women into those with pre-existing cardiac disease (cardiac disease group) and those with non-cardiac comorbidities (non-cardiac disease group) and compared their characteristics and peripartum outcomes...
February 17, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29454333/comparative-study-of-ultrasound-guided-paravertebral-block-versus-intravenous-tramadol-for-postoperative-pain-control-in-percutaneous-nephrolithotomy
#10
Zehra Hatipoglu, Ersel Gulec, Mediha Turktan, Volkan Izol, Atilla Arıdogan, Yasemin Gunes, Dilek Ozcengiz
BACKGROUND: Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure for renal calculi, and nephrostomy tubes lead to postoperative pain after PCNL. Regional techniques (e.g., epidural analgesia and peripheral blocks) and opioids are applied for postoperative pain treatment. The aim of this study was to compare effectiveness of ultrasound-guided paravertebral block (PVB) and tramadol on postoperative pain in patients who underwent PCNL. METHOD: Fifty-three patients were included in this prospective randomized study...
February 17, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29447711/no-355-physiologic-basis-of-pain-in-labour-and-delivery-an-evidence-based-approach-to-its-management
#11
Julie Bonapace, Guy-Paul Gagné, Nils Chaillet, Raymonde Gagnon, Emmanuelle Hébert, Sarah Buckley
OBJECTIVE: To review the evidence relating to nonpharmacological approaches in the management of pain during labour and delivery. To formulate recommendations for the usage of nonpharmacological approaches to pain management. OPTIONS: Nonpharmacological methods available for pain management during labour and delivery exist. These should be included in the counselling and care of women. EVIDENCE: PubMed and Medline were searched for articles in French and English on subjects related to "breastfeeding," "pain," "epidural," "anaesthesia," "analgesia," "labour," "labor," and combined with "gate control theory," "alternative therapies," "massage," "position," "mobility," "TENS," "bathing," "DNIC," "acupuncture," "acupressure," "sterile water injection," "higher center," "control mind," "cognitive structuring," "holistic health," "complementary therapy(ies)," "breathing," "relaxation," "mental imagery," "visualization," "mind focusing," "hypnosis," "auto-hypnosis," "sophrology," "mind and body interventions," "music," "odors," "biofeedback," "Lamaze," "Bonapace," "prenatal training," "gymnastic," "chanting," "haptonomy," "environment," "transcutaneous electrical stimulus-stimulation," "antenatal education," "support," "continuous support," "psychosocial support," "psychosomatic medicine," "supportive care," "companion," "intrapartum care," "nurse," "midwife(ves)," "father," "doula," "caregiver," " hormones," "oxytocin," "endorphin," "prolactin," "catecholamine," "adrenaline," and "noradrenaline" from 1990 to December 2015...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29445296/the-ultrasound-guided-retrolaminar-block-volume-dependent-injectate-distribution
#12
Marija Damjanovska, Tatjana Stopar Pintaric, Erika Cvetko, Kamen Vlassakov
Purpose: The ultrasound-guided retrolaminar block is one of the newer and simpler alternatives to the traditional, often technically challenging, paravertebral (PV) block. Its feasibility, safety, and efficacy have already been clinically demonstrated in patients with multiple rib fractures using higher volumes of local anesthetic, when compared with the traditional approach. The primary aim of this observational anatomical study was to assess the spread of local anesthetic from the retrolaminar injection point to the PV space and its volume dependence...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29434783/the-application-of-nalbuphine-in-patient-controlled-intravenous-analgesia-for-patients-undergoing-subtotal-gastrectomy
#13
Li Yang, Jinjing Wu, Tao Li
The aim of the present study was to investigate the analgesic effect and safety of the application of different doses of nalbuphine in patient-controlled intravenous analgesia (PCIA) for patients undergoing subtotal gastrectomy. A total of 120 patients, who underwent subtotal gastrectomy at our hospital between May, 2015 and January, 2017 under combined spinal epidural combined anesthesia, were selected. The patients received PCIA after surgery. The patients were randomly divided into four groups, including the morphine (MOP group), nalbuphine 60 mg (N60 group), nalbuphine 80 mg (N80 group) and nalbuphine 100 mg (N100 group)...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29416155/erector-spinae-plane-block-as-an-alternative-to-epidural-analgesia-for-post-operative-analgesia-following-video-assisted-thoracoscopic-surgery-a-case-study-and-a-literature-review-on-the-spread-of-local-anaesthetic-in-the-erector-spinae-plane
#14
Sanjib Das Adhikary, Ashlee Pruett, Mauricio Forero, Venkatesan Thiruvenkatarajan
Post-operative pain after minimally invasive video-assisted thoracoscopic surgery (VATS) in adults is commonly managed with oral and parenteral opioids and invasive regional techniques such as thoracic epidural blockade. Emerging research has shown that the novel erector spinae plane (ESP) block, can be employed as a simple and safe alternative analgesic technique for acute post-surgical, post-traumatic and chronic neuropathic thoracic pain in adults. We illustrate this by presenting a paediatric case of VATS, in which an ESP block provided better analgesia, due to greater dermatomal coverage, as well as reduced side-effects when compared with a thoracic epidural that had previously been employed on the same patient for a similar procedure on the opposite side...
January 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29411048/comparison-of-analgesic-interventions-for-traumatic-rib-fractures-a-systematic-review-and-meta-analysis
#15
Jesse Peek, Diederik P J Smeeing, Falco Hietbrink, Roderick M Houwert, Marije Marsman, Mirjam B de Jong
PURPOSE: Many studies report on outcomes of analgesic therapy for (suspected) traumatic rib fractures. However, the literature is inconclusive and diverse regarding the management of pain and its effect on pain relief and associated complications. This systematic review and meta-analysis summarizes and compares reduction of pain for the different treatment modalities and as secondary outcome mortality during hospitalization, length of mechanical ventilation, length of hospital stay, length of intensive care unit stay (ICU) and complications such as respiratory, cardiovascular, and/or analgesia-related complications, for four different types of analgesic therapy: epidural analgesia, intravenous analgesia, paravertebral blocks and intercostal blocks...
February 6, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29409594/-horner-s-syndrome-and-paresthesia-in-the-trigeminal-nerve-territory-secondary-to-epidural-analgesia-for-labor
#16
Céline Ferreira, Ana Luísa Macedo, Valentina Almeida
Currently, epidural analgesia is a common procedure for labor analgesia. Although it is considered a safe technique, it is not without complications. Horner's syndrome and paresthesia within the trigeminal nerve distribution are rare complications of epidural analgesia. We report a case of a pregnant woman who developed Horner's syndrome and paresthesia within the distribution of the trigeminal nerve following epidural analgesia for the relief of labor pain.
February 3, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29405534/dura-to-spinal-cord-distance-at-different-vertebral-levels-in-children-and-its-implications-on-epidural-analgesia-a-retrospective-mri-based-study
#17
Tariq Wani, Ralph Beltran, Giorgio Veneziano, Faris AlGhamdi, Hatem Azzam, Nahida Akhtar, Dmitry Tumin, Yasser Majid, Joseph D Tobias
BACKGROUND: The distance from the dura to spinal cord is not uniform at different vertebral levels. The dura to spinal cord distance may be a critical factor in avoiding the potential for neurological injury caused by needle trauma after a dural puncture. Typically, the greater the dura to spinal cord distance, the larger the potential safety margin. The objective of our study is to measure dura to spinal cord distance at two thoracic levels T6 -7 , T9 -10 , and one lumbar level L1 -2 using MRI images...
February 6, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29402627/survey-of-postoperative-regional-analgesia-for-thoracoscopic-surgeries-in-canada
#18
Harsha Shanthanna, Peter Moisuik, Turlough O'Hare, Sadeesh Srinathan, Christian Finley, James Paul, Peter Slinger
OBJECTIVES: To determine the preferences and perceptions regarding analgesic options for video-assisted thoracic surgery (VATS) among thoracic anesthesiologists in Canada. DESIGN: A cross-sectional survey of thoracic anesthesiologists with 30 multiple choice questions was e-mailed through an online survey tool called FluidSurveys was performed to members of the Canadian Anesthesiologists' Society. SETTING: A nationwide survey. PARTICIPANTS: Members of Canadian Anesthesiologists' Society who provide thoracic anesthesia INTERVENTIONS: None...
January 5, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29399781/epidural-extension-failure-in-obese-women-is-comparable-to-that-of-non-obese-women
#19
V A Eley, A Chin, I Tham, J Poh, P Aujla, E Glasgow, H Brown, K Steele, L Webb, A van Zundert
BACKGROUND: Management of labor epidurals in obese women is difficult and extension to surgical anesthesia is not always successful. Our previous retrospective pilot study found epidural extension was more likely to fail in obese women. This study used a prospective cohort to compare the failure rate of epidural extension in obese and non-obese women and to identify risk factors for extension failure. METHODS: One hundred obese participants (Group O, body mass index ≥ 40 kg/m2 ) were prospectively identified and allocated two sequential controls (Group C, body mass index ≤ 30 kg/m2 )...
February 4, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29398425/educating-anesthesia-residents-to-obtain-and-document-informed-consent-for-epidural-labor-analgesia-does-simulation-play-a-role
#20
A Antoniou, K Marmai, F Qasem, R Cherry, P M Jones, S Singh
BACKGROUND: Informed consent is required before placing an epidural. At our hospital, teaching of residents about this is done informally at the bedside. This study aimed to assess the ability of anesthesia residents to acquire and retain knowledge required when seeking informed consent for epidural labor analgesia. It assessed how well this knowledge was translated to clinical ability, by assessing the verbal consent process during an interaction with a standardized patient. METHODS: Twenty anesthesia residents were randomized to a 'didactic group' or a 'simulation group'...
December 29, 2017: International Journal of Obstetric Anesthesia
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