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Spinal anesthesia

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https://www.readbyqxmd.com/read/28098058/repair-of-an-inguinoscrotal-hernia-in-a-patient-with-becker-muscular-dystrophy
#1
F Tatulli, A Caraglia, A Delcuratolo, S Cassano, G S Chetta
INTRODUCTION: Inguinal hernia repairs are routinely performed as outpatient procedures in most patients, whereas a few require admission due to clinical or social peculiarities. Muscular dystrophies are inherited disorders characterized by progressive muscle wasting and weakness. In case of surgery there is no definite recommendation for either general or regional anesthesia. CASE REPORT: This contribution regards a 48 y. o. male patient diagnosed with Becker Muscular Dystrophy by muscle biopsy 10 years earlier...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28096583/addition-of-clonidine-to-bupivacaine-in-transversus-abdominis-plane-block-prolongs-postoperative-analgesia-after-cesarean-section
#2
Ranju Singh, Nishant Kumar, Aruna Jain, Sudipta Joy
BACKGROUND AND AIMS: The aim was to compare duration of postoperative analgesia with addition of clonidine to bupivacaine in bilateral transversus abdominis plane (TAP) block after lower segment cesarean section (LSCS). MATERIAL AND METHODS: One hundred American Society of Anesthesiologists (ASA) grade I and II pregnant patients undergoing LSCS under spinal anesthesia were randomly divided to receive either 20 ml bupivacaine 0.25% (Group B; n = 50) or 20 ml bupivacaine+1ug/kg clonidine bilaterally (Group BC; n = 50) in TAP block in a double-blind fashion...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28095795/intrathecal-magnesium-sulfate-does-not-reduce-the-ed50-of-intrathecal-hyperbaric-bupivacaine-for-cesarean-delivery-in-healthy-parturients-a-prospective-double-blinded-randomized-dose-response-trial-using-the-sequential-allocation-method
#3
Fei Xiao, Wenping Xu, Ying Feng, Feng Fu, Xiaomin Zhang, Yinfa Zhang, Lizhong Wang, Xinzhong Chen
BACKGROUND: Addition of intrathecal magnesium sulfate to local anesthetics has been reported to potentiate spinal anesthesia and prolong analgesia in parturients. The current study was to determine whether intrathecal magnesium sulfate would reduce the dose of hyperbaric bupivacaine in spinal anesthesia with bupivacaine and sufentanil for cesarean delivery. METHODS: Sixty healthy parturients undergoing scheduled cesarean delivery were randomly assigned to receive spinal anesthesia with 0...
January 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28094482/real-time-ultrasound-guided-spinal-anesthesia-in-patients-with-predicted-difficult-anatomy
#4
Hesham Elsharkawy, Ankit Maheshwari, Rovnat Babazade, Anahi Perlas, Sherif Zaky, Loran M Soliman
BACKGROUND: There are limited reports of lumbar neuraxial blocks using real-time ultrasound in patients with predicted difficulties. We compared the number of attempts to perform spinal anesthesia using real time ultrasound guidance versus landmark technique in patients meeting predefined criteria for difficult spinal anesthesia. We also compared procedure time, block success, patient satisfaction and difficulty scores between groups. METHODS: Following institutional review board approval patients scheduled for total hip or knee arthroplasty with expected difficulty to perform spinal anesthesia were included...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28091734/level-of-conus-medullaris-termination-in-adult-population-analyzed-by-kinetic-magnetic-resonance-imaging
#5
An Liu, Kaixiang Yang, Daling Wang, Changqing Li, Zhiwei Ren, Shigui Yan, Zorica Buser, Jeffrey C Wang
PURPOSE: To investigate the change of conus medullaris termination (CMT) level in neutral, flexion and extension positions and to analyze the effects of age and gender on the CMT level. METHODS: The midline sagittal T2-weighted kinetic magnetic resonance imaging (kMRI) study of 585 patients was retrospectively reviewed to identify the level of CMT. All patients were in an upright position. A straight line perpendicular to the long axis of the cord was drawn from the tip of the cord and then subtended to the adjacent vertebra or disk space...
January 16, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28059836/neurally-mediated-syncope-during-cesarean-delivery-a-case-report
#6
Seiko Sato, Erisa Nakamori, Go Kusumoto, Kenji Shigematsu, Ken Yamaura
A 28-year-old woman with preeclampsia at 32 weeks of gestation underwent a cesarean delivery under spinal anesthesia. Administration of nitroglycerin at 200 μg to relax uterine smooth muscles and the application of fundal pressure led to severe bradycardia and loss of consciousness, followed by cardiac arrest. Delivery was completed immediately and recovery was achieved 10 seconds later following cardiopulmonary resuscitation. Neurally mediated syncope was considered the cause of cardiac arrest. Anesthetists should be aware of the potential risk during cesarean delivery following the administration of nitroglycerin, fundal pressure, regional anesthesia, and hypovolemia because of preeclampsia...
January 4, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28056870/anti-n-methyl-d-aspartate-receptor-nmdar-antibody-encephalitis-presents-in-atypical-types-and-coexists-with-neuromyelitis-optica-spectrum-disorder-or-neurosyphilis
#7
Kaiyu Qin, Wenqing Wu, Yuming Huang, Dongmei Xu, Lei Zhang, Bowen Zheng, Meijuan Jiang, Cheng Kou, Junhua Gao, Wurong Li, Jinglin Zhang, Sumei Wang, Yanfei Luan, Chaoling Yan, Dan Xu, Xinmei Zheng
BACKGROUND: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a clinically heterogeneous disorder characterized by epileptic seizures, psychosis, dyskinesia, consciousness impairments, and autonomic instability. Symptoms are always various. Sometimes it presents in milder or incomplete forms. We report 4 cases of anti-NMDAR encephalitis with incomplete forms, 3 cases of which were accompanied by neuromyelitis optica spectrum disorder or neurosyphilis respectively. CASE PRESENTATION: A 33-year-old man presented with dysarthria, movement disorder and occasional seizures...
January 5, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28053243/descending-antinociception-induced-by-secondary-somatosensory-cortex-stimulation-in-experimental-neuropathy-role-of-the-medullospinal-serotonergic-pathway
#8
Boriss Sagalajev, Hanna Viisanen, Hong Wei, Antti Pertovaara
Stimulation of the secondary somatosensory cortex (S2) has attenuated pain in humans and inflammatory nociception in animals. Here we studied S2 stimulation-induced antinociception and its underlying mechanisms in an experimental animal model of neuropathy induced by spinal nerve ligation (SNL). Effect of S2 stimulation on heat-evoked limb withdrawal latency was assessed in lightly anesthetized rats that were divided into three groups based on prior surgery and monofilament testing before induction of anesthesia: i) Sham operated group, ii-iii) (mechanically) hypersensitive and non-hypersensitive SNL groups...
January 4, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28051832/fast-glycorrhachia-and-cerebrospinal-fluid-protein-as-predictors-of-sensory-block-in-anesthesia-with-subarachnoid-ropivacaine
#9
S Collini, F Troisi, F Pacella, P Merlin, S De Sio, E Pacella
BACKGROUND: Identify if glycorrhachia and cerebrospinal fluid protein could influence the time of sensory block to T10, the duration and the metameric block's level, after a standard dose of Ropivacaine. METHODS: 80 patients, ASA I - III undergoing to transurethral prostate resection with spinal anesthesia in a prospected open study were recruited. A 0.2 ml liquor's sample was taken; glycorrhachia, by glycemic stix and CSF protein, by urinary stix, were got, before Ropivacaine 0...
November 2016: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28045856/a-multiparametric-alarm-criterion-for-motor-evoked-potential-monitoring-during-spine-deformity-surgery
#10
Martín J Segura, María E Talarico, Mariano A Noel
PURPOSE: This is a pilot study to compare changes in the amplitude, area below the curve, number of phases, duration, and latency of the intraoperative transcranial motor evoked potentials (TcMEP) for early detection of impending spinal cord injury. An empirical ratio calculated by a combination of the above-mentioned parameters was also assessed. METHODS: Intraoperative TcMEP recordings from five patients presenting with neuromuscular kyphoscoliosis, idiopathic scoliosis, achondroplasia and lumbar kyphosis, congenital kyphosis, and achondroplasia with cervical instability were reviewed...
January 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28045758/a-virtual-reality-simulation-model-of-spinal-ultrasound-role-in-teaching-spinal-sonoanatomy
#11
Reva Ramlogan, Ahtsham U Niazi, Rongyu Jin, James Johnson, Vincent W Chan, Anahi Perlas
BACKGROUND AND OBJECTIVES: Ultrasound assessment of the lumbar spine improves the success of spinal and epidural anesthesia, especially for patients with underlying difficult anatomy. To assist with the teaching and learning of ultrasound-guided neuraxial anesthesia, we have created an online interactive educational model (http://www.usra.ca/vspine.php and http://pie.med.utoronto.ca/vspine). The aim of the current study was to determine whether the virtual spine model improved the knowledge of neuraxial anatomy and sonoanatomy...
December 29, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28040125/preoperative-measurement-of-maternal-abdominal-circumference-relates-the-initial-sensory-block-level-of-spinal-anesthesia-for-cesarean-section-an-observational-study
#12
Chi-Hang Kuok, Chung-Hsin Huang, Pei-Shan Tsai, Yuan-Pi Ko, Wei-Shih Lee, Yung-Wei Hsu, Fang-Yu Hung
OBJECTIVE: Lumbosacral cerebrospinal fluid volume is decreased as the enlarging uterus compresses the inferior vena cava during pregnancy. A subsequent greater cephalad spread of sensory blockade is observed. Gravid uterus plays a crucial role in affecting the spinal anesthesia level. We hypothesized that maternal abdominal circumference can reflect compressive effect of the uterus and investigated the relationship between abdominal circumference and the level of sensory blockade, and incidence of hypotension following spinal anesthesia with hyperbaric bupivacaine in term parturients...
December 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28033693/comparison-of-morphine-suppository-and-diclofenac-suppository-for-pain-management-after-elective-caesarean-section
#13
RANDOMIZED CONTROLLED TRIAL
Atossa Mahdavi, Zeinab Telkabadi, Ashraf Aleyasin, Marzieh Agha Hosseini, Leili Safdarian, Ali Momenzadeh
This study investigated efficacy and side effects of Morphine suppository for pain management after the first elective caesarean delivery in comparison to Diclofenac suppository. One hundred women aged 18-40 with term pregnancies undergoing elective caesarean section for the first time participated in this prospective project. Exclusion criteria included drug sensitivity, fetal malformations or defects, and complications during the cesarean operation. After same spinal anesthesia and same surgical techniques and in the recovery room patients consecutively received 100 mg diclofenac suppository or 10 mg morphine suppository...
November 2016: Acta Medica Iranica
https://www.readbyqxmd.com/read/28033295/a-sewing-needle-in-contact-with-the-cervical-dura-mater-and-vertebral-artery-a-case-report
#14
Arizumi Fumihiro, Inoue Shinichi, Tachibana Toshiya, Maruo Keishi, Yoshiya Shinichi
RATIONALE: Although cervical foreign bodies have been previously reported, the report of a needle in the cervical spinal cord is rare. Herein, we report a rare case of a sewing needle in contact with the cervical dura mater and vertebral artery. PATIENTS CONCERNS: A 47-year-old man presented with discomfort in the posterior region of his neck. Approximately 2 years before admission, he suffered a stiff neck and had stabbed the posterior region of his neck with a sewing needle...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28033253/postoperative-cognitive-changes-after-total-knee-arthroplasty-under-regional-anesthesia
#15
Young-Tae Jeon, Byung-Gun Kim, Young Ho Park, Hye-Min Sohn, Jungeun Kim, Seung Chan Kim, Seong Soo An, SangYun Kim
BACKGROUND: The type of postoperative cognitive decline after surgery under spinal anesthesia is unknown. We investigated the type of postoperative cognitive decline after total knee arthroplasty (TKA). Neuropsychological testing was conducted and the changes in cerebrospinal fluid (CSF) biomarkers after surgery were evaluated. METHODS: Fifteen patients who required bilateral TKA at a 1-week interval under spinal anesthesia were included. Neuropsychological tests were performed twice, once the day before the first operation and just before the second operation (usually 1 week after the first test) to determine cognitive decline...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28030871/obesity-and-neonatal-cord-blood-gas-results-at-cesarean-effect-of-intraoperative-blood-pressure
#16
Mark F Powell, Charity J Morgan, Jessica A Cantu, Yasser Sakawi, Joseph R Biggio, Alan T N Tita, Jeff M Szychowski, Rodney K Edwards
Objective Our aims were to evaluate whether there is an inverse association between body mass index (BMI) and umbilical artery pH and to investigate the contribution of intraoperative hypotension on the umbilical artery pH. Study Design We conducted a retrospective cohort study of all women with a nonanomalous singleton at 37 to 41 weeks who underwent a scheduled cesarean delivery under spinal anesthesia at our facility from January 2006 to March 2012. The primary outcome was the proportion of patients in each BMI category with arterial cord pH < 7...
December 28, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/28027388/spinal-anesthesia-in-elderly-patients-undergoing-lumbar-spine-surgery
#17
Noah L Lessing, Charles C Edwards, Charles H Brown, Emily C Ledford, Clayton L Dean, Charles Lin, Charles C Edwards
Spinal anesthesia is increasingly viewed as a reasonable alternative to general anesthesia for lumbar spine surgery. However, the results of spinal anesthesia in elderly patients undergoing lumbar spine decompression and combined decompression and fusion procedures are limited in the literature. The aim of this study was to report a single institution's experience using spinal anesthesia in elderly patients undergoing lumbar spine surgery. A retrospective review was conducted using a prospectively collected database of consecutive lumbar spine surgeries performed under spinal anesthesia in patients 70 years or older at a single center between December 2013 and October 2015...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/28026887/combined-spinal-epidural-anesthesia-with-hypobaric-ropivacaine-in-sitting-position-significantly-increases-the-incidence-of-hypotension-in-parturients-undergoing-cesarean-section
#18
Zhendong Xu, Fuyi Shen, Yueqi Zhang, Yiyi Tao, Xiubing Chen, Zhiqiang Liu
AIM: Maternal position during induction of combined spinal-epidural anesthesia (CSEA) may affect hemodynamics and block characteristics. This study aimed to assess whether the sitting position is more likely to induce hypotension and higher block level than the lateral position in CSEA with hypobaric ropivacaine. METHODS: Ninety American Society of Anesthesiologists physical status I and II parturients undergoing elective cesarean section were randomized into three groups: the sitting, left-lateral, and right-lateral position groups...
December 27, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28017670/presynaptic-facilitation-by-tetracaine-of-glutamatergic-spontaneous-excitatory-transmission-in-the-rat-spinal-substantia-gelatinosa-involvement-of-trpa1-channels
#19
Lian-Hua Piao, Tsugumi Fujita, Ting Yu, Eiichi Kumamoto
The amide-type local anesthetic (LA) lidocaine activates transient receptor potential (TRP) ankyrin-1 (TRPA1) channels to facilitate spontaneous L-glutamate release onto spinal substantia gelatinosa (SG) neurons, which play a crucial role in regulating nociceptive transmission. In contrast, the ester-type LA procaine reduces the spontaneous release of L-glutamate in SG neurons. In order to determine whether TRPA1 activation by LAs is specific to amide-types, we examined the actions of tetracaine, another ester-type LA, and other amide-type LAs on glutamatergic spontaneous excitatory transmission in SG neurons by focusing on TRP activation...
December 22, 2016: Brain Research
https://www.readbyqxmd.com/read/28017175/anesthesia-for-cesarean-section-in-a-patient-with-isolated-unilateral-absence-of-a-pulmonary-artery
#20
Tomonori Furuya, Ryoji Iida, Jyumpei Konishi, Jitsu Kato, Takahiro Suzuki
BACKGROUND AND OBJECTIVES: Congenital unilateral absence of a pulmonary artery (UAPA) is a rare anomaly. Although there are several reports regarding pregnancy in patients with unilateral absence of a pulmonary artery, there are no case reports describing anesthesia for Cesarean section in a patient with unilateral absence of a pulmonary artery. CASE REPORT: We present a patient with unilateral absence of a pulmonary artery who underwent Cesarean sections twice at the ages of 24 and 26 years under spinal anesthesia for surgery and epidural analgesia for postoperative pain relief...
January 2017: Brazilian Journal of Anesthesiology
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