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Epidural analgesia

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https://www.readbyqxmd.com/read/28428505/-neurolysis-and-spinal-analgesia-in-cancer-pain-management
#1
Seiji Hattori, Junko Tachibana
Cancer pain appears as a complex pain and often progressive.WhenWHO pain management strategy and/or palliative care failed to relieve their pain, patients are given high dose opioids or anonymous adjuvant drugs and have no chance to meet specialized pain treatment. This section briefly covers the outline of neurolysis and spinal analgesia for these cancer patients with severe pain. Purpose of nerve block and neurolysis are to block the incoming signal of pain in order to reduce pain, reduce analgesic dose, recover ADL, and finally to be discharged from the hospital...
April 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28425307/epidural-fentanyl-does-not-affect-cervical-dilation-and-progress-of-first-stage-of-vaginal-delivery-a-randomized-double-blind-study
#2
Chryssoula Staikou, Theodoros Kalampokas, Emmanouil Kalampokas, Sophia Vassiloglou, Anteia Paraskeva
OBJECTIVE: Local anesthetics combined with opioids are commonly used in labor epidural analgesic schemes. We investigated if the addition of fentanyl to epidural ropivacaine can affect cervical dilation and progress of vaginal delivery. METHODS: Sixty-two nulliparous parturients were randomized to receive epidurally 8ml ropivacaine 0.2% combined with fentanyl 20μg (F/R-group, n = 31) or with normal saline 0.4ml (R-group, n = 31), every hour. Rescue doses of 5ml ropivacaine 0...
April 20, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28424138/comparative-analysis-of-the-paravertebral-analgesic-pump-catheter-with-the-epidural-catheter-in-elderly-trauma-patients-with-multiple-rib-fractures
#3
Brian S Shapiro, Tarik Wasfie, Mathew Chadwick, Kimberly R Barber, Raquel Yapchai
Presently, trauma guidelines recommend epidural analgesia as the optimal modality of pain relief from rib fractures. They are not ideally suited for elderly trauma patients and have disadvantages including bleeding risk. The paravertebral analgesic pump (PVP) eliminates such disadvantages and includes ease of placement in the trauma setting. This study compares pain control in patients treated by EPI versus PVP. This is a retrospective, historical cohort study comparing two methods of pain management in the trauma setting...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28419420/reliability-of-pressure-waveform-analysis-to-determine-correct-epidural-needle-placement-in-labouring-women
#4
I Al-Aamri, S H Derzi, A Moore, M F Elgueta, M Moustafa, T Schricker, D Q Tran
Pressure waveform analysis provides a reliable confirmatory adjunct to the loss-of-resistance technique to identify the epidural space during thoracic epidural anaesthesia, but its role remains controversial in lumbar epidural analgesia during labour. We performed an observational study in 100 labouring women of the sensitivity and specificity of waveform analysis to determine the correct location of the epidural needle. After obtaining loss-of-resistance, the anaesthetist injected 5 ml saline through the epidural needle (accounting for the volume already used in the loss-of-resistance)...
April 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28418067/a-case-series-of-vital-signs-controlled-patient-assisted-intravenous-analgesia-vpia-using-remifentanil-for-labour-and-delivery
#5
W L Leong, B L Sng, Q Zhang, N L R Han, R Sultana, A T H Sia
Intravenous remifentanil patient-controlled analgesia can be used during labour as an alternative to epidural analgesia. Adverse effects of opioids, including hypoxia and bradycardia, may lead to maternal morbidity and mortality. We devised an interactive feedback system based on a clinical proportional algorithm, to continuously monitor for adverse effects to enhance safety and better titrate analgesia. This vital signs-controlled, patient-assisted intravenous analgesia with remifentanil used a prototype delivery system linked to a pulse oximeter that evaluated maternal oxygen saturation and heart rate continuously...
April 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28417354/perioperative-epidural-analgesia-is-not-associated-with-increased-survival-from-renal-cell-cancer-but-overall-survival-may-be-improved-a-retrospective-chart-review
#6
Evan Kovac, Farhad Firoozbakhsh, Homayoun Zargar, Amr Fergany, Hesham Elsharkawy
PURPOSE: We investigated the possible association between perioperative epidural and both cancer-specific survival (CSS) and overall survival (OS) in patients undergoing partial or radical nephrectomy for localized renal cell carcinoma (RCC). METHODS: A retrospective chart review was performed on patients who underwent complete surgical resection of localized RCC from 1994-2008 at our institution. Baseline demographics and pathological and survival data were collected...
April 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28413286/transversus-abdominis-plane-catheters-for-postoperative-pain-relief-in-pediatric-patients
#7
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/28413284/combined-mitral-and-aortic-stenosis-in-parturient-anesthesia-management-for-labor-and-delivery
#8
Manish Kela, Madhvi Buddhi
Maternal heart disease complicates 0.2-3% of pregnancies. The optimal management of the pregnant patient with cardiac disease depends on the co-operative efforts of the obstetrician, the cardiologist and the anesthesiologist involved in peripartum care. A comprehensive understanding of physiology of pregnancy and pathophysiology of underlying cardiac disease is of primary importance in provision of obstetric analgesia or anesthesia for these high-risk groups of patients. We report a successful and uncomplicated use of epidural anesthesia for labor and delivery in patient with combined aortic and mitral stenosis...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28413269/localization-of-epidural-space-a-review-of-available-technologies
#9
REVIEW
Hesham Elsharkawy, Abraham Sonny, Ki Jinn Chin
Although epidural analgesia is widely used for pain relief, it is associated with a significant failure rate. Loss of resistance technique, tactile feedback from the needle, and surface landmarks are traditionally used to guide the epidural needle tip into the epidural space (EDS). The aim of this narrative review is to critically appraise new and emerging technologies for identification of EDS and their potential role in the future. The PubMed, Cochrane Central Register of Controlled Clinical Studies, and Web of Science databases were searched using predecided search strategies, yielding 1048 results...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28412845/fetal-and-maternal-temperatures-during-labor-and-delivery-a-prospective-descriptive-study
#10
Tony Lavesson, Karin Källén, Per Olofsson
OBJECTIVE: To study the fetal scalp temperature (FST) and maternal axillary temperature (MAT) during vaginal delivery relative to progression of labor, uterine contractions (UC) and epidural analgesia (EDA), and to construct normal temperature reference ranges related to stage of labor. MATERIAL AND METHODS: Temperatures were recorded continuously in labor of 132 women with a bi-metal temperature sensor attached to the axilla (MAT) and a similar sensor mounted in a scalp electrode (FST)...
April 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28410219/the-effects-of-intra-and-postoperative-anaesthesia-and-analgesia-choice-on-outcome-after-gastric-cancer-resection-a-retrospective-study
#11
Yu Wang, Liping Wang, Hong Chen, Yang Xu, Xiaoyu Zheng, Guonian Wang
BACKGROUND: Epidural use can provide a better short-term outcome and protect patients from the postoperative development of tumour recurrence and metastases. In this study, we sought to assess the effects of intra- and postoperative anaesthesia and analgesia choice on outcome after gastric cancer resection, searched for evidence of interaction between intra-and postoperative epidural use and outcomes of gastric cancer patients. METHODS: Four thousand two hundred and eighteen cases of gastric cancer were identified from the Records of Hospital Patients...
March 30, 2017: Oncotarget
https://www.readbyqxmd.com/read/28407220/patient-controlled-analgesia-with-remifentanil-versus-alternative-parenteral-methods-for-pain-management-in-labour
#12
REVIEW
Stephanie Weibel, Yvonne Jelting, Arash Afshari, Nathan Leon Pace, Leopold Hj Eberhart, Johanna Jokinen, Thorsten Artmann, Peter Kranke
BACKGROUND: Multiple analgesic strategies for pain relief during labour are available. Recently remifentanil, a short-acting opioid, has recently been used as an alternative analgesic due to its unique pharmacological properties. OBJECTIVES: To systematically assess the effectiveness of remifentanil intravenous patient-controlled analgesia (PCA) for labour pain, along with any potential harms to the mother and the newborn. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (9 December 2015), ClinicalTrials...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28405034/a-multicentre-survey-of-the-current-acute-post-operative-pain-management-practices-in-tertiary-care-teaching-hospitals-in-maharashtra
#13
Samina Khaliloddin Khatib, Syed Shamim Razvi, Sadhana Sudhir Kulkarni, Swapnil Parab
BACKGROUND AND AIMS: Undertreated pain can have negative consequences on patients' health as well as the health-care system. The present study was aimed at identifying the current trends in post-operative pain management and availability of acute pain services (APS). In addition, it is also an attempt to assess the availability of analgesia for non-surgical cases, and the attitudes, beliefs, and perceptions of clinicians regarding acute pain management in the tertiary hospitals in the state of Maharashtra (India)...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28404067/continuous-wound-infiltration-versus-epidural-analgesia-after-hepato-pancreato-biliary-surgery-pop-up-a-randomised-controlled-open-label-non-inferiority-trial
#14
Timothy H Mungroop, Denise P Veelo, Olivier R Busch, Susan van Dieren, Thomas M van Gulik, Tom M Karsten, Steve M de Castro, Marc B Godfried, Bram Thiel, Markus W Hollmann, Philipp Lirk, Marc G Besselink
BACKGROUND: Epidural analgesia is the international standard for pain treatment in abdominal surgery. Although some studies have advocated continuous wound infiltration with local anaesthetics, robust evidence is lacking, especially on patient-reported outcome measures. We aimed to determine the effectiveness of continuous wound infiltration in hepato-pancreato-biliary surgery. METHODS: In this randomised controlled, open label, non-inferiority trial (POP-UP), we enrolled adult patients undergoing hepato-pancreato-biliary surgery by subcostal or midline laparotomy in two Dutch hospitals...
October 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28403113/incidence-of-persistent-postoperative-pain-after-hepatectomies-with-2-regimes-of-perioperative-analgesia-containing-ketamine
#15
Paula Masgoret, Carmen Gomar, Beatriz Tena, Pilar Taurá, José Ríos, Miquel Coca
Studies designed to assess persistent postoperative pain (PPP) incidence after hepatectomies are lacking. Our aim was to assess PPP incidence 6 months after hepatectomies with intravenous (IV) or epidural (EPI) analgesia containing ketamine.Prospective observational comparative study between 2 cohorts of patients submitted to hepatectomy. Patients received 1 of 2 analgesic regimes containing ketamine: EPI group or IV group. Visual analog scale (VAS), Neuropathic Pain Symptom Inventory (NPSI), Pain Catastrophizing Scale (PCS), and quantitative sensorial testing (QST: to determine area of hyperalgesia/allodynia) were assessed preoperatively and postoperatively at 2 h, 24 h, 7 days, 1 month, and 6 months...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28396863/real-time-ultrasound-mri-fusion-for-suprasacral-parallel-shift-approach-to-lumbosacral-plexus-blockade-and-analysis-of-injectate-spread-an-exploratory-randomized-controlled-trial
#16
Jennie Maria Christin Strid, Erik Morre Pedersen, Sinan Naseer Hussain Al-Karradi, Mathias Alrø Fichtner Bendtsen, Siska Bjørn, Mette Dam, Morten Daugaard, Martin Sejr Hansen, Katrine Danker Linnet, Jens Børglum, Kjeld Søballe, Thomas Fichtner Bendtsen
Fused real-time ultrasound and magnetic resonance imaging (MRI) may be used to improve the accuracy of advanced image guided procedures. However, its use in regional anesthesia is practically nonexistent. In this randomized controlled crossover trial, we aim to explore effectiveness, procedure-related outcomes, injectate spread analyzed by MRI, and safety of ultrasound/MRI fusion versus ultrasound guided Suprasacral Parallel Shift (SSPS) technique for lumbosacral plexus blockade. Twenty-six healthy subjects aged 21-36 years received two SSPS blocks (20 mL 2% lidocaine-epinephrine [1 : 200,000] added 1 mL diluted contrast) guided by ultrasound/MRI fusion versus ultrasound...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28395435/-application-of-general-anesthesia-combined-with-epidural-anesthesia-analgesia-in-rehabilitation-after-gastric-cancer-resection
#17
F Liu, J Zhang, X Q Zeng, Y Q Zhao, Y X Zuo
Objective: To investigate the efficacy of general anesthesia with epidural anesthesia and postoperative epidural analgesia in terms of pain relief and post-operative functional recovery. Methods: Ninety-six patients were randomly assigned to general anesthesia and intravenous analgesia group (GI) or general anesthesia combined with epidural anesthesia and epidural analgesia group (GE). Demographic and operative data, postoperative VAS pain scores, gastrointestinal function, postoperative hospital stays, general complications were assessed prospectively...
April 11, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28389846/continuous-transversus-abdominis-plane-blocks-via-laparoscopically-placed-catheters-for-bariatric-surgery
#18
Alfred M Said, Hany A Balamoun
OBJECTIVES: The objective of the present study is to evaluate postoperative analgesic outcome of the continuous bilateral transversus abdominis plane (TAP) block using bupivacaine infusion through an epidural catheter inserted through laparoscopic ports. PATIENTS AND METHODS: Ninety patients assigned for laparoscopic sleeve gastrectomy (LSG) were divided into two equal groups according to postoperative analgesia: Control group received IV morphine, and TAP group received bupivacaine 0...
April 7, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28389801/comparison-of-the-effects-of-patient-controlled-epidural-and-intravenous-analgesia-on-postoperative-bowel-function-after-laparoscopic-gastrectomy-a-prospective-randomized-study
#19
Jin Sun Cho, Hyoung-Il Kim, Ki-Young Lee, Taeil Son, Sun Joon Bai, Haegi Choi, Young Chul Yoo
BACKGROUND: Although laparoscopic surgery significantly reduces surgical trauma compared to open surgery, postoperative ileus is a frequent and significant complication after abdominal surgery. Unlike laparoscopic colorectal surgery, the effects of epidural analgesia on postoperative recovery after laparoscopic gastrectomy are not well established. We compared the effects of epidural analgesia to those of conventional intravenous (IV) analgesia on the recovery of bowel function after laparoscopic gastrectomy...
April 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28384375/risk-factors-for-anastomotic-leakage-following-esophagectomy-impact-of-thoracic-epidural-analgesia
#20
Wen Wang, Gefei Zhao, Linxin Wu, Yanpeng Dong, Chaobin Zhang, Li Sun
BACKGROUND AND OBJECTIVES: Anastomotic leakage (AL) is one of common complications after esophageal cancer surgery. Thoracic epidural analgesia (TEA) is often recommended in patients undergoing esophagectomy. However, the impact of TEA on AL is still controversial. Thus, we conducted this study to evaluate the effect of TEA on the occurrence of AL and identify risk factors for the development of AL following esophagectomy. METHODS: Our retrospective study identified patients who underwent elective esophagectomy between July 2013 and July 2016...
April 6, 2017: Journal of Surgical Oncology
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