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Lumbar epidural

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https://www.readbyqxmd.com/read/28937423/deep-serratus-plane-catheter-for-management-of-acute-postthoracotomy-pain-after-descending-aortic-aneurysm-repair-in-a-morbidly-obese-patient-a-case-report
#1
Renuka M George, Maria Yared, Sylvia H Wilson
Regional procedures for postthoracotomy pain control have classically focused on paravertebral blocks and thoracic epidurals; however, these techniques may be challenging in an increasingly obese population and contraindicated with numerous anticoagulant and antiplatelet agents. While less studied, truncal blocks allow analgesic intervention for this growing patient cohort. This case report describes placement of a deep serratus anterior plane catheter in an intubated, morbidly obese patient with a lumbar drain who failed extubation secondary to acute postthoracotomy pain...
September 20, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28936912/epidural-hematoma-development-contralateral-to-dura-after-lumbar-transforaminal-epidural-steroid-injection
#2
Semih Gungor, Rohit Aiyer
AIM: To illustrate the anatomical and pathophysiological risks of epidural hematoma formation, other than direct needle trauma, after lumbar transforaminal epidural steroid injection in the setting of severe central canal stenosis. CASE REPORT: This case report presents the development of an epidural hematoma after lumbar transforaminal epidural steroid injection in a patient who has anatomical risk factor of severe lumbar spinal stenosis. The anatomic location of epidural hematoma was at the injected level, but on the contralateral side of the dura at a distance from the needle path...
September 22, 2017: Pain Management
https://www.readbyqxmd.com/read/28936608/the-effect-of-an-increased-pulse-width-on-the-pattern-of-motor-response-unilateral-versus-bilateral-during-the-tsui-test-in-labouring-parturients-a-randomized-crossover-trial
#3
Paul Zakus, Ricardo Bittencourt, Kristi Downey, Ban C H Tsui, Jose C A Carvalho
BACKGROUND AND OBJECTIVES: The typical response to the Tsui test performed via an epidural catheter placed in the lumbar area is the unilateral motor response of the lower limbs. Studies show that longer pulse widths can stimulate peripheral nerves at a lower threshold current from a farther distance. Therefore, we designed a study to test the hypothesis that epidural catheter stimulation with a 1.0-msec pulse width would increase the incidence of bilateral motor response in parturients when compared with stimulation with a 0...
September 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28934790/factors-associated-with-successful-responses-to-transforaminal-balloon-adhesiolysis-for-chronic-lumbar-foraminal-stenosis-retrospective-study
#4
Doo Hwan Kim, Seong-Sik Cho, Yeon-Jin Moon, Koo Kwon, Kunhee Lee, Jeong-Gil Leem, Jin-Woo Shin, Ji Hyun Park, Seong-Soo Choi
BACKGROUND: Recently, transforaminal balloon adhesiolysis was introduced to manage patients with chronic radicular pain occurring with or without low back pain. However, the factors associated with successful responses to transforaminal balloon adhesiolysis are not known. OBJECTIVE: To evaluate the factors associated with successful responses to transforaminal balloon adhesiolysis for chronic lumbar spinal stenosis. STUDY DESIGN: This is a retrospective observational study...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28929033/baastrup-s-disease-interspinal-bursitis-and-dorsal-epidural-cysts-radiologic-evaluation-and-impact-on-treatment-options
#5
REVIEW
Jesse Hatgis, Michelle Granville, Robert E Jacobson
Baastrup's disease or "kissing spines syndrome" was first described as a cause of lumbar pain before computerized tomography (CT) and magnetic resonance imaging (MRI) scanning existed. The diagnosis was based on x-ray studies, which showed that the spinous processes, especially in the lower lumbar spine, became approximated to each other and this was a generator of positional back pain. Biomechanically, the interspinous and supraspinous ligaments that are degenerated in Baastrup's disease normally contribute significantly to sagittal alignment...
July 9, 2017: Curēus
https://www.readbyqxmd.com/read/28928589/laparoscopic-cholecystectomy-under-segmental-thoracic-spinal-anesthesia-a-feasible-economical-alternative
#6
Aditya Kumar Kejriwal, Shaheen Begum, Gopal Krishan, Richa Agrawal
Laparoscopic surgery is normally performed under general anesthesia, but regional techniques like thoracic epidural and lumbar spinal have been emerging and found beneficial. We performed a clinical case study of segmental thoracic spinal anaesthesia in a healthy patient. We selected an ASA grade I patient undergoing elective laparoscopic cholecystectomy and gave spinal anesthetic in T10-11 interspace using 1 ml of bupivacaine 5 mg ml(-1) mixed with 0.5 ml of fentanyl 50 μg ml(-1). Other drugs were only given (systemically) to manage patient anxiety, pain, nausea, hypotension, or pruritus during or after surgery...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928587/unexpected-complication-after-caudal-epidural-steroid-injection-hiccup
#7
Ayhan Kaydu, Ebru Tarıkçı Kılıç, Erhan Gökçek, Mehmet Salim Akdemir
Persistent hiccup is uncommon, and the mechanism is poorly understood. We present the case of a 43-year-old male patient referred to the Algology department due to chronic back pain who developed what we believe a rare case of persistent hiccup secondary to caudal epidural steroid injection (CESI). The causes of hiccup are many and include electrolyte derangement, nutritional deficiencies, gastrointestinal disorders and instrumentation, cardiovascular disorders, renal impairment, central nervous system disorders, and drugs; however, the cause may be unknown...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928574/impact-of-different-approaches-of-epidural-steroid-injection-on-outcome-of-patients-treated-for-low-backache
#8
Sukhdeep Kaur, Ruchi Gupta, Saru Singh, Raj Kumar, Kulvinder Singh
OBJECTIVES: The objective of this study was to evaluate the clinical efficacy of epidural steroid injections through different approaches using pain relief and improvement in functional capacity as outcome measures. MATERIALS AND METHODS: Sixty patients with low backache and unilateral radiculopathy were randomly assigned to three groups of twenty patients each, for undergoing lumbar epidural steroid injection (LESI) through midline, transforaminal, and paramedian approaches under fluoroscopic guidance...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928569/comparison-of-epidural-analgesia-with-transversus-abdominis-plane-analgesia-for-postoperative-pain-relief-in-patients-undergoing-lower-abdominal-surgery-a-prospective-randomized-study
#9
Sadasivan Shankar Iyer, Harshit Bavishi, Chadalavada Venkataram Mohan, Navdeep Kaur
BACKGROUND: Anesthesiologists play an important role in postoperative pain management. For analgesia after lower abdominal surgery, epidural analgesia and ultrasound-guided transversus abdominis plane (TAP) block are suitable options. The study aims to compare the analgesic efficacy of both techniques. MATERIALS AND METHODS: Seventy-two patients undergoing lower abdominal surgery under spinal anesthesia were randomized to postoperatively receive lumbar epidural catheter (Group E) or ultrasound-guided TAP block (Group T) through intravenous cannulas placed bilaterally...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28927205/rare-neurosurgical-complications-of-epidural-injections-an-8-yr-single-institution-experience
#10
Gabriel A Smith, Jonathan Pace, Madeleine Strohl, Anand Kaul, Salim Hayek, Jonathan P Miller
BACKGROUND: Neurosurgical complications from epidural injections have rarely been reported. OBJECTIVE: To define the spectrum of complications from these procedures in order to identify risk factors and strategies for prevention. METHODS: A prospectively maintained database of 14 247 neurosurgical admissions over 8 yr was screened to identify patients who had suffered procedural complications associated with 1182 cervical and 4617 lumbar interlaminar epidural injection procedures performed at a single institution...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28913495/improvement-of-recovery-parameters-using-patient-controlled-epidural-analgesia-after-oncological-surgery-a-prospective-randomized-single-center-study
#11
Armeana Olimpia Zgâia, Cosmin Ioan Lisencu, Alexandru Rogobete, Cătălin Vlad, Patriciu Achimaş-Cadariu, Gabriel Lazăr, Maximilian Muntean, Florin Ignat, Vlad Ormindean, Alexandru Irimie
PURPOSE: The aim of this study was to compare patient-controlled epidural analgesia (PCEA) versus conventional opioid intravenous (IV) infusion after gastrointestinal cancer surgery regarding several post-surgery parameters of recovery. METHODS: One hundred and one patients were prospectively randomized to receive either thoracic/lumbar PCEA (PCEA group) or the standard analgesia technique used in our hospital, conventional IV infusion of morphine (IVMO group) after gastrointestinal cancer surgery...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28899867/epidural-interlaminar-injections-in-severe-degenerative-lumbar-spine-fluoroscopy-should-not-be-a-luxury
#12
Dimitrios K Filippiadis, Thomas Rodt, Maria-Chrysanthi Kitsou, Chrysanthi Batistaki, Nikolaos Kelekis, Georgia Kostopanagiotou, Alexis Kelekis
OBJECTIVE: To assess technical efficacy, accuracy, and safety of epidural (interlaminar) injections performed blindly in patients with a severely degenerated lumbar spine. METHODS: Over 12 consecutive months, 138 patients with a severe degenerative lumbar spine underwent epidural (interlaminar) injection as therapy for low back pain and neuralgia. Patients had already undergone a blind epidural infiltration with minimum or no pain reduction. The session was repeated in the angiography suite...
September 12, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28895256/relevant-anatomy-morphology-and-implantation-techniques-of-the-dorsal-root-ganglia-at-the-lumbar-levels
#13
Tim Vancamp, Robert M Levy, Isaac Peña, Antonio Pajuelo
OBJECTIVES: While dorsal root ganglion (DRG) stimulation has been available in Europe and Australia for the past five years and in the United States for the past year, there are no published details concerning the optimal procedures for DRG lead implantation. MATERIALS AND METHODS: We describe several techniques that can be applied to implant cylindrical leads over the DRG, highlighting some tips and tricks according to our experiences. Focus is mainly shifted toward implantations in the lumbar area...
September 12, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28891544/comparison-of-epidrum-epi-jet-and-loss-of-resistance-syringe-techniques-for-identifying-the-epidural-space-in-obstetric-patients
#14
S Kartal, B Kösem, H Kılınç, H Köşker, S Karabayırlı, N K Çimen, R I Demircioğlu
BACKGROUND: Identifying the epidural space is essential during epidural anesthesia (EA). Pressure of the epidural space in pregnancy is higher than that in nonpregnant woman. Loss of resistance (LOR) method is the most commonly preferred method for identifying the epidural space. Epidrum and Epi-Jet are recently innovated supporting devices that facilitate identifying process for epidural space. In this study we aimed to compare Epidrum, Epi-Jet, and LOR methods in identifying the epidural space, feasibility of technique...
August 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28881110/endoscopic-spine-surgery
#15
REVIEW
Gun Choi, Chetan S Pophale, Bhupesh Patel, Priyank Uniyal
Surgical treatment of the degenerative disc disease has evolved from traditional open spine surgery to minimally invasive spine surgery including endoscopic spine surgery. Constant improvement in the imaging modality especially with introduction of the magnetic resonance imaging, it is possible to identify culprit degenerated disc segment and again with the discography it is possible to diagnose the pain generator and pathological degenerated disc very precisely and its treatment with minimally invasive approach...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28869902/acute-effects-of-anesthetic-lumbar-spine-injections-on-temporal-spatial-parameters-of-gait-in-individuals-with-chronic-low-back-pain-a-pilot-study
#16
Carl L Herndon, MaryBeth Horodyski, Heather K Vincent
This study examined whether epidural injection-induced anesthesia acutely and positively affected temporal spatial parameters of gait in patients with chronic low back pain (LBP) due to lumbar spinal stenosis. Twenty-five patients (61.7±13.6years) who were obtaining lumbar epidural injections for stenosis-related LBP participated. Oswestry Disability Index (ODI) scores, Medical Outcomes Short Form (SF-36) scores, 11-point Numerical pain rating (NRSpain) scores, and temporal spatial parameters of walking gait were obtained prior to, and 11-point Numerical pain rating (NRSpain) scores, and temporal spatial parameters of walking gait were obtained after the injection...
August 31, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28858898/the-accuracy-of-a-handheld-ultrasound-device-for-neuraxial-depth-and-landmark-assessment-a-prospective-cohort-trial
#17
Katherine M Seligman, Carolyn F Weiniger, Brendan Carvalho
This study investigated the accuracy of a wireless handheld ultrasound with pattern recognition software that recognizes lumbar spine bony landmarks and measures depth to epidural space (Accuro, Rivanna Medical, Charlottesville, VA) (AU). AU measurements to epidural space were compared to Tuohy needle depth to epidural space (depth to loss of resistance at epidural placement). Data from 47 women requesting labor epidural analgesia were analyzed. The mean difference between depth to epidural space measured by AU versus needle depth was -0...
August 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28858184/idiopathic-spinal-epidural-fat-accumulation-is-associated-with-hyperlipidemia
#18
Shinichi Ishihara, Nobuyuki Fujita, Mitsuru Yagi, Takashi Tsuji, Takehiro Michikawa, Yuji Nishiwaki, Yasuyuki Fukui, Keisuke Horiuchi, Ken Ishii, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
STUDY DESIGN: Single-center retrospective analysis of consecutively collected data. OBJECTIVES: To determine the clinical characteristics of idiopathic spinal epidural lipomatosis (SEL). SUMMARY OF BACKGROUND DATA: SEL is associated with the overt accumulation of nonencapsulated adipose tissue in the epidural space, leading to spinal cord or nerve root compression. The etiology of this condition is currently not completely understood. METHODS: Data of 166 male patients who underwent primary surgery for lumbar spinal canal stenosis (LSS) from May 2013 to February 2016 were retrospectively reviewed...
August 29, 2017: Spine
https://www.readbyqxmd.com/read/28855219/dural-ectasia-associated-with-mounier-kuhn-syndrome-a-novel-association-in-the-context-of-spinal-stenosis
#19
Gerard Anthony Sheridan, Owen Godkin, Aiden Devitt
We present the case of a patient undergoing lumbar spine decompression for stenosis with a history of Mounier-Kuhn syndrome. The patient presented with axial lumbar spine pain over 6 months with progressive radicular pain to the left L3 dermatome. MRI confirmed spinal stenosis at L3/4 level with associated dural ectasia. The patient had an uneventful spinal decompression with resolution of radicular symptoms and axial spine pain. Dural ectasia poses a significant risk when operating on the lumbosacral spine...
August 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28852822/incidence-and-risk-factors-for-symptomatic-spinal-epidural-haematoma-following-lumbar-spinal-surgery
#20
Jia-Ming Liu, Hui-Lin Deng, Yang Zhou, Xuan-Yin Chen, Dong Yang, Man-Sheng Duan, Shan-Hu Huang, Zhi-Li Liu
PURPOSE: Spinal epidural haematoma (SEH) is a common complication after lumbar spinal decompression surgery, and symptomatic SEH usually causes devastating neurological deficits. Although different risk factors for post-operative SEH have been reported, few studies focused on patients' laboratory tests. The purpose of this study was to analyze the incidence of symptomatic SEH following lumbar spinal surgery, as well as identify the risk factors for it. METHODS: Patients who underwent posterior lumbar spinal decompression surgery between January 2010 and August 2016 were included in this study and their medical records were retrospectively reviewed...
August 29, 2017: International Orthopaedics
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