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Spine anesthesia

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https://www.readbyqxmd.com/read/28727707/continuing-anti-thrombotic-medication-during-low-to-intermediate-risk-spinal-procedures-a-retrospective-evaluation
#1
Noud van Helmond, Wesley Day, Kenneth B Chapman
BACKGROUND: The current American Society of Regional Anesthesia (ASRA) guidelines recommend discontinuing anti-thrombotic therapy prior to any interventional spine procedures to decrease the incidence of bleeding complications. However, discontinuing anti-thrombotics may pose considerable danger in terms of cerebrovascular and cardiovascular events. Recent evidence suggests that some spinal interventions may still be performed safely with anti-thrombotics on board and some practitioners thus elect to continue certain anti-thrombotics for these procedures...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28716031/a-rare-case-of-intradural-and-extramedullary-epidermoid-cyst-after-repetitive-epidural-anesthesia-case-report-and-review-of-the-literature
#2
Haruki Funao, Norihiro Isogai, Kenshi Daimon, Yuichiro Mima, Hitoshi Sugiura, Takahiro Koyanagi, Masaya Nakamura, Morio Matsumoto, Ken Ishii
BACKGROUND: Spinal epidermoid cysts are benign tumors, which are rarely seen as an intradural extramedullary spinal cord tumor in the conus medullaris region. Acquired spinal epidermoid cysts are mostly caused by iatrogenic procedures, such as lumbar puncture, and the majority of acquired spinal epidermoid cysts have been reported below the L1 level, because lumbar puncture is usually performed around the iliac crest. Here, we report an extremely rare case of an epidermoid cyst that occurred as an intradural and extramedullary spinal cord tumor attached to the conus medullaris after repetitive epidural anesthesia...
July 17, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28696044/practice-patterns-of-palliative-radiation-therapy-in-pediatric-oncology-patients-in-an-international-pediatric-research-consortium
#3
Avani Dholakia Rao, Qinyu Chen, Ralph P Ermoian, Sara R Alcorn, Maria Luisa S Figueiredo, Michael J Chen, Karin Dieckmann, Shannon M MacDonald, Matthew M Ladra, Daria Kobyzeva, Alexey V Nechesnyuk, Kristina Nilsson, Eric C Ford, Brian A Winey, Rosangela C Villar, Stephanie A Terezakis
BACKGROUND/OBJECTIVES: The practice of palliative radiation therapy (RT) is based on extrapolation from adult literature. We evaluated patterns of pediatric palliative RT to describe regimens used to identify opportunity for future pediatric-specific clinical trials. DESIGN/METHODS: Six international institutions with pediatric expertise completed a 122-item survey evaluating patterns of palliative RT for patients ≤21 years old from 2010 to 2015. Two institutions use proton RT...
July 11, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28683067/early-postnatal-exposure-to-isoflurane-causes-cognitive-deficits-and-disrupts-development-of-newborn-hippocampal-neurons-via-activation-of-the-mtor-pathway
#4
Eunchai Kang, Danye Jiang, Yun Kyoung Ryu, Sanghee Lim, Minhye Kwak, Christy D Gray, Michael Xu, Jun H Choi, Sue Junn, Jieun Kim, Jing Xu, Michele Schaefer, Roger A Johns, Hongjun Song, Guo-Li Ming, C David Mintz
Clinical and preclinical studies indicate that early postnatal exposure to anesthetics can lead to lasting deficits in learning and other cognitive processes. The mechanism underlying this phenomenon has not been clarified and there is no treatment currently available. Recent evidence suggests that anesthetics might cause persistent deficits in cognitive function by disrupting key events in brain development. The hippocampus, a brain region that is critical for learning and memory, contains a large number of neurons that develop in the early postnatal period, which are thus vulnerable to perturbation by anesthetic exposure...
July 2017: PLoS Biology
https://www.readbyqxmd.com/read/28681191/low-back-pain-due-to-middle-cluneal-nerve-entrapment-neuropathy
#5
Kyongsong Kim, Toyohiko Isu, Juntaro Matsumoto, Kazuyoshi Yamazaki, Masanori Isobe
PURPOSE: The etiology of low back pain (LBP) is complicated and the diagnosis can be difficult. Superior cluneal nerve entrapment neuropathy (SCN-EN) is a known cause of LBP, although the middle cluneal nerve (MCN) can be implicated in the elicitation of LBP. METHODS: A 76-year-old woman with a 4-year history of severe LBP was admitted to our department in a wheelchair. She complained of bilateral LBP that was exacerbated by lumbar movement. Her pain was severe on the right side and she also suffered right leg pain and numbness...
July 5, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28680780/immediate-remote-cerebellar-hemorrhage-and-seizure-following-revision-lumbosacral-fusion
#6
Alvin Y Chan, Jeffrey P Mullin, Edward Benzel, William Bingaman
Cerebellar hemorrhage (CH) is a rare but devastating complication following spine surgery. It is associated with a compromise to dura integrity and typically has a delayed post-operative onset. Here, we describe a patient who suffered a CH that presented with a generalized tonic-clonic (GTC) seizure immediately after a revision lumbar fusion. The patient did not regain consciousness from anesthesia prior to the hemorrhage. There are no reports indicating that CHs can occur abruptly following a spine surgery...
May 30, 2017: Curēus
https://www.readbyqxmd.com/read/28663633/comparing-the-efficacy-of-caudal-with-intravenous-dexamethasone-in-the-management-of-pain-following-lumbosacral-spine-surgeries-a-randomized-double-blinded-controlled-study
#7
Sandhya Kalappa, Raghavendra Biligiri Sridhar, Saraswathi Nagappa
BACKGROUND: The challenge in providing analgesia for spine surgeries is to provide extended postoperative pain relief and simultaneously allow early neurological assessment and mobilization. Our study aimed to evaluate the analgesic efficacy of intravenous versus caudal dexamethasone in lumbosacral spine surgeries. MATERIALS AND METHODS: In this prospective double-blind study, a total of 96 patients undergoing lumbosacral spine surgery were randomized into three groups to receive 25 ml of preemptive caudal epidural injection of either injection ropivacaine 0...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663613/hemodynamic-responses-at-intubation-change-of-position-and-skin-incision-a-comparison-of-multimodal-analgesia-with-conventional-analgesic-regime
#8
Keelara Shivalingaiah Savitha, Radhika Dhanpal, M S Vikram
BACKGROUND: Lumbar spine surgery is associated with hemodynamic variations at intubation, change of position, and skin incision. A balanced anesthesia with multimodal analgesia (MMA) is necessary to attenuate these changes. AIM: To assess the relative effectiveness of preemptive MMA compared with the conventional analgesic regime in suppressing the hemodynamic response to endotracheal intubation, prone positioning, and skin incision. SETTINGS AND DESIGN: A randomized, prospective study involving 42 patients belonging to the American Society of Anesthesiologists Physical Status 1 and II scheduled to undergo elective lumbar spine surgery were allocated into two groups of 21 each...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28658163/effects-of-preconditioning-of-electro-acupuncture-on-postoperative-cognitive-dysfunction-in-elderly-a-prospective-randomized-controlled-trial
#9
RANDOMIZED CONTROLLED TRIAL
Qi Zhang, Ya-Nan Li, Yang-Yang Guo, Chun-Ping Yin, Fang Gao, Xi Xin, Shu-Ping Huo, Xiu-Li Wang, Qiu-Jun Wang
Electro-acupuncture is a burgeoning treatment using the needle inserting into the body acupoints and the low-frequency pulse current being electrified by an electric acupuncture machine. This study was designed to evaluate the effects of preconditioning of electro-acupuncture on postoperative cognitive dysfunction in elderly.Ninety patients scheduled spine surgery were randomly assigned into 2 groups using a random number table: control group (group C) and electro-acupuncture group (group EA). In group EA, electro-acupuncture was applied on Baihui, Dazhui, and Zusanli acupoints 30 minutes before anesthesia...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28651520/surgical-anesthesia-with-a-combination-of-t12-paravertebral-block-and-lumbar-plexus-sacral-plexus-block-for-hip-replacement-in-ankylosing-spondylitis-care-compliant-4-case-reports
#10
Xijian Ke, Ji Li, Yong Liu, Xi Wu, Wei Mei
BACKGROUND: Anesthesia management for patients with severe ankylosing spondylitis scheduled for total hip arthroplasty is challenging due to a potential difficult airway and difficult neuraxial block. We report 4 cases with ankylosing spondylitis successfully managed with a combination of lumbar plexus, sacral plexus and T12 paravertebral block. CASE PRESENTATION: Four patients were scheduled for total hip arthroplasty. All of them were diagnosed as severe ankylosing spondylitis with rigidity and immobilization of cervical and lumbar spine and hip joints...
June 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28648141/anesthetic-management-of-spontaneous-cervical-epidural-hematoma-during-pregnancy-a-case-report
#11
Mehdi Samali, Abdelghafour Elkoundi, Achraf Tahri, Mustapha Bensghir, Charki Haimeur
BACKGROUND: Spontaneous spinal epidural hematoma during pregnancy is a quite rare event requiring emergent decompressive surgery in the majority of cases to prevent permanent neurological damage. Therefore, there is little data in the literature regarding anesthetic management of cervical localization during pregnancy. The potential for difficult airway management with the patient under general anesthesia is one of the major concerns that needs to be addressed to prevent further cord compression...
June 26, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28645675/anatomical-considerations-of-the-iliac-crest-on-percutaneous-endoscopic-discectomy-using-a-transforaminal-approach
#12
Fumitake Tezuka, Toshinori Sakai, Mitsunobu Abe, Kazuta Yamashita, Yoichiro Takata, Kosaku Higashino, Akihiro Nagamachi, Takashi Chikawa, Koichi Sairyo
BACKGROUND CONTEXT: Percutaneous endoscopic discectomy (PED) is a minimally invasive procedure for the surgical treatment of lumbar disc herniation (LDH). It can be performed under local anesthesia and requires a skin incision of only 8 mm, with minimal disruption of the spinal structures including ligaments and muscles. However, performing PED with a transforaminal approach (TF-PED) for the lower lumbar spine is associated with some anatomical problems such as interference from the iliac crest...
June 20, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28642137/overexpression-cdc42-attenuates-isoflurane-induced-neurotoxicity-in-developmental-brain-of-rats
#13
Xi Fang, Shiyong Li, Qiang Han, Yilin Zhao, Jie Gao, Jing Yan, Ailin Luo
Nowadays many children receive operations with general anesthesia. Isoflurane is a commonly-used general anesthetic. Numbers of studies demonstrated that isoflurane induced neurotoxicity and neurobehavioral deficiency in young rats, however, the underlying mechanism remained unknown. Cell division cycle 42 (cdc42) played an important role in regulating synaptic vesicle trafficking and actin dynamics in neuron, which closely linked to synaptic plasticity and dendritic spine formation. Meanwhile, cdc42 also involved in many neurodegenerative diseases...
June 20, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28640124/comparison-of-the-temperature-and-humidity-in-the-anesthetic-breathing-circuit-among-different-anesthetic-workstations-updated-guidelines-for-reporting-parallel-group-randomized-trials
#14
RANDOMIZED CONTROLLED TRIAL
Yoon Ji Choi, Sam Hong Min, Jeong Jun Park, Jang Eun Cho, Seung Zhoo Yoon, Suk Min Yoon
BACKGROUND: For patients undergoing general anesthesia, adequate warming and humidification of the inspired gases is very important. The aim of this study was to evaluate the differences in the heat and moisture content of the inspired gases with low-flow anesthesia using 4 different anesthesia machines. METHODS: The patients were divided into 11 groups according to the anesthesia machine used (Ohmeda, Excel; Avance; Dräger, Cato; and Primus) and the fresh gas flow (FGF) rate (0...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28607336/cervical-spine-motion-during-tracheal-intubation-with-king-visiontm-video-laryngoscopy-and-conventional-laryngoscopy-a-crossover-randomized-study
#15
Mohamed R El-Tahan, Samah El Kenany, Alaa M Khidr, Abdulmohsen A Al Ghamdi, Ahmed M Tawfik, Abdullah S Al Mulhim
BACKGROUND: The King VisonTM (KVL) videolaryngoscope with a wide field of view could potentially reduce cervical spine motion during intubation. We aimed to compare the extent of cervical spine movement during laryngoscopy using the KVL and Macintosh laryngoscopes. METHODS: Following ethical approval, 29 patients with a normal cervical spine requiring general anesthesia and tracheal intubation were randomly subjected to both KVL and Macintosh laryngoscopy in a crossover...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28605377/an-anesthesia-surgery-and-harvest-method-for-the-evaluation-of-transpedicular-screws-using-an-in-vivo-porcine-lumbar-spine-model
#16
Young Jae Moon, Jong-Kil Kim, Hong-Geun Oh, Ji-Hun Kang, Gun-Joo Park, Kwang-Bok Lee
Pedicle screw fixation is the gold standard for the treatment of spinal diseases. However, many studies have reported the issue of loosening pedicle screws after spinal surgery, which is a serious concern. To address this problem, diverse types of pedicle screws have been examined to identify those with good fixation strength and osseointegration in spine bone. The porcine spine is a good alternative for the human spine in the evaluation of pedicle screws due to the anatomical size, mechanical characteristics, and cost...
May 31, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28589067/intraoperative-dexmedetomidine-induced-polyuric-syndrome
#17
Shannon Granger, David Ninan
A 23-year-old male trauma patient with a cervical spine fracture underwent an anterior and posterior discectomy and spinal fusion surgery. The patient presented to the operating room with a stabilizing halo fixation device in place, and a fiberoptic intubation was performed with dexmedetomidine for sedation. During the surgical procedure, general anesthesia was maintained with a propofol and remifentanil infusion as the patient was monitored using somatosensory and motor evoked potentials. The patient's urine output increased gradually during the nine-hour surgical procedure from 150 mL/hour to over 700 mL/hour in the eighth hour of the procedure, where it remained until the end of the procedure...
May 3, 2017: Curēus
https://www.readbyqxmd.com/read/28585992/complex-lumbar-spine-fusion-for-an-elderly-patient-under-spinal-anesthesia
#18
Noah L Lessing, Charles C Edwards, Charles Lin, Charles H Brown
Spinal anesthesia for spine surgery is an emerging technique. Because of their lack of physiologic reserve, elderly patients are an appealing population for this technique. Unfortunately, the safe limits of spine surgery using spinal anesthesia for the geriatric population are not well defined. The authors describe an elderly patient with severe spine degeneration who elected for a 5-level lumbar spine fusion with spinal anesthesia. Adequate anesthesia was maintained throughout the procedure, which lasted 3 hours and 24 minutes...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28571040/videolaryngoscopy-during-conscious-sedation-in-patients-not-suitable-for-phonosurgery-by-microlaryngoscopy-a-pilot-study
#19
Vincenzo Saita, Eugenia Allegra, Nicolò Marino, Serena Trapasso, Maria Concetta Monea
BACKGROUND: Microlaryngoscopy is the preferred and most widely used technique in phonosurgery for the treatment of benign and early malignant glottic lesions. However, the procedure may be technically difficult or impossible due to alterations of the cervical spine that may not allow hyperextension of the head or may present general anesthesia contraindications. The aim of this study is to evaluate the efficacy and safety of our surgical approach for lesions of the vocal folds in patients who are not suitable for phonosurgery by microlaryngoscopy...
June 2, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28570360/atlanto-axial-subluxation-after-adenoidectomy
#20
Isabel Theresia Gross, Laleh Bahar-Posey
Atlanto-axial subluxation is a rare but potentially serious complication after otolaryngological procedures. We are describing a case of a 4-year-old child who developed atlanto-axial subluxation of the cervical spine after adenoidectomy. Our patient underwent adenoidectomy and, 18 days later, presented to the emergency department with her neck tilted to the left in a cock-robin position and complaining of neck pain persisting since the surgery. A multiplanar 3-dimensional computed tomography was obtained and confirmed the diagnosis of an atlanto-axial subluxation (Fielding type 3)...
June 2017: Pediatric Emergency Care
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