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Spinal anesthesia

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https://www.readbyqxmd.com/read/28321993/metatropic-dysplasia-a-skeletal-dysplasia-with-challenging-airway-and-other-anesthetic-concerns
#1
Mary C Theroux, Martha Lopez, Patricia J Olszewsky, Sabina DiCindio, Lynda Arai, Colleen Ditro, Michael B Bober, Olubukola Opeyemi Olla, Tetsu Uejima, David W West, William G Mackenzie
BACKGROUND: Metatropic dysplasia is a rare form of skeletal dysplasia requiring multiple anesthetics for surgical and imaging procedures, most of which are orthopedic procedures. We provide centralized care to patients with skeletal dysplasia at our tertiary care pediatric hospital, and we were able to collect the largest number of metatropic dysplasia patients reported to date. AIM: The aim of this retrospective study was to describe and characterize the anesthetic difficulties in this high-risk population...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28315990/model-based-registration-of-preprocedure-mr-and-intraprocedure-us-of-the-lumbar-spine
#2
Delaram Behnami, Alireza Sedghi, Emran Mohammad Abu Anas, Abtin Rasoulian, Alexander Seitel, Victoria Lessoway, Tamas Ungi, David Yen, Jill Osborn, Parvin Mousavi, Robert Rohling, Purang Abolmaesumi
PURPOSE: Epidural and spinal needle insertions, as well as facet joint denervation and injections are widely performed procedures on the lumbar spine for delivering anesthesia and analgesia. Ultrasound (US)-based approaches have gained popularity for accurate needle placement, as they use a non-ionizing, inexpensive and accessible modality for guiding these procedures. However, due to the inherent difficulties in interpreting spinal US, they yet to become the clinical standard-of-care...
March 18, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28303086/anesthesia-provision-in-disasters-and-armed-conflicts
#3
REVIEW
Miguel Trelles Centurion, Rafael Van Den Bergh, Henry Gray
PURPOSE OF REVIEW: Disasters and armed conflicts are characterized by high numbers of trauma cases, and occur mainly in developing countries where the healthcare response is already impaired, resulting in an inadequate response. Aside of the trauma cases, other surgical health conditions are also still present and require urgent care. Surgical care needs are different from context to context and depend on local means and capabilities. RECENT FINDINGS: Doctors without Borders (MSF) has proven that even in precarious situations, safe administration of anesthesia is possible, and the "do no harm" principle can and must be upheld...
2017: Current Anesthesiology Reports
https://www.readbyqxmd.com/read/28302458/the-effects-of-dexmedetomidine-pretreatment-on-the-pro-and-anti-inflammation-systems-after-spinal-cord-injury-in-rats
#4
Hui Rong, Zhibin Zhao, Jiying Feng, Yishan Lei, Hao Wu, Rao Sun, Zuoxia Zhang, Bailing Hou, Wei Zhang, YuE Sun, Xiaoping Gu, Zhengliang Ma, Yue Liu
Excessive inflammatory responses play important roles in the aggravation of secondary damage to an injured spinal cord. Dexmedetomidine (DEX), a selective α2-adrenoceptor agonist, has recently been implied to be neuroprotective in clinical anesthesia, but the underlying mechanism is elusive. As signaling through Toll-like receptor 4 (TLR4) and nicotinic receptors (nAChRs, notably α7nAChR) play important roles in the pro- and anti-inflammation systems in the central nervous system, respectively, this study investigated whether and how they were modulated by DEX pretreatment in a rat model of spinal cord compression...
March 14, 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/28298799/case-of-neurological-complication-following-subarachnoid-block-in-a-patient-with-unsuspected-coagulopathy
#5
Arun Mathur, C Venkatesh Nagappa
Subarachnoid block (SAB) is an extensively used regional anesthesia technique for many surgeries. Neurological complications are rare following spinal anesthesia. We are reporting neurological complication in a patient the following appendectomy under SAB with unsuspected coagulopathy. The complication was noticed early and managed conservatively with a high dose of intravenous steroid and improved drastically in a short period.
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298786/comparison-of-dexmedetomidine-and-magnesium-sulfate-as-adjuvants-with-ropivacaine-for-spinal-anesthesia-in-infraumbilical-surgeries-and-postoperative-analgesia
#6
Reena Makhni, Joginder Pal Attri, Payal Jain, Veena Chatrath
INTRODUCTION: Postoperative pain is a major cause of fear and anxiety in hospitalized patients and so if patients remain pain-free during this period, they can cooperate with the circumstances well, leading to early recovery. Over the last two decades, there has been considerable revival of interest in the use of regional anesthesia techniques for surgery and pain management. As very few studies have been conducted using ropivacaine with dexmedetomidine and magnesium sulfate (MgSO4) as adjuvants, the present study was undertaken with primary aims to compare the hemodynamic stability, onset and duration of sensory and motor block and with secondary aims of the postoperative analgesic effect of dexmedetomidine and MgSO4 along with ropivacaine...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298775/a-comparative-study-of-intravenous-dexmedetomidine-and-intravenous-clonidine-for-postspinal-shivering-in-patients-undergoing-lower-limb-orthopedic-surgeries
#7
Manohar Panneer, Prakash Murugaiyan, Sufala Viswas Rao
BACKGROUND: Dexmedetomidine and clonidine have been used for the prevention and treatment of shivering following spinal blockade. A prospective randomized, double-blinded study was conducted to compare the efficacy and safety of dexmedetomidine and clonidine in controlling postspinal shivering. METHODS: A total of sixty participants of equal sex, aged between 18 and 60 years of American Society of Anesthesiologists (ASA) I/II Class, who underwent orthopedic lower limb surgeries under spinal anesthesia with ≥Grade III shivering were randomly divided into two groups, Group D (n = 30) received injection dexmedetomidine 0...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298765/obturator-nerve-block-in-transurethral-resection-of-bladder-tumor-a-comparative-study-by-two-techniques
#8
Deepak Sharma, V P Singh, Nidhi Agarwal, M K Malhotra
CONTEXT: Sparing of obturator nerve is a common problem encountered during transurethral resection of bladder tumor (TURBT) under spinal anesthesia. AIMS: To evaluate and compare obturator nerve block (ONB) by two different techniques during TURBT. SETTINGS AND DESIGN: This is prospective observational study. SUBJECTS AND METHODS: Forty adult male patients from the American Society of Anesthesiologists Class I-IV planned to undergo TURBT under spinal anesthesia were divided into two groups of twenty each...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298762/comparison-of-butorphanol-and-fentanyl-for-the-relief-of-postoperative-shivering-associated-with-spinal-anesthesia
#9
Venkata Sesha Sai Krishna Manne, Srinivasa Rao Gondi
AIM: The aim of this study was to compare fentanyl and butorphanol for the relief of postoperative shivering in spinal anesthesia. MATERIALS AND METHODS: A total of 100 American Society of Anesthesiologists physical status Class I and II patients aged 19-60 years belonging to both sexes who were posted for elective surgical procedures under spinal anesthesia were divided into two groups (fentanyl and butorphanol) and monitored intraoperatively for the occurrence of shivering and time taken to control shivering after administration of fentanyl and butorphanol drugs...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298760/the-effectiveness-of-intravenous-dexmedetomidine-on-perioperative-hemodynamics-analgesic-requirement-and-side-effects-profile-in-patients-undergoing-laparoscopic-surgery-under-general-anesthesia
#10
Vinayak Panchgar, Akshaya N Shetti, H B Sunitha, Vithal K Dhulkhed, A V Nadkarni
BACKGROUND: There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28295616/associations-between-anesthetic-variables-and-functional-outcome-in-dogs-with-thoracolumbar-intervertebral-disk-extrusion-undergoing-decompressive-hemilaminectomy
#11
J Fenn, E Laber, K Williams, C A Rousse, P J Early, C L Mariani, K R Muñana, S De Decker, H A Volk, N J Olby
BACKGROUND: Outcome of acute experimental spinal cord injury is strongly associated with tissue perfusion and oxygenation. Cardiopulmonary depression could affect outcome in dogs undergoing general anesthesia for surgical treatment of thoracolumbar intervertebral disk extrusion (IVDE). HYPOTHESIS/OBJECTIVES: To evaluate the effects of general anesthesia on functional outcome in dogs undergoing surgery to treat thoracolumbar IVDE. ANIMALS: Eighty-four client-owned dogs with acute thoracolumbar IVDE treated by decompressive hemilaminectomy...
March 13, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28291456/anesthesia-and-postoperative-respiratory-compromise-following-major-lower-extremity-surgery-implications-for-combat-casualties
#12
Samuel M Galvagno, Jordan Brayanov, George Williams, Edward E George
Care of military casualties requires not only assessment of patient, injury, and setting, but also the consequences of care decisions on other organ systems. In contemporary conflicts, pelviperineal and lower extremity trauma are common injuries, yet the optimal perioperative anesthetic and analgesic care remains unclear. Residual anesthesia and opioids can cause respiratory depression, specifically postoperative respiratory depression and opioid-induced respiratory depression. This observational study quantified and compared the incidences of respiratory depression following general anesthesia (GA) and spinal anesthesia (SA) for lower extremity surgery...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28289667/laparoscopic-cholecystectomy-under-spinal-epidural-anesthesia-vs-general-anaesthesia-a-prospective-randomised-study
#13
Turgut Donmez, Vuslat Muslu Erdem, Sinan Uzman, Dogan Yildirim, Huseyin Avaroglu, Sina Ferahman, Oguzhan Sunamak
PURPOSE: Laparoscopic cholecystectomy (LC) is usually performed under the general anesthesia (GA). Aim of the study is to investigate the availability, safety and side effects of combined spinal/epidural anesthesia (CSEA) and comparison it with GA for LC. METHODS: Forty-nine patients who have a LC plan were included into the study. The patients were randomly divided into GA (n = 25) and CSEA (n = 24) groups. Intraoperative and postoperative adverse events, postoperative pain levels were compared between groups...
March 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28289619/the-effect-of-ondansetron-and-dexamethasone-on-nausea-and-vomiting-under-spinal-anesthesia
#14
Navid Kalani, Hasan Zabetian, Mohammad Sadegh Sanie, Mansour Deylami, Mohammad Radmehr, Reza Sahraei, Hossein Kargar Jahromi, Wesam Kooti
BACKGROUND: During abdominal surgery under regional anesthesia, nausea may happen due to several contributing factors. This study compared the effects of ondansetron and dexamethasone on nausea and vomiting under spinal anesthesia. METHODS: One hundred and twenty patients of 15 to 35 years old with ASA class I and II were enrolled. Before administering either ondansetron or dexamethasone, blood pressure and heart rate of the patients were recorded. The patients received 70 mg of 5% lidocaine for spinal anesthesia...
January 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28285318/effects-on-qtc-interval-of-2-different-doses-of-spinal-anesthesia-in-inguinal-hernia-operations
#15
Onur Hanbeyoglu, Aykut Urfalioglu, Fatih Mehmet Yazar, Sibel Ozcan
BACKGROUND Cardiac arrhythmia is a significant cause of morbidity and mortality. In this study, through examination of the effects on the QTc interval of different doses of hyperbaric bupivacaine, we investigated the relationship with arrhythmia. MATERIAL AND METHODS A total of 60 patients were separated into 2 groups: spinal block was applied with 10 mg bupivacaine to Group S1 and with 15 mg to Group S2. The mean arterial pressure (MAP) and heart rate (HR) values were recorded before the spinal block and at 5 and 30 min after the block and at 60 min postoperatively...
March 12, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28282425/administration-of-tranexamic-acid-to-patients-undergoing-surgery-for-adolescent-idiopathic-scoliosis-evokes-pain-and-increases-the-infusion-rate-of-remifentanil-during-the-surgery
#16
Nobuko Ohashi, Masayuki Ohashi, Naoto Endo, Tatsuro Kohno
BACKGROUND: We recently reported that tranexamic acid (TXA) evokes pain in rats by inhibiting γ-aminobutyric acid and glycine receptors on neurons in the spinal dorsal horn. Although TXA is commonly used to reduce perioperative blood loss during various surgeries, its potential to induce intraoperative nociception, thereby increasing the need for more analgesics during surgery, has not been investigated. Therefore, this study aimed to investigate whether TXA evokes pain and increases the need for a higher infusion rate of remifentanil in patients undergoing surgery for adolescent idiopathic scoliosis (AIS)...
2017: PloS One
https://www.readbyqxmd.com/read/28277546/decerebrate-mouse-model-for-studies-of-the-spinal-cord-circuits
#17
Claire F Meehan, Kyle A Mayr, Marin Manuel, Stan T Nakanishi, Patrick J Whelan
The adult decerebrate mouse model (a mouse with the cerebrum removed) enables the study of sensory-motor integration and motor output from the spinal cord for several hours without compromising these functions with anesthesia. For example, the decerebrate mouse is ideal for examining locomotor behavior using intracellular recording approaches, which would not be possible using current anesthetized preparations. This protocol describes the steps required to achieve a low-blood-loss decerebration in the mouse and approaches for recording signals from spinal cord neurons with a focus on motoneurons...
April 2017: Nature Protocols
https://www.readbyqxmd.com/read/28277380/update-on-developmental-anesthesia-neurotoxicity
#18
Laszlo Vutskits, Andrew Davidson
PURPOSE OF REVIEW: Adverse long-term impact of general anesthesia on the developing brain is a widely discussed and controversial issue with potential public health relevance. The goal of this article is to give insights into the most recent experimental and clinical observations aimed to advance our understanding in this field. RECENT FINDINGS: Recent investigations demonstrate long-term behavioral consequences of early-life anesthesia exposure in nonhuman primates under experimental conditions that are translationally relevant to human clinical practice...
March 8, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28277324/risk-factors-for-severe-postpartum-hemorrhage-after-cesarean-delivery-case-control-studies
#19
Alexander J Butwick, Bharathi Ramachandran, Priya Hegde, Edward T Riley, Yasser Y El-Sayed, Lorene M Nelson
BACKGROUND: Women who undergo intrapartum caesarean delivery (CD) are at increased risk of postpartum hemorrhage (PPH) compared with those undergoing prelabor CD. To determine whether the presence and strength of the associations between individual risk factors and severe PPH vary among women undergoing prelabor CD or intrapartum CD, stratified analyses are needed according to CD subtype. METHODS: To identify risk factors for severe PPH within 2 distinct CD populations, prelabor CD and intrapartum CD, we performed 2 case-control studies...
March 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28268745/development-of-artificial-tissue-like-structures-for-a-hybrid-epidural-anesthesia-simulator
#20
Benjamin Esterer, Johannes Razenbock, Marianne Hollensteiner, David Fuerst, Andreas Schrempf
Puncturing the epidural space and lumbar puncture are common procedures in anesthesia. They are carried out blind, where a needle is advanced from posterior between two adjacent vertebrae. Two different approaches are common practice for this technique, the midline and the paramedian one. The learning curve characteristics of both approaches significantly depends on the number of punctures carried out by a medical novice. For the training of these blind procedures a hybrid simulator requires artificial structures imitating the tissues which are penetrated by the needle...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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