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Spine anesthesia

Catherine M Kuza, Monica S Vavilala, Rebecca M Speck, Richard P Dutton, Maureen McCunn
BACKGROUND: Few trauma guidelines evaluate and recommend anesthesiology practices and there are no trauma anesthesia-specific guidelines. There is no information on how anesthesiologists perceive clinical practice patterns. Our objective was to understand the perceptions of anesthesiologists regarding trauma anesthesia practices. METHODS: A survey assessing anesthesia management of trauma patients was distributed to 21,491 anesthesiologists. A subset of 10 of these questions was subsequently reviewed by a trauma anesthesiology focus group through a 3-round web-based Delphi process...
March 12, 2018: Anesthesia and Analgesia
Abirami Kumaresan, Robert Gerber, Ariel Mueller, Stephen H Loring, Daniel Talmor
BACKGROUND: The effects of prone positioning on esophageal pressures have not been investigated in mechanically ventilated patients. Our objective was to characterize effects of prone positioning on esophageal pressures, transpulmonary pressure, and lung volume, thereby assessing the potential utility of esophageal pressure measurements in setting positive end-expiratory pressure (PEEP) in prone patients. METHODS: We studied 16 patients undergoing spine surgery during general anesthesia and neuromuscular blockade...
March 9, 2018: Anesthesiology
Narender Kaloria, Pooja Bihani, Pradeep Bhatia, Bharat Paliwal, Ankur Sharma
No abstract text is available yet for this article.
February 28, 2018: Journal of Neurosurgical Anesthesiology
Ankur S Narain, Fady Y Hijji, Gabriel Duhancioglu, Brittany E Haws, Benjamin Khechen, Blaine T Manning, Matthew W Colman, Kern Singh
STUDY DESIGN: Prospective questionnaire. OBJECTIVE: To describe patient perceptions of minimally invasive spine (MIS) versus open surgery, and to determine which factors are most heavily considered by the patient when choosing between approaches. SUMMARY OF BACKGROUND DATA: MIS surgery has increased in popularity due to proposed advantages in the perioperative and immediate postoperative periods. However, patient preferences and understanding with regard to the differences between MIS and open surgery have not been elucidated...
February 20, 2018: Clinical Spine Surgery
Yogita Patil, Suyog Bagade, Nilesh Patil, Nalini Jadhav
Background and Aims: Desflurane and sevoflurane are inhalational anesthetics which provide stable intraoperative hemodynamics and rapid emergence from anesthesia. Dexmedetomidine is an α2-agonist with sedative and hypnotic effects. We compared recovery following anesthesia with a combination of a continuous intravenous infusion of dexmedetomidine and desflurane or sevoflurane in cases of spine surgeries because no such data are available from India. Material and Methods: It was a single-blind, prospective, randomized study...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
Bo Zhuang, Robert Rohling, Purang Abolmaesumi
In recent years, ultrasound has been increasingly used to guide needle insertion procedures for spinal anesthesia. The primary anatomical targets are facet joints and epidural spaces. For these procedures, accurate visualization of the spine anatomy is of critical importance. Challenges arising from the interactions between the ultrasound beam and spinal structures including tilt caused by specular reflections, off-axis interference, and reverberations often result in weakened and blurred vertebra surfaces...
February 2018: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
Sheng-Hua Tsai, Hsuan-Han Wu, Chun-Yuan Cheng, Chien-Min Chen
BACKGROUND: Endoscopic surgery has been successfully applied in the treatment of degenerative spinal disease, but few studies have assessed its use in treating sacral metastasis. Herein, a successful full endoscopic interlaminar approach for sacral nerve root decompression of a sacral metastatic tumor was presented. CASE DESCRIPTION: An 80-year-old man with history of hepatocellular carcinoma suffered from buttock pain with radiation to the right lower leg for one week...
January 17, 2018: World Neurosurgery
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
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
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
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
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...
February 2018: International Journal of Obstetric Anesthesia
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
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. METHODS: Twelve children with previous meningomyelocele repair, in the age group of 6-12 years posted for hip or bilateral lower limb surgeries were included...
March 2018: Paediatric Anaesthesia
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
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
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
David J Kim, Raheel Bengali, T Anthony Anderson
No abstract text is available yet for this article.
December 2017: Korean Journal of Anesthesiology
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
Jorge Luiz Amorim Correa, Marcus André Acioly
BACKGROUND: Perioperative visual loss after spinal surgery is a devastating complication for the patient and the surgical team. Two known major causes are ischemic optic neuropathy and central retinal artery occlusion (CRAO). Traditional understanding of CRAO has been consistently related to occurrence of periocular trauma and signs of increased intraorbital pressure in addition to visual loss. However, such orbital signs are not a feature of any common perioperative visual loss syndrome...
February 2018: World Neurosurgery
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