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Spine anesthesia

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https://www.readbyqxmd.com/read/28430606/ketamine-administered-pregnant-rats-impair-learning-and-memory-in-offspring-via-the-creb-pathway
#1
Xinran Li, Cen Guo, Yanan Li, Lina Li, Yuxin Wang, Yiming Zhang, Yue Li, Yu Chen, Wenhan Liu, Li Gao
Ketamine has been reported to impair the capacity for learning and memory. This study examined whether these capacities were also altered in the offspring and investigated the role of the CREB signaling pathway in pregnant rats, subjected to ketamine-induced anesthesia. On the 14th day of gestation (P14), female rats were anesthetized for 3 h via intravenous ketamine injection (200 mg/Kg). Morris water maze task, contextual and cued fear conditioning, and olfactory tasks were executed between the 25th to 30th day after birth (B25-30) on rat pups, and rats were sacrificed on B30...
February 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28415680/long-term-neurocognitive-dysfunction-in-offspring-via-ngf-erk-creb-signaling-pathway-caused-by-ketamine-exposure-during-the-second-trimester-of-pregnancy-in-rats
#2
Yanan Li, Xinran Li, Cen Guo, Lina Li, Yuxin Wang, Yiming Zhang, Yu Chen, Wenhan Liu, Li Gao
Early life exposure to ketamine caused neurohistopathologic changes and persistent cognitive dysfunction. For this study, a pregnant rat model was developed to investigate neurocognitive effects in the offspring, following ketamine exposure during the second trimester. Pregnant rats on gestational day 14 (equal to midtrimester pregnancy in humans), intravenously received 200 mg/kg ketamine for 3 h. Their behavior was tested (Morris water maze, odor recognition test, and fear conditioning) at postnatal days (P25-30)...
March 9, 2017: Oncotarget
https://www.readbyqxmd.com/read/28413736/targeted-intraspinal-radiofrequency-ablation-for-lumbar-spinal-stenosis
#3
Robert E Jacobson, Michelle Granville, Jesse Hatgis DO
INTRODUCTION: By using a combination of magnetic resonance imaging (MRI) and computed tomography (CT) of the lumbar spine, it is possible to distinguish between spinal stenosis caused by bone compression and specific soft tissue epidural intraspinal lesions that cause localized spinal canal stenosis and neural compression. Examples include facet cysts and yellow ligament hypertrophy. Many of these patients are elderly with medical comorbidities that make open surgery problematic. MATERIALS & METHODS: This is a study of patients with predominantly soft tissue stenosis being treated with targeted intraspinal radiofrequency (RF) heat ablation...
March 10, 2017: Curēus
https://www.readbyqxmd.com/read/28410821/-analgesia-nociception-index-for-perioperative-analgesia-monitoring-in-spinal-surgery
#4
Guldem Turan, Arzu Yıldırım Ar, Yıldız Yigit Kuplay, Oznur Demiroluk, Mustafa Gazi, Nur Akgun, Erhan Celikoglu
BACKGROUND AND OBJECTIVES: The Analgesia Nociception Index is an index used to measure the levels of pain, sympathetic system activity and heart rate variability during general anesthesia. In our study, Analgesia Nociception Index monitoring in two groups who had undergone spinal stabilization surgery and were administered propofol-remifentanil (Total Intravenous Anesthesia) and sevoflurane-remifentanyl anesthesia was compared regarding its significance for prediction of postoperative early pain...
April 11, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28395952/a-novel-methodology-for-assessing-laryngeal-and-vagus-nerve-integrity-in-patients-under-general-anesthesia
#5
Catherine F Sinclair, Maria J Téllez, Oscar R Tapia, Sedat Ulkatan, Vedran Deletis
OBJECTIVE: To describe a novel methodology for intraoperative neuro-monitoring of laryngeal and vagus nerves by utilizing the laryngeal adductor reflex (LAR). METHODS: Case series of 15 patients undergoing thyroid and cervical spine surgeries under total intravenous general anesthesia. Vocal fold mucosa was electrically stimulated to elicit a LAR using endotracheal tube based electrodes. Contralateral R1 (cR1) and R2 (cR2) responses were recorded using the endotracheal tube electrode contralateral to the simulating electrode...
March 14, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28383416/comparison-of-cutting-and-pencil-point-spinal-needle-in-spinal-anesthesia-regarding-postdural-puncture-headache-a-meta-analysis
#6
Hong Xu, Yang Liu, WenYe Song, ShunLi Kan, FeiFei Liu, Di Zhang, GuangZhi Ning, ShiQing Feng
BACKGROUND: Postdural puncture headache (PDPH), mainly resulting from the loss of cerebral spinal fluid (CSF), is a well-known iatrogenic complication of spinal anesthesia and diagnostic lumbar puncture. Spinal needles have been modified to minimize complications. Modifiable risk factors of PDPH mainly included needle size and needle shape. However, whether the incidence of PDPH is significantly different between cutting-point and pencil-point needles was controversial. Then we did a meta-analysis to assess the incidence of PDPH of cutting spinal needle and pencil-point spinal needle...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28376741/neck-circumference-to-inter-incisor-gap-ratio-a-new-predictor-of-difficult-laryngoscopy-in-cervical-spondylosis-patients
#7
Yong-Zheng Han, Yang Tian, Mao Xu, Cheng Ni, Min Li, Jun Wang, Xiang-Yang Guo
BACKGROUND: Preoperative airway assessment help anticipate a difficult airway. We hypothesized that a close association existed between difficult laryngoscopy and the neck circumference/inter-incisor gap ratio (RNIIG). Our aim was to determine its utility in predicting difficult laryngoscopy in cervical spondylosis patients. METHODS: Two hundred thirteen consecutive patients, aged 20-70 years, scheduled to undergo cervical spine surgery under general anesthesia, were recruited...
April 4, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28373604/a-new-concept-of-transforaminal-ventral-facetectomy-including-simultaneous-decompression-of-foraminal-and-lateral-recess-stenosis-technical-considerations-in-a-fresh-cadaver-model-and-a-literature-review
#8
Koichi Sairyo, Kosaku Higashino, Kazuta Yamashita, Fumio Hayashi, Keizo Wada, Toshinori Sakai, Yoichiro Takata, Fumitake Tezuka, Masatoshi Morimoto, Tomoya Terai, Takashi Chikawa, Hiroshi Yonezu, Akihiro Nagamachi, Yoshihiro Fukui
Percutaneous endoscopic surgery for the lumbar spine, which was established in the last decade, requires only an 8-mm skin incision and causes minimal damage to the paravertebral muscles; thus, it is considered to be a minimally invasive technique for spinal surgery. It has been used to perform percutaneous endoscopic discectomy via two main approaches: the TF approach is a posterolateral one through the intervertebral foramen and can be done under local anesthesia; the IL approach is a more traditional one through the interlaminar space and is difficult to perform under local anesthesia...
2017: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/28362214/a-systematic-multidisciplinary-initiative-for-reducing-the-risk-of-complications-in-adult-scoliosis-surgery
#9
Rajiv Sethi, Quinlan D Buchlak, Vijay Yanamadala, Melissa L Anderson, Eric A Baldwin, Robert S Mecklenburg, Jean-Christophe Leveque, Alicia M Edwards, Mary Shea, Lisa Ross, Karen J Wernli
OBJECTIVE Systematic multidisciplinary approaches to improving quality and safety in complex surgical care have shown promise. Complication rates from complex spine surgery range from 10% to 90% for all surgeries, and the overall mortality rate is 1%-4%. These rates suggest the need for improved perioperative complex spine surgery processes designed to minimize risk and improve quality. METHODS The Group Health Research Institute and Virginia Mason Medical Center implemented a systematic multidisciplinary protocol, the Seattle Spine Team Protocol, in 2010...
March 31, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28357164/subdural-thoracolumbar-spine-hematoma-after-spinal-anesthesia-a-rare-occurrence-and-literature-review-of-spinal-hematomas-after-spinal-anesthesia
#10
REVIEW
Prasanthi Maddali, Blake Walker, Christian Fisahn, Jeni Page, Vicki Diaz, Michael E Zwillman, Rod J Oskouian, R Shane Tubbs, Marc Moisi
Spinal hematomas are a rare but serious complication of spinal epidural anesthesia and are typically seen in the epidural space; however, they have been documented in the subdural space. Spinal subdural hematomas likely exist within a traumatically induced space within the dural border cell layer, rather than an anatomical subdural space. Spinal subdural hematomas present a dangerous clinical situation as they have the potential to cause significant compression of neural elements and can be easily mistaken for spinal epidural hematomas...
February 16, 2017: Curēus
https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#11
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting.:  Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective.:  To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
October 6, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28321993/metatropic-dysplasia-a-skeletal-dysplasia-with-challenging-airway-and-other-anesthetic-concerns
#12
Mary C Theroux, Martha Lopez, Patricia J Olszewsky, Sabina DiCindio, Lynda Arai, Colleen Ditro, Michael B Bober, Olubukola Opeyemi Olla, Tetsu Uejima, David W West, William G Mackenzie
BACKGROUND: Metatropic dysplasia is a rare form of skeletal dysplasia requiring multiple anesthetics for surgical and imaging procedures, most of which are orthopedic procedures. We provide centralized care to patients with skeletal dysplasia at our tertiary care pediatric hospital, and we were able to collect the largest number of metatropic dysplasia patients reported to date. AIM: The aim of this retrospective study was to describe and characterize the anesthetic difficulties in this high-risk population...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28320029/morphometric-changes-of-the-lumbar-intervertebral-foramen-after-percutaneous-endoscopic-foraminoplasty-under-local-anesthesia
#13
Tatsuhiko Henmi, Tomoya Terai, Akihiro Nagamachi, Koichi Sairyo
Background Percutaneous endoscopic diskectomy (PED) for the lumbar spine is a relatively new technique that is becoming more common due to its relatively less invasive nature. However, one possible serious complication is an exiting nerve injury when the cannula of the endoscope is inserted into the neural canal through the intervertebral foramen. A technique to enlarge the intervertebral foramen, called foraminoplasty, was recently established to insert the cannula safely into an appropriate position in the neural canal...
March 20, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28315990/model-based-registration-of-preprocedure-mr-and-intraprocedure-us-of-the-lumbar-spine
#14
Delaram Behnami, Alireza Sedghi, Emran Mohammad Abu Anas, Abtin Rasoulian, Alexander Seitel, Victoria Lessoway, Tamas Ungi, David Yen, Jill Osborn, Parvin Mousavi, Robert Rohling, Purang Abolmaesumi
PURPOSE: Epidural and spinal needle insertions, as well as facet joint denervation and injections are widely performed procedures on the lumbar spine for delivering anesthesia and analgesia. Ultrasound (US)-based approaches have gained popularity for accurate needle placement, as they use a non-ionizing, inexpensive and accessible modality for guiding these procedures. However, due to the inherent difficulties in interpreting spinal US, they yet to become the clinical standard-of-care...
March 18, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28301408/k-cl-cotransporter-2-mediated-cl-extrusion-determines-developmental-stage-dependent-impact-of-propofol-anesthesia-on-dendritic-spines
#15
Martin Puskarjov, Hubert Fiumelli, Adrian Briner, Timea Bodogan, Kornel Demeter, Claudia-Marvine Lacoh, Martina Mavrovic, Peter Blaesse, Kai Kaila, Laszlo Vutskits
BACKGROUND: General anesthetics potentiating γ-aminobutyric acid (GABA)-mediated signaling are known to induce a persistent decrement in excitatory synapse number in the cerebral cortex when applied during early postnatal development, while an opposite action is produced at later stages. Here, the authors test the hypothesis that the effect of general anesthetics on synaptogenesis depends upon the efficacy of GABA receptor type A (GABAA)-mediated inhibition controlled by the developmental up-regulation of the potassium-chloride (K-Cl) cotransporter 2 (KCC2)...
May 2017: Anesthesiology
https://www.readbyqxmd.com/read/28291143/the-role-of-multimodal-analgesia-in-spine-surgery
#16
Mark F Kurd, Tyler Kreitz, Gregory Schroeder, Alexander R Vaccaro
Optimal postoperative pain control allows for faster recovery, reduced complications, and improved patient satisfaction. Historically, pain management after spine surgery relied heavily on opioid medications. Multimodal regimens were developed to reduce opioid consumption and associated adverse effects. Multimodal approaches used in orthopaedic surgery of the lower extremity, especially joint arthroplasty, have been well described and studies have shown reduced opioid consumption, improved pain and function, and decreased length of stay...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28263243/use-of-3-dimensional-printing-to-create-patient-specific-thoracic-spine-models-as-task-trainers
#17
Jelliffe Jeganathan, Yanick Baribeau, Jeffrey Bortman, Feroze Mahmood, Marc Shnider, Muneeb Ahmed, Azad Mashari, Rabia Amir, Yannis Amador, Robina Matyal
BACKGROUND AND OBJECTIVES: Thoracic epidural anesthesia is a technically challenging procedure with a high failure rate of 24% to 32% nationwide. Residents in anesthesiology have limited opportunities to practice this technique adequately, and there are no training tools available for this purpose. Our objective was to build a low-cost patient-specific thoracic epidural training model. METHODS: We obtained thoracic computed tomography scan data from patients with normal and kyphotic spine...
March 3, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28248542/two-photon-laser-scanning-microscopy-for-single-and-repetitive-imaging-of-dorsal-and-lateral-spinal-white-matter-in-vivo
#18
F Nadrigny, K Le Meur, H Steffens, E D Schomburg, S Safavi-Abbasi, P Dibaj
We developed appropriate surgical procedures for single and repetitive multi-photon imaging of spinal cord in vivo. By intravenous anesthesia, artificial ventilation and laminectomy, acute experiments were performed in the dorsal and lateral white matter. By volatile anesthesia and minimal-invasive surgery, chronic repetitive imaging up to 8 months were performed in the dorsal column through the window between two adjacent spines. Transgenic mouse technology enabled simultaneous imaging of labeled axons, astrocytes and microglia...
February 28, 2017: Physiological Research
https://www.readbyqxmd.com/read/28243379/preemptive-caudal-ropivacaine-an-effective-analgesic-during-degenerative-lumbar-spine-surgery
#19
Shashwat Kumar, Jagannath Manickam Palaniappan, Anantha Kishan
STUDY DESIGN: This was a prospective, randomized, controlled trial comprising 60 patients undergoing lumbosacral spine (noninstrumentation/nonfusion) surgery. PURPOSE: The purpose of this study was to evaluate the efficacy of 0.2% ropivacaine (20 mL) administered alone as a single, preoperative, caudal epidural block injection versus that of intravenous analgesics in providing effective postoperative analgesia to patients undergoing lumbosacral spine surgery. OVERVIEW OF LITERATURE: Various studies have shown the effectiveness of a caudal epidural injection (bupivacaine or ropivacaine) in providing postoperative analgesia in combination with steroids or other analgesics...
February 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28240718/a-peripherally-inserted-central-catheter-line-inserted-the-day-before-surgery-decreases-the-time-from-induction-to-incision-for-spinal-deformity-surgery-and-safely-provides-central-venous-access-during-surgery-a-pilot-study
#20
Anne E Stuedemann, Richard M Schwend, Valorie K Thomas, Julia M Leamon, Tammy S Lightner
Pediatric patients undergoing surgery for spinal deformity may benefit from central venous access to provide intraoperative monitoring and fluid resuscitation. For pediatric surgical patients requiring central access, we hypothesized that placing a peripherally inserted central catheter (PICC) line preoperatively should decrease time from induction of anesthesia to incision and result in improved patient safety and decreased operating room charges. This was a retrospective, nonrandomized, and case comparison study...
February 24, 2017: Journal of Pediatric Orthopedics. Part B
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