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Spinal anesthesia

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https://www.readbyqxmd.com/read/29675556/patients-perspectives-on-urethral-bulk-injection-therapy-and-mid-urethral-sling-surgery-for-stress-urinary-incontinence
#1
Fenne M Casteleijn, Sandra E Zwolsman, Claudia R Kowalik, Jan-Paul P W R Roovers
INTRODUCTION AND HYPOTHESIS: The aim of this study was to identify all treatment decision factors that determined the preference for peri-urethral bulk injection therapy (PBI) or mid-urethral sling (MUS) surgery in patients with primary stress urinary incontinence (SUI). Second, we explored what patients expect from treatment for SUI and whether patients would consider PBI as a primary treatment option. METHODS: In a qualitative design, 20 semi-structured, face-to-face interviews were conducted in women with primary SUI...
April 19, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29673420/neurologic-complications-associated-with-transdermal-placement-of-intrathecal-catheters-in-sheep
#2
Gabrielle C Musk, Nolan J McDonnell, Mark Newman, Matthew W Kemp
A study using an ovine model of transdermal intrathecal catheterization was planned to investigate the neurotoxicity ofmagnesium sulfate. Nonpregnant Merino cross ewes (n = 8; age, 5 y; weight, 55.0 ± 6.5 kg) were anesthetized for placementof a lumbar intrathecal catheter. The study protocol defined a 5-d recovery period after introduction of the catheter before theadministration of test substances (2 mL of 0.9% saline or 50 or 150 mg MgSO4) followed by euthanasia 1 wk later. Although 3sheep successfully completed the study as planned, one of the remaining 5 sheep was withdrawn when the catheter was accidentally dislodged 2 d after anesthesia; another was withdrawn because of persistent neurologic deficits of the left hindlimb and intense pruritus during the first 24 h after placement of the catheter; and the remaining 3 animals experienced unacceptable complications within the first 4 h of administration of the test substance...
April 19, 2018: Comparative Medicine
https://www.readbyqxmd.com/read/29670012/percutaneous-imaging-guided-biopsy-of-bone-metastases
#3
REVIEW
Dimitrios Filippiadis, Argyro Mazioti, Alexios Kelekis
Approximately 70% of cancer patients will eventually develop bone metastases. Spine, due to the abundance of red marrow in the vertebral bodies and the communication of deep thoracic-pelvic veins with valve-less vertebral venous plexuses, is the most common site of osseous metastatic disease. Open biopsies run the risk of destabilizing an already diseased spinal or peripheral skeleton segment. Percutaneous biopsies obviate such issues and provide immediate confirmation of correct needle location in the area of interest...
April 18, 2018: Diagnostics
https://www.readbyqxmd.com/read/29666737/a-rare-case-of-progressive-palsy-of-the-lower-leg-during-percutaneous-endoscopic-lumbar-discectomy-via-a-transforaminal-approach
#4
Hiroaki Manabe, Kosaku Higashino, Kosuke Sugiura
Percutaneous endoscopic discectomy (PED) for lumbar disc herniation is gaining popularity with the transforaminal (TF) approach preferred because it allows surgery under local anesthesia and preserves the spinal muscles. Although this procedure has some characteristic complications, it is rare for PED to be converted to conventional open surgery due to worsening of symptoms intraoperatively. Here, we report PED via the TF approach that required conversion to open surgery. A 20-year-old man with a large disc herniation at L3/4 developed severe progressive leg pain and muscle weakness of the left leg intraoperatively...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29663067/impact-of-age-on-postoperative-complication-rates-among-elderly-patients-with-hip-fracture-a-retrospective-matched-study
#5
Mitsuhiro Matsuo, Tohru Yamagami, Akiko Higuchi
This study was performed to assess the impact of age of ≥ 90 years on predicting postoperative complications. We retrospectively identified all patients aged ≥ 65 years who underwent surgical repair of hip fractures over a 4.5-year period in our hospital. In total, 261 patients were identified (mean age, 86.2 ± 6.8 years). Ninety-one patients were aged ≥ 90 years (oldest-old group), and the remaining 170 were aged < 89 years (control old group). Postoperative complications developed in 54 of 261 patients (20...
April 16, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29659437/the-impact-of-spinal-needle-selection-on-postdural-puncture-headache-a-meta-analysis-and-metaregression-of-randomized-studies
#6
Andres Zorrilla-Vaca, Vineesh Mathur, Christopher L Wu, Michael C Grant
BACKGROUND AND OBJECTIVES: Potentially broadened indications for spinal anesthesia require increased understanding of the risk factors and prevention measures associated with postdural puncture headache (PDPH). This review is designed to examine the association between spinal needle characteristics and incidence of PDPH. METHODS: Meta-analysis and metaregression was performed on randomized controlled trials to determine the effect of needle design and gauge on the incidence of PDPH after controlling for patient confounders such as age, sex, and year of publication...
April 14, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29657246/effects-of-three-forms-of-local-anesthesia-on-perioperative-fentanyl-induced-hyperalgesia
#7
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/29652112/mucopexy-recto-anal-lifting-mu-ral-a-standardized-minimally-invasive-method-of-managing-symptomatic-hemorrhoids-with-an-innovative-suturing-technique-and-the-hemorpex-system%C3%A2
#8
Claudio Pagano, Contardo Vergani, Carlo Invernizzi, Massimo Bussone, Guido Benegiamo, Marco Venturi
BACKGROUND: Conservative surgery of hemorrhoidal disease is less painful than traditional hemorrhoidectomy, and mucopexy has less risk of serious postoperative complications than stapled hemorrhoidopexy. The aim of this study was to evaluate the safety and effectiveness of a standardized, modified hemorrhoidopexy, named Mucopexy-Recto Anal Lifting (MuRAL),with the HemorPex System (HPS) in patients with symptomatic III and IV degree hemorrhoids. MATERIALS AND METHODS: Patients were enrolled from May 2013 to Dec 2015 and operated on with the MuRAL technique, based on arterial ligation and mucopexy at 6 locations, using a standardized clockwise/anti-clockwise rotation sequence of the HPS anoscope...
April 12, 2018: Minerva Chirurgica
https://www.readbyqxmd.com/read/29643726/early-versus-delayed-oral-feeding-after-uncomplicated-cesarean-section-under-spinal-anesthesia-a-randomized-controlled-trial
#9
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/29643629/intraoperative-neurophysiological-monitoring-team-s-communiqu%C3%A3-with-anesthesia-professionals
#10
Anurag Tewari, Lisa Francis, Ravi N Samy, Dean C Kurth, Joshua Castle, Tiffany Frye, Mohamed Mahmoud
Background and Aims: Intraoperative neurophysiological monitoring (IONM) is the standard of care during many spinal, vascular, and intracranial surgeries. High-quality perioperative care requires the communication and cooperation of several multidisciplinary teams. One of these multidisciplinary services is intraoperative neuromonitoring (IONM), while other teams represent anesthesia and surgery. Few studies have investigated the IONM team's objective communication with anesthesia providers...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29628827/a-prospective-randomized-study-on-the-impact-of-low-dose-dexamethasone-on-perioperative-blood-glucose-concentrations-in-diabetics-and-nondiabetics
#11
Athul M Purushothaman, Vinayak Seenappa Pujari, Nalini B Kadirehally, Yatish Bevinaguddaiah, Pratheek R Reddy
Background: Dexamethasone is a potent corticosteroid when administered alone or in combination alone has proven efficacious in preventing nausea and vomiting (PONV) perioperatively. However, the administration of even a single dose has been associated with hyperglycemia. This is the first study that evaluates the effect of two low-doses of dexamethasone (4 and 8 mg) on blood glucose concentrations among diabetics and nondiabetics in patients who have received spinal anesthesia. Materials and Methods: After obtaining ethical clearance and patient consent, 180 American Society of Anesthesiologists 1-3 patients undergoing the elective infraumbilical surgeries under spinal anesthesia aged between 18 and 70 years were included in this study...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628594/an-unusual-case-of-a-parturient-with-uncorrected-pentalogy-of-fallot-presenting-for-elective-cesarean-section-delivery-of-twins
#12
Ying Ci Ho, Sek Koon Boey, Abey Matthew Varughese Mathews, Hooi Geok See, Nian Chih Hwang
We present a 31-year-old primigravida with uncorrected pentalogy of Fallot, pregnant with monochorionic-diamniotic twins, undergoing elective lower segment cesarean section at 36 weeks gestation. Preoperative workup included a transthoracic echocardiogram which revealed a large ventricular septal defect of 1.8 cm with bidirectional shunting, a moderate size atrial septal defect of 1.8 cm with predominant left-to-right shunting, an overriding aorta, moderate right ventricular hypertrophy, and severe pulmonary valve stenosis...
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
#13
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
#14
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
#15
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/29628579/incidence-of-postspinal-headache-and-low-backache-following-the-median-and-paramedian-approaches-in-spinal-anesthesia
#16
Balwinderjit Singh, Amartej Singh Sohal, Iqbal Singh, Subash Goyal, Prabhjot Kaur, Joginder Pal Attri
Background and Aims: Postspinal headache and low backache are common complaints following spinal anesthesia which regresses spontaneously but sometimes becomes very troublesome for the patient as well as for the anesthesiologists. The aim of this study was to evaluate the incidence of postspinal headache and low backache after spinal anesthesia in lower abdominal surgery. Materials and Methods: One hundred patients of 18-60 years of age group with patients physical status the American Society of Anesthesiologists Class I or II after due consent divided into equal numbers of two groups: median (M) approach and paramedian (P) approach scheduled for lower abdominal surgery...
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
#17
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/29628568/comparison-of-prophylactic-intravenous-magnesium-sulfate-with-tramadol-for-postspinal-shivering-in-elective-cesarean-section-a-placebo-controlled-randomized-double-blind-pilot-study
#18
Roopa Sachidananda, K Basavaraj, Safiya I Shaikh, G Umesh, Triveni Bhat, B Arpitha
Background and Aims: Cesarean sections are performed mostly under spinal anesthesia. Shivering is one of the distressing complications. The aim of the study was to compare the efficacy of intravenous (i.v) magnesium sulfate and tramadol with placebo (normal saline) on postspinal shivering in elective cesarean section when used as prophylaxis. Methods: One hundred and thirty-five pregnant women between 18 and 35 years age, belonging to the American Society of Anesthesiologists' physical Status II, undergoing elective cesarean section under spinal anesthesia were enrolled into the study...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628565/postoperative-cognitive-dysfunction-in-indian-patients-undergoing-total-knee-replacement-under-spinal-anesthesia
#19
Praful Kilaru, A Ramachandra Reddy, Maryada Venketeshwar Reddy, Brijesh Kidiyoor, Vinay Mathew Joseph, Annapareddy Venkata Gurava Reddy
Introduction: Total knee replacement is a common surgical procedure in the elderly. The number of surgeries has increased owing to the increasing life expectancy of the population and better functional outcomes postsurgery. Postoperative cognitive dysfunction (POCD) is an identified entity postsurgery in elderly but most of the studies have been on patients undergoing cardiac and other nonorthopaedic surgeries. The studies have shown variable incidence due to selection bias. We studied the incidence and probable predictive factors of POCD in elderly Indian population undergoing total knee replacement under spinal anesthesia...
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
#20
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
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