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Spine anesthesia

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https://www.readbyqxmd.com/read/29352624/anesthetic-management-of-two-parturients-with-cerebral-palsy-and-prior-selective-dorsal-rhizotomy
#1
C M Aiudi, E E Sharpe, K W Arendt, J J Pasternak, H P Sviggum
Selective dorsal rhizotomy is a surgical spine procedure used to reduce spasticity in patients with upper motor neuron dysfunction caused by conditions such as cerebral palsy. The optimal anesthetic approach for obstetric patients who have undergone a selective dorsal rhizotomy is unknown. The use and efficacy of neuraxial anesthesia in these patients has not been described. We describe the use of neuraxial anesthesia in two patients with prior selective dorsal rhizotomy. Unless contraindicated for other reasons, a neuraxial anesthetic approach appears to be an effective option in patients with a history of a selective dorsal rhizotomy...
December 15, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29319605/epidural-hematoma-following-interlaminar-epidural-injection-in-patient-taking-aspirin
#2
Rebecca A Sanders, Markus A Bendel, Susan M Moeschler, William D Mauck
OBJECTIVE: We present a case report of a patient who developed an epidural hematoma following an interlaminar epidural steroid injection with no risk factors aside from old age and aspirin use for secondary prevention. CASE REPORT: A 79-year-old man developed an epidural hematoma requiring surgical treatment following an uncomplicated interlaminar epidural steroid injection performed for neurogenic claudication. In the periprocedural period, he continued aspirin for secondary prophylaxis following a myocardial infarction...
January 9, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29316474/spinal-versus-general-anesthesia-for-lumbar-spine-surgery-in-high-risk-patients-perioperative-hemodynamic-stability-complications-and-costs
#3
Michael Finsterwald, Marco Muster, Mazda Farshad, Andrea Saporito, Muriel Brada, José A Aguirre
OBJECTIVE: More stable perioperative hemodynamic conditions, lower costs and a lower perioperative complication rate were reported in young healthy patients undergoing lumbar spine surgery in spinal anesthesia (SA) compared to general anesthesia (GA). However, the benefits of SA in high risk patients (ASA≥II suffering from cardiovascular and/or pulmonary pathologies) undergoing this surgery are unclear. Our objective was to analyze whether SA leads to an improved perioperative hemodynamic stability and to a more cost-effective management compared to GA in high risk patients undergoing this surgery...
January 6, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29312845/transforaminal-percutaneous-endoscopic-discectomy-using-transforaminal-endoscopic-spine-system-technique-pitfalls-that-a-beginner-should-avoid
#4
REVIEW
Stylianos Kapetanakis, Grigorios Gkasdaris, Antonios G Angoules, Panagiotis Givissis
Transforaminal Percutaneous Endoscopic Discectomy (TPED) is a minimally invasive technique mainly used for the treatment of lumbar disc herniation from a lateral approach. Performed under local anesthesia, TPED has been proven to be a safe and effective technique which has been also associated with shorter rehabilitation period, reduced blood loss, trauma, and scar tissue compared to conventional procedures. However, the procedure should be performed by a spine surgeon experienced in the specific technique and capable of recognizing or avoiding various challenging conditions...
December 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29305266/pre-emptive-awake-airway-management-under-dexmedetomidine-sedation-in-a-parturient-with-spinal-muscular-atrophy-type-2
#5
C A Godlewski, P F Castellanos
Historically, pregnancy in females with spinal muscular atrophy was contraindicated due to the great risk to the parturient, but with improved management and increased survival more patients are becoming pregnant. We describe the management of a pregnant patient with spinal muscular atrophy type-2, who had severe restrictive lung disease, extensive spinal fusion that precluded neuraxial anesthesia, and chronic respiratory failure on nocturnal Bilevel Positive Airway Pressure. Airway management was further complicated by limited mouth opening and cervical spine ankylosis...
November 13, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29303921/blood-loss-management-in-spine-surgery
#6
Jesse E Bible, Muhammad Mirza, Mark A Knaub
Substantial blood loss during spine surgery can result in increased patient morbidity and mortality. Proper preoperative planning and communication with the patient, anesthesia team, and operating room staff can lessen perioperative blood loss. Advances in intraoperative antifibrinolytic agents and modified anesthesia techniques have shown promising results in safely reducing blood loss. The surgeon's attention to intraoperative hemostasis and the concurrent use of local hemostatic agents also can lessen intraoperative bleeding...
January 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29285839/role-of-ultrasound-guided-epidural-anesthesia-for-lower-limb-surgery-in-children-with-previously-repaired-meningomyelocele
#7
Vrushali C Ponde, Vinit V Bedekar, Dilip Chavan, Anuya Gursale, Dipal Shah
BACKGROUND: Children that have had a meningomyelocele repair often present for hip and bilateral lower limb surgeries. Due to vertebral, epidural, and nerve root abnormalities, placement of epidural catheter is difficult. AIMS: We aim to describe the potential role of ultrasound in delineating the most appropriate intervertebral space for central neuroaxial blocks in these patients. METHOD: Twelve children with previous meningomyelocele repair, in the age group of 6-12 years posted for hip or bilateral lower limb surgeries were included...
December 28, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29284890/a-safe-regional-technique-in-a-high-risk-patient-cervical-plexus-blockage
#8
Ayhan Kaydu, Ebru Tarıkçı Kılıç, Erhan Gökçek, Mehmet Salim Akdemir
Regional anesthesia in the form of combined cervical plexus block is gaining popularity as a technique of choice for cervical spine surgeries, especially for urgent ones. An important advantage is that it allows continuous monitoring of patient's neurological status. The success of the block often depends on accurate placement of the local anesthetic. Landmarks for the block are therefore of great importance. In this case, we aimed to present a 74-year-old man with C4-5 odontoid fracture. We planned to perform a unilateral combined cervical plexus block for anterior cervical instrumentation and fusion (ACIF) operation because of his associated high-risk comorbid disorders...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29278603/interventional-spine-and-pain-procedures-in-patients-on-antiplatelet-and-anticoagulant-medications-second-edition-guidelines-from-the-american-society-of-regional-anesthesia-and-pain-medicine-the-european-society-of-regional-anaesthesia-and-pain-therapy-the
#9
Samer Narouze, Honorio T Benzon, David Provenzano, Asokumar Buvanendran, José De Andres, Timothy Deer, Richard Rauck, Marc A Huntoon
The American Society of Regional Anesthesia and Pain Medicine (ASRA) 2012 survey of meeting attendees showed that existing ASRA anticoagulation guidelines for regional anesthesia were insufficient for their needs. Those surveyed agreed that procedure-specific and patient-specific factors required separate guidelines for pain and spine procedures. In response, a guidelines committee was formed. After preliminary review of published complications reports and studies, the committee stratified interventional spine and pain procedures according to potential bleeding risk: low-, intermediate-, and high-risk procedures...
December 22, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29248305/state-of-the-art-transforaminal-percutaneous-endoscopic-lumbar-surgery-under-local-anesthesia-discectomy-foraminoplasty-and-ventral-facetectomy
#10
REVIEW
Koichi Sairyo, Takashi Chikawa, Akihiro Nagamachi
Transforaminal (TF) percutaneous endoscopic surgery for the lumbar spine under the local anesthesia was initiated in 2003 in Japan. Since it requires only an 8-mm skin incision and damage of the paravertebral muscles would be minimum, it would be the least invasive spinal surgery at present. At the beginning, the technique was used for discectomy; thus, the procedure was called PELD (percutaneous endoscopic lumbar discectomy). TF approach can be done under the local anesthesia, there are great benefits. During the surgery patients would be in awake and aware condition; thus, severe nerve root damage can be avoided...
December 13, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29225750/opioid-free-anesthesia-using-continuous-dexmedetomidine-and-lidocaine-infusions-in-spine-surgery
#11
David J Kim, Raheel Bengali, T Anthony Anderson
No abstract text is available yet for this article.
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29206797/instability-of-the-hip-joint-after-posterior-acetabular-wall-fracture-independent-risk-factors-remain-elusive
#12
Jay H Patel, Berton R Moed
BACKGROUND: Exact determinants of hip instability have not been established for fractures of the posterior wall of the acetabulum involving ≤50% of the wall. Therefore, examination of the hip under anesthesia (EUA) is routinely performed. Recently, the superior exit point of the fracture has been reported to be an important identifiable risk factor. Pre-existing adult hip dysplasia (developmental dysplasia of the hip [DDH]) is thought to have a similar role. The purpose of this study was to determine if any known radiographic measurements and signs associated with DDH, or any fracture characteristics, are independent risk factors for hip instability after fracture of the posterior wall of the acetabulum...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29191536/the-enigma-of-orbital-compartment-syndrome-after-lumbar-spine-surgery-in-the-prone-position-case-report-and-literature-review
#13
Jorge Luiz Amorim Correa, Marcus André Acioly
Perioperative visual loss (POVL) after spinal surgery is a devastating complication for both the patient and the surgical team. Two major causes are known: ischemic optic neuropathy (ION) and central retinal artery occlusion (CRAO). The traditional understanding of CRAO has been consistently related to the occurrence of periocular trauma and signs of increased intraorbital pressure in addition to visual loss. Such orbital signs are, however, not a feature of any common POVL syndrome. A 55-year-old woman underwent prolonged lumbar decompression and fusion for spinal stenosis under general anesthesia in the prone position...
November 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29189536/incidence-of-fractures-from-perioperative-blood-pressure-cuff-use-tourniquet-use-and-patient-positioning-in-osteogenesis-imperfecta
#14
Brian T Sullivan, Adam Margalit, Vaibhav S Garg, Dolores B Njoku, Paul D Sponseller
BACKGROUND: Osteogenesis imperfecta (OI) is a rare connective tissue disease with varying severity. Patients with OI are highly susceptible to skeletal fractures. Optimal perioperative management of these patients is not well defined. We investigated the risks associated with intraoperative use of noninvasive blood pressure (NIBP) cuffs, tourniquets, and intra-arterial catheters, and patient positioning in children with OI. METHODS: We retrospectively reviewed records of patients younger than 21 years with OI who underwent surgery with general anesthesia from 2010 to 2016 at our tertiary care center...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29096273/effects-of-chemical-castration-using-20-cacl2-with-0-5-dmso-in-tomcats-evaluation-of-inflammatory-reaction-by-infrared-thermography-and-effectiveness-of-treatment
#15
Cristiane Sella Paranzini, Anne Kemmer Sousa, Guilherme Schiess Cardoso, Felipe Montanheiro Perencin, Luiz Guilherme Corsi Trautwein, Ana Paula Frederico Rodrigues Loureiro Bracarense, Maria Isabel Mello Martins
This study used infrared thermography to monitor the immediate inflammatory reaction to an intratesticular injection of 20% (calcium chloride) CaCl2 with 0.5% dimethyl sulfoxide (DMSO) for chemical castration and to provide evidence of the treatment's clinical viability. Six animals received a 0.25 mL intratesticular injection of 20% CaCl2 with 0.5% DMSO in each testis. Thermographic imaging, testicular measurement, penile spine evaluation, electroejaculation, and sperm analysis were performed before the injection...
January 15, 2018: Theriogenology
https://www.readbyqxmd.com/read/29095302/spontaneous-spinal-epidural-hematomas-one-case-report-and-rehabilitation-outcome
#16
Hang Xian, Li-Wei Xu, Cong-Han Li, Jian-Ming Hao, Wei-Xia Wan, Guo-Dong Feng, Ke-Jian Lian, Lin Li
RATIONALE: Spontaneous spinal epidural hematoma (SSEH) is a relatively rare but potentially disabling disease, and the classical presentation of it includes an acute onset of severe, sometimes radiating back or neck pain, followed by signs and symptoms of rapidly evolving nerve root or spinal cord compression. PATIENT CONCERNS: Here, we report a 26-year-old female patient presented with weakness in bilateral lower extremities, progressing to intense paraplegia and anesthesia without recent medical history of trauma, infection, surgery, or drug use...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29060565/gabor-based-automatic-spinal-level-identification-in-ultrasound
#17
Mohammad Ikhsan, Kok Kiong Tan, Ting Ting Oh, John Paul Lew, Ban Leong Sng
This paper presents an automatic lumbar spine level identification system based on image processing of ultrasound images. The goal is to aid anesthetists in identifying the correct spinal level during epidural anesthesia. Spine level identification is initiated by detecting the location of the sacrum using a classifier based on a support vector machine. Image stitching is then conducted to produce a panorama image of the spinal area. During this process, the location of spinal processes are enhanced using a Gabor filter and detected through template matching...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29050715/the-effect-of-two-attending-surgeons-on-patients-with-large-curve-adolescent-idiopathic-scoliosis-undergoing-posterior-spinal-fusion
#18
Liam Bosch, Carla Boan, Miranda Falk, Greg R White, M Wade Shrader
STUDY DESIGN: Retrospective, chart review. OBJECTIVES: The objective of this study is to investigate the impact of using two surgeons for posterior spinal fusion (PSF) in patients with AIS with large-magnitude curves (greater than 70°). SUMMARY OF BACKGROUND DATA: Previous studies have shown that intraoperative risk factors can be reduced by having two surgeons operate simultaneously. METHODS: A retrospective chart review identified 47 patients between January 1, 2009, and December 31, 2014, who underwent a posterior spinal fusion (PSF) with AIS with large-magnitude curves (greater than 70°)...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29043849/absorption-of-ibuprofen-orodispersible-tablets-in-early-postoperative-phase-a-pharmacokinetic-study
#19
A Piirainen, M Kokki, H M Lidsle, M Lehtonen, V P Ranta, H Kokki
OBJECTIVE: Patient-controlled oral analgesia has gained popularity in postoperative pain management. Anesthesia and surgery delay gastrointestinal tract function and this may therefore decrease bioavailability of drugs taken by mouth. To hasten absorption, an orodispersible ibuprofen tablet has been developed. In this study, we evaluated the pharmacokinetics and feasibility of orodispersible ibuprofen tablets in spine surgery patients. METHODS: The study design was a prospective clinical trial where each patient served as her/his own control...
October 18, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29033731/ultrasound-guided-continuous-spinal-anesthesia-for-cesarean-section-in-a-parturient-with-scoliosis-corrected-with-harrington-s-rod-surgery
#20
Amer Majeed, Iftikhar Ahmed, Ghadah Jamaan Alkahtani, Nasser Abdullah Altahtam
With rapid improvement in healthcare in Saudi Arabia, increasing number of women with surgically corrected kyphoscoliosis are likely to present for cesarean section (CS) or vaginal delivery requiring anesthesia or analgesia. Despite the surgical correction, these patients have poor cardiopulmonary reserves which increase the risks associated with general anesthesia. Whereas altered vertebral anatomy from previous surgery and the presence of metal work in spine make performing of regional anesthesia (RA) difficult and unpredictable, we report anesthetic management of such a patient who underwent CS using continuous spinal anesthesia technique...
October 2017: Saudi Journal of Anaesthesia
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