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https://www.readbyqxmd.com/read/29662278/comparison-of-efficacy-of-bupivacaine-with-dexmedetomidine-versus-bupivacaine-alone-for-transversus-abdominis-plane-block-for-post-operative-analgesia-in-patients-undergoing-elective-caesarean-section
#1
A Ramya Parameswari, Prabha Udayakumar
Background: Increasing rate of Caesarean sections and inadequate pain relief following Caesarean section is seen in almost all parts of the world. Transversus abdominis plane block is gaining popularity as a part of multimodal analgesia for post-operative pain relief following abdominal surgeries. Aim: To compare bupivacaine and bupivacaine with dexmedetomidine in transversus abdominis plane block for pain relief after Caesarean section. Method: American Society of Anaesthesiologists I and II parturients with no comorbidities admitted for elective Caesarean section were included in the study...
April 2018: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/29657246/effects-of-three-forms-of-local-anesthesia-on-perioperative-fentanyl-induced-hyperalgesia
#2
Lu Chang, Fang Ye, Quehua Luo, Zewen Wang, Yimin Wang, Zhengyuan Xia, Haihua Shu
Both local infiltration analgesia (LIA) and nerve block are common analgesic modalities for pain relief after surgery. The aim of the current study was to investigate the effects of those two modalities on pain behavior and the expression of pro-inflammatory cytokines such as interleukin (IL)-1β and IL-6 and tumor necrosis factor-α (TNF-α) in the spinal cord and dorsal root ganglion (DRG) in a rat model of perioperative fentanyl induced hyperalgesia. Rats were injected with fentanyl (60 μg/kg) 4 times and received a plantar incision after the second injection or they received pre-incision LIA and sciatic nerve block (SNB) or post-incision LIA with levobupivacaine (0...
April 15, 2018: Bioscience Trends
https://www.readbyqxmd.com/read/29656623/superior-and-middle-cluneal-nerve-entrapment-as-a-cause-of-low-back-pain
#3
REVIEW
Toyohiko Isu, Kyongsong Kim, Daijiro Morimoto, Naotaka Iwamoto
Low back pain (LBP) is encountered frequently in clinical practice. The superior and the middle cluneal nerves (SCN and MCN) are cutaneous nerves that are purely sensory. They dominate sensation in the lumbar area and the buttocks, and their entrapment around the iliac crest can elicit LBP. The reported incidence of SCN entrapment (SCN-E) in patients with LBP is 1.6%-14%. SCN-E and MCN entrapment (MCN-E) produce leg symptoms in 47%-84% and 82% of LBP patients, respectively. In such patients, pain is exacerbated by lumbar movements, and the symptoms mimic radiculopathy due to lumbar disorder...
March 2018: Neurospine
https://www.readbyqxmd.com/read/29656591/amp-activated-protein-kinase-dependent-induction-of-autophagy-by-erythropoietin-protects-against-spinal-cord-injury-in-rats
#4
Peng Wang, Zhong-Dong Xie, Chang-Nan Xie, Chao-Wei Lin, Ji-Li Wang, Li-Na Xuan, Chun-Wu Zhang, Yu Wang, Zhi-Hui Huang, Hong-Lin Teng
AIMS: Autophagy has been regarded as a promising therapeutic target for spinal cord injury (SCI). Erythropoietin (EPO) has been demonstrated to exhibit neuroprotective effects in the central nervous system (CNS); however, the molecular mechanisms of its protection against SCI remain unknown. This study aims to investigate whether the neuroprotective effects of EPO on SCI are mediated by autophagy via AMP-activated protein kinase (AMPK) signaling pathways. METHODS: Functional assessment and Nissl staining were used to investigate the effects of EPO on SCI...
April 15, 2018: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/29643726/early-versus-delayed-oral-feeding-after-uncomplicated-cesarean-section-under-spinal-anesthesia-a-randomized-controlled-trial
#5
Adamu O Ogbadua, Teddy E Agida, Godwin O Akaba, Olumide A Akitoye, Bissallah A Ekele
Objective: The objective of this study is to compare the safety of early versus delayed oral feeding after uncomplicated cesarean section (CS) under spinal anesthesia. Methods: This was a randomized, controlled trial that enrolled 152 women who had uncomplicated CS under spinal anesthesia between January 2014 and June 2014. Women in the early feeding group had sips of oral fluid 6 h postoperatively while those in the delayed feeding group were on nil per oral for the first 24 h after surgery before commencement on liquid diet...
January 2018: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/29643618/a-randomized-clinical-trial-of-intrathecal-magnesium-sulfate-versus-midazolam-with-epidural-administration-of-0-75-ropivacaine-for-patients-with-preeclampsia-scheduled-for-elective-cesarean-section
#6
Sophia Paleti, P Krishna Prasad, B Sowbhagya Lakshmi
Background and Aims: Magnesium sulfate and midazolam have been used as adjuvants to local anesthetics via intrathecal and epidural routes to augment the quality of block and prolong postoperative analgesia. This study compares addition of intrathecal magnesium sulfate versus intrathecal midazolam to epidurally administered isobaric ropivacaine as a part of combined spinal epidural technique in pre-eclamptic parturients undergoing elective cesarean section. Material and Methods: After institutional ethics committee approval and written informed consent, 50 pre-eclamptic parturients were randomly allocated to one of the two groups of 25 each to either receive intrathecal magnesium sulfate (50 mg) or intrathecal midazolam (1 mg) in combination with epidural ropivacaine (0...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29629601/occipital-neuralgia-associates-with-high-cervical-spinal-cord-lesions-in-idiopathic-inflammatory-demyelinating-disease
#7
Narayan R Kissoon, James C Watson, Christopher J Boes, Orhun H Kantarci
Background The association of trigeminal neuralgia with pontine lesions has been well documented in multiple sclerosis, and we tested the hypothesis that occipital neuralgia in multiple sclerosis is associated with high cervical spinal cord lesions. Methods We retrospectively reviewed the records of 29 patients diagnosed with both occipital neuralgia and demyelinating disease by a neurologist from January 2001 to December 2014. We collected data on demographics, clinical findings, presence of C2-3 demyelinating lesions, and treatment responses...
January 1, 2018: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29628771/activation-of-spinal-dorsal-horn-p2y-13-receptors-can-promote-the-expression-of-il-1%C3%AE-and-il-6-in-rats-with-diabetic-neuropathic-pain
#8
Rui Zhou, Tao Xu, XiaoHong Liu, YuanShou Chen, DeYing Kong, Hong Tian, Mingxia Yue, Dujuan Huang, Junwei Zeng
Objective: The dorsal horn P2Y13 receptor is involved in the development of pain behavior induced by peripheral nerve injury. It is unclear whether the expression of proinflammatory cytokines interleukin (IL)-1β and IL-6 at the spinal dorsal horn are influenced after the activation of P2Y13 receptor in rats with diabetic neuropathic pain (DNP). Methods: A rat model of type 1 DNP was induced by intraperitoneal injection of streptozotocin (STZ). We examined the expression of P2Y13 receptor, Iba-1, IL-1β, IL-6, JAK2, STAT3, pTyr1336 , and pTyr1472 NR2B in rat spinal dorsal horn...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29628682/perioperative-pain-management-following-total-joint-arthroplasty-a-review-and-update-to-an-institutional-pain-protocol
#9
REVIEW
Kimberly L Stevenson, Alexander L Neuwirth, Neil Sheth
As the rate of total joint arthroplasty increases with the aging population of the United States, new focus on decreasing opioid use through the development of multimodal pain regimens (MPRs) is becoming an important area of research. MPRs use different agents and modes of delivery in order to synergistically address pain at many levels of the pain pathway. MPRs include a combination of acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), gabapentinoids, opioids (short- and long-acting), spinal/epidural analgesia, regional nerve blocks, and local anesthetics...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29628596/subarachnoid-block-a-safe-choice-for-cesarean-section-in-neurofibromatosis-patient-with-severe-kyphoscoliosis
#10
Ibrahim Demir, Ebru Tarıkçı Kılıç, Mehmet Salim Akdemir
Neurofibromatosis type 1 (NF1) is an autosomal-dominant neuroectodermal hereditary disorder, in which spinal skeletal deformities are one of the manifestations. Pectus carinatum, temporomandibular joint dysfunction, and kyphoscoliosis can be seen with this genetic disorder which can lead to cardiorespiratory system problems and can cause difficulty in airway management. We present the anesthetic management of a NF1 patient with a sharp thoracolumbar dystrophic kyphoscoliosis who have been posted for emergency cesarean section as a result of fetal distress...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628591/comparison-of-levobupivacaine-and-levobupivacaine-with-dexmedetomidine-in-infraumbilical-surgeries-under-spinal-anesthesia
#11
Amar Parkash Kataria, Vishal Jarewal, Rajan Kumar, Ankush Kashyap
Introduction: Spinal anesthesia is a widely used technique providing faster onset with effective and uniformly distributed sensory and motor block. Due to decreased cardiovascular and central nervous system toxicity, levobupivacaine is a good alternative for spinal anesthesia. Dexmedetomidine when used intrathecally is associated with prolonged motor and sensory block, hemodynamic stability, and less requirement of rescue analgesia in 24 h. Materials and Methods: A prospective, randomized study was carried out which included 60 adult patients between the age group of 20 and 65 years of physical status American Society of Anesthesiologists Classes I and II who underwent infraumbilical surgeries...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628589/clonidine-as-an-adjuvant-to-caudal-epidural-ropivacaine-for-lumbosacral-spine-surgeries
#12
Saraswathi Nagappa, Sandhya Kalappa, Raghavendra Biligiri Sridhara
Background: Caudal epidural analgesia is a proven technique for providing analgesia for spinal surgeries. Prolonged pain relief with no motor blockade is desired for early mobilization. Objective: The objective of this study is to compare the effect of adding 1 μg/kg of clonidine to injection ropivacaine 0.2% with respect to duration of analgesia, hemodynamic effects, and associated side effects. Methodology: In this prospective double-blind study, a total of 60 patients undergoing lumbosacral spine surgery were randomized to receive 25 cc caudal epidural injection of either injection ropivacaine 0...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628580/comparison-of-intravenous-bolus-and-infusion-of-dexmedetomidine-on-characteristics-of-subarachnoid-block
#13
Tripti Vatsalya, Chandrakant Waikar, Madhurima Singh
Aims: Dexmedetomidine is very dynamic drug, used for analgesia, sedation, blunting the laryngoscopic responses and as adjuvants in regional anesthesia. Studies have shown that intravenous (iv) dexmedetomidine given during spinal anesthesia increases the quality of subarachnoid block (SAB). In this study, we compare the two iv regimen of dexmedetomidine on analgesic effect of spinal anesthesia. One is bolus dose of dexmedetomidine and other is infusion during the surgery, both given after induction of spinal anesthesia...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628571/epidural-volume-extension-with-saline-in-combined-spinal-epidural-anesthesia-for-hip-surgeries-using-low-dose-of-intrathecal-hyperbaric-bupivacaine
#14
Rajiv Singh Bhandari, Rohan Bhatia, Sanjay Agrawal
Background and Aims: The aim of the study was to evaluate the effectiveness of epidural volume extension (EVE) technique in terms of sensory and motor block characteristics along with hemodynamic parameters as a part of combined spinal-epidural anesthesia (CSEA). Materials and Methods: A total of 60 patients undergoing hip surgeries were assigned to one of the two groups containing 30 patients each. Group I (the CSE-EVE group) patients were anesthetized using CSE with EVE and Group II (the CSE group) patients were anesthetized using CSE without EVE, using the same technique and low dose of intrathecal hyperbaric bupivacaine...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628561/norepinephrine-versus-ephedrine-to-maintain-arterial-blood-pressure-during-spinal-anesthesia-for-cesarean-delivery-a-prospective-double-blinded-trial
#15
Ali Mohamed Ali Elnabtity, Mohamed Foad Selim
Background: Ephedrine was conventionally regarded as the first-choice drug to maintain maternal blood pressure during spinal anesthesia for cesarean delivery, due to its stimulant activity on α- and β-adrenergic receptors. Norepinephrine is a weak β-adrenergic and potent α-adrenergic receptor agonist. Therefore, it may be suitable for maintaining blood pressure with less chronotropic effects compared to ephedrine. Patients and Methods: One hundred and forty healthy patients having cesarean delivery under spinal anesthesia were randomized to Group N ( n = 61) who received a prophylactic bolus of norepinephrine 5 μg intravenous (i...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628559/comparison-of-postoperative-analgesic-efficacy-of-wound-site-infiltration-and-ultrasound-guided-transversus-abdominis-plane-block-with-0-5-ropivacaine-in-lower-abdominal-surgeries-under-spinal-anesthesia
#16
N Pratheeba, R Remadevi, I Joseph Raajesh, V Bhavani, D K Tripathy, R Ravindra Bhat
Context: Optimization and providing excellent quality of postoperative analgesia after total abdominal hysterectomy is a determinant factor of better clinical outcome, increases patient satisfaction, and allows early mobilization of the patient. Aims: The aim of this study is to compare the postoperative analgesic efficacy of wound site infiltration (WSI) and ultrasound-guided transversus abdominis plane block (TAPB) with 0.5% ropivacaine in lower abdominal surgeries under spinal anesthesia...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628551/perianal-block-is-it-as-good-as-spinal-anesthesia-for-closed-hemorrhoidectomies
#17
Kavitha Jinjil, Deepak Dwivedi, Vidhu Bhatnagar, Rahul K Ray, Swayam Tara
Background and Aims: This study compared if perianal block using ropivacaine and dexmedetomidine was as good as spinal anesthesia (SA) using bupivacaine (heavy) for closed hemorrhoidectomies. Methods: A prospective randomized study was conducted in sixty patients who underwent closed hemorrhoidectomy. Thirty patients of Group A received SA. Thirty patients in Group B received local perianal block. Patients were evaluated for onset of the block, total pain-free period, and time to ambulation...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29627015/spinal-cord-infarction-clinical-and-imaging-insights-from-the-periprocedural-setting
#18
Nicholas L Zalewski, Alejandro A Rabinstein, Karl N Krecke, Robert D Brown, Eelco F M Wijdicks, Brian G Weinshenker, Derrick A Doolittle, Eoin P Flanagan
OBJECTIVE: Describe the range of procedures associated with spinal cord infarction (SCI) as a complication of a medical/surgical procedure and define clinical and imaging characteristics that could be applied to help diagnose spontaneous SCI, where the diagnosis is often less secure. METHODS: We used an institution-based search tool to identify patients evaluated at Mayo Clinic, Rochester, MN from 1997 to 2016 with a periprocedural SCI. We performed a descriptive analysis of clinical features, MRI and other laboratory findings, and outcome...
May 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29620988/a-simple-guide-to-regional-anaesthesia
#19
E M Valsamis, S Wade, C Thornhill, C Carey, D Ricketts
Regional anaesthesia is widely used in modern anaesthetic practice for perioperative and postoperative analgesia. In the operating theatre, regional anaesthesia is used both on its own and in combination with other techniques (general anaesthesia and sedation). Regional anaesthesia is now a core skill set in anaesthetic training. This article provides a basic outline of regional anaesthesia for surgeons and other non-anaesthetic staff working with anaesthetists, reviewing preparation, consent, basic and specialist equipment, central neuraxial blocks (spinal, epidural and caudal), trunk blocks, upper limb blocks (interscalene, supraclavicular, infraclavicular and axillary) and lower limb blocks (femoral, fascia iliaca, sciatic, popliteal and ankle)...
April 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29620648/epiduroscopic-laser-neural-decompression-as-a-treatment-for-migrated-lumbar-disc-herniation-case-series
#20
Jinyoung Oh, Daehyun Jo
OBJECTIVE: Epiduroscopic laser neural decompression (ELND) is one of the more invasive techniques for managing patients with herniated lumbar disc. However, ELND can be used to treat, and diagnose the epidural pathology; indications for ELND remain controversial, especially, when applied in cases of large disc extrusion and migrated disc. This paper reports cases of patients that were satisfied with the ELND procedure for migrated lumbar disc herniation. METHODS: We reviewed the medical records of patients that received ELND for migrated lumbar disc in an outpatient clinic...
April 2018: Medicine (Baltimore)
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