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https://www.readbyqxmd.com/read/29470714/surgical-management-of-cauda-syndrome-in-third-trimester-of-pregnancy-focusing-on-spinal-anesthesia-and-right-lateral-positioning-during-surgery-as-possible-practices
#1
REVIEW
Viktor Zsolt Kovari, Laszlo Horvath
PURPOSE: This article presents a surgical solution of a lumbar disc hernia of a pregnant woman focusing on the use of right lateral positioning, spinal anesthesia which has not previously been utilized in third trimester and discusses positioning options, and possible anesthesia methods with the surgical procedure options. METHODS: Case report. RESULTS: A left-sided L5/S1 lumbar disc hernia (verified by magnetic resonance imaging) of a 35-year-old, 32-week-pregnant woman with a deteriorating neurological status leading to cauda syndrome was treated successfully by microdiscectomy in right lateral position applying spinal anesthesia...
February 22, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29470317/the-effects-of-leukocyte-filtration-on-cell-salvaged-autologous-blood-transfusion-on-lung-function-and-lung-inflammatory-and-oxidative-stress-reactions-in-elderly-patients-undergoing-lumbar-spinal-surgery
#2
Lili Xu, Jianjun Shen, Jianliang Sun, Patrick M McQuillan, Zhiyong Hu
BACKGROUND: This study was designed to investigate the effects of leukocyte filtration of autologous salvaged blood on lung function, lung inflammatory reaction, and oxidative stress reaction in elderly patients undergoing lumbar spinal surgery. MATERIALS AND METHODS: Sixty elderly patients undergoing lumbar spinal surgery were randomly divided into 2 groups: Leukocyte Filter group and Control group. Serum levels of inflammatory markers including white blood cell and polymorphonuclear count, neutrophil elastase, serum surfactant protein A, methane dicarboxylic aldehyde, superoxide dismutase, interleukin (IL)-6, IL-8, tumor necrosis factor-α, and respiratory function markers including dynamic respiratory system compliance, oxygenation index, and respiratory index were measured immediately before induction of anesthesia (T0), immediately before blood transfusion (T1), and 1 (T2), 6 (T3), and 12 hours (T4) after end of blood transfusion...
February 21, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29466935/endovascular-approach-in-isolated-abdominal-aortic-dissections
#3
Kaptanıderya Tayfur, Mehmet Senel Bademci, Serkan Yazman, Murat Canyigit
Background Here, we report the mid-term results of endovascular treatment of isolated dissection of the abdominal aorta, which is a very rare pathology. Materials and methods A total of 11 patients (4 males (36.3%) and 7 females (63.6%)) aged 42-72 (mean, 60.3 ± 10.45) years with isolated dissection of the abdominal aorta underwent endovascular stent-graft treatment at our institution between August 2010 and September 2015. Eight patients were symptomatic, and the remaining three were asymptomatic. The asymptomatic patients had aortic aneurysms coexisting with dissection...
January 1, 2018: Vascular
https://www.readbyqxmd.com/read/29461392/combined-colloid-preload-and-crystalloid-coload-versus-crystalloid-coload-during-spinal-anesthesia-for-cesarean-delivery-a-randomized-controlled-trial
#4
Mohamed Mohamed Tawfik, Amany Ismail Tarbay, Ahmed Mohamed Elaidy, Karim Ali Awad, Hanaa Mohamed Ezz, Mohamed Ahmed Tolba
BACKGROUND: The optimal strategy of fluid administration during spinal anesthesia for cesarean delivery is still unclear. Ultrasonography of the inferior vena cava (IVC) has been recently used to assess the volume status and predict fluid responsiveness. In this double-blind, randomized controlled study, we compared maternal hemodynamics using a combination of 500-mL colloid preload and 500-mL crystalloid coload versus 1000-mL crystalloid coload. We assessed the IVC at baseline and at subsequent time points after spinal anesthesia...
February 14, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29457538/effects-of-dexmedetomidine-infusion-during-spinal-anesthesia-on-hemodynamics-and-sedation
#5
Ebru Tarıkçı Kılıç, Gaye Aydın
We evaluated the effects of intravenous dexmedetomidine during spinal anesthesia on hemodynamics, respiratory rate, oxygen saturation, sedpain, and compared them with those of saline infusion. Sixty American Society of Anesthesiologists physical status I and II cases were randomly divided into two groups. Patients were connected to the monitor after premedication, and spinal anesthesia was administered. Sensory and motor blockades were assessed using pinprick test and Bromage scale, respectively. Group I received dexmedetomidine infusion and Group II received saline infusion...
December 2018: Libyan Journal of Medicine
https://www.readbyqxmd.com/read/29457122/a-case-of-spinal-anesthesia-in-a-patient-with-progressive-supranuclear-palsy
#6
Momoka Tonan, Moritoki Egi, Nana Furushima, Satoshi Mizobuchi
Progressive supranuclear palsy (PSP) is one of the rare diseases. PSP is characterized by oculomotor dysfunction, postural instability, akinesia, dysarthria, and dysphagia. The major cause of death in patients with PSP is aspiration pneumonia. Considering these complications, spinal anesthesia is useful in patients with PSP. However, the potential harmful effects of spinal anesthesia including neurotoxicity of local anesthetics and neurologic complications for patients with PSP are unclear, because there has been no report...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29457116/a-spinal-cord-infarction-that-occurred-after-laparoscopic-gastrectomy-performed-under-general-anesthesia-and-epidural-analgesia
#7
Kei Houri, Shinichi Hamasaki, Takatoshi Tsujimoto, Tomohisa Uchida, Tatsushige Iwamoto, Toru Shirai, Shinichi Nakao
Background: Spinal cord infarction (SCI) after epidural anesthesia is quite rare. Although most cases of perioperative SCI are associated with aortic, cardiac, or spinal surgery, and/or abnormal preoperative conditions, such as spinal stenosis or hypercoagulopathy, intraoperative events, such as severe hypotension or epidural puncture and catheterization, can be contributory factors. Case presentation: A 52-year-old male was underwent laparoscopic gastrectomy. Before induction of general anesthesia, an epidural catheter was placed without any problems...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29457115/comparison-of-inflationary-non-invasive-blood-pressure-inibp-monitoring-technology-and-conventional-deflationary-non-invasive-blood-pressure-dnibp-measurement-in-detecting-hypotension-during-cesarean-section
#8
Akiko Yamashita, Shingo Irikoma
Background: The Nihon Kohden linear inflationary non-invasive blood pressure (iNIBP) monitoring technology is an oscillometric device that measures blood pressure by detecting oscillations during inflation. Systolic blood pressure can be recorded without overinflating the cuff higher than the true systolic pressure. Thus, total time taken for inflation and deflation is shorter than that by the conventional deflation devices. In this study, the ability of iNIBP to detect maternal hypotension during cesarean section faster than deflationary non-invasive blood pressure (dNIBP) monitoring devices under clinical settings was evaluated prospectively...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29457113/pulmonary-embolism-caused-by-ovarian-vein-thrombosis-during-cesarean-section-a-case-report
#9
Yutaka Oda, Michie Fujita, Chika Motohisa, Shinichi Nakata, Motoko Shimada, Ryushi Komatsu
Background: Ovarian vein thrombosis is a rare complication of pregnancy. The representative complaints of patients with ovarian vein thrombosis are abdominal pain and fever. In some cases, however, fatal pulmonary embolism may develop. We report a case of pulmonary embolism presenting with severe hypotension and loss of consciousness during cesarean section possibly caused by ovarian vein thrombosis. Case presentation: A 25-year-old woman at 38 weeks 4 days of gestation was scheduled for repeat cesarean section...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29457112/anesthetic-management-during-a-cesarean-section-in-a-patient-with-cleidocranial-dysplasia-a-case-report
#10
Yumiko Nishio, Teruyuki Hiraki, Hiroko Taniguchi, Kazuo Ushijima
Background: Cleidocranial dysplasia is a type of skeletal dysplasia, which is primarily characterized by delayed ossification of skeletal structures. It causes facial and oral abnormalities, resulting in difficult airway management and neuraxial anesthesia. Case presentation: The patient was a 24-year-old primipara (height 138 cm, weight 42 kg) with a hypoplastic right clavicle, patent fontanelles, dental malalignment, and a high palate. She was diagnosed with cleidocranial dysplasia at birth, although gene examination has not been performed...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29453468/prevention-of-shivering-during-spinal-anesthesia-comparison-between-tramadol-ketamine-and-ondansetron
#11
Gajal Lakhe, Krishna Murari Adhikari, Kiran Khatri, Anil Maharjan, Akriti Bajracharya, Himdip Khanal
INTRODUCTION: Shivering is an unpleasant experience after spinal anesthesia. We conducted this study to evaluate the efficacy of ondansetron, ketamine and tramadol for prevention of shivering. METHODS: In this randomized controlled study, 120 patients aged 18-65 years of American Society of Anesthesiologist (ASA) physical status I and II undergoing various surgical procedures were included and allocated alternately to one of the 4 groups; Normal saline (Group1), Ondansetron 4mg (Group2), Ketamine 0...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29447730/no-163-gynaecological-and-obstetric-management-of-women-with-inherited-bleeding-disorders
#12
Christine Demers, Christine Derzko, Michele David, Joanne Douglas
OBJECTIVE: The prevalence of bleeding disorders, notably von Willebrand disease (vWD), among adult women with objectively documented menorrhagia is consistently reported to be 10% to 20% and is even higher in adolescents presenting with menorrhagia. OPTIONS: Diagnostic tools and specific medical and, where appropriate, surgical alternatives to management are reviewed and evidence-based recommendations presented. EVIDENCE: A MEDLINE search of the English literature between January 1975 and November 2003 was performed using the following key words: menorrhagia, uterine bleeding, pregnancy, von Willebrand, congenital bleeding disorder, desmopressin/DDAVP, tranexamic acid, oral contraceptives, medroxyprogesterone, therapy, hysterectomy, anesthesia, epidural, spinal...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29438243/effect-of-spinal-versus-general-anesthesia-in-study-comparing-three-methods-of-using-local-anesthetics-to-achieve-post-knee-arthroplasty-pain
#13
https://www.readbyqxmd.com/read/29434783/the-application-of-nalbuphine-in-patient-controlled-intravenous-analgesia-for-patients-undergoing-subtotal-gastrectomy
#14
Li Yang, Jinjing Wu, Tao Li
The aim of the present study was to investigate the analgesic effect and safety of the application of different doses of nalbuphine in patient-controlled intravenous analgesia (PCIA) for patients undergoing subtotal gastrectomy. A total of 120 patients, who underwent subtotal gastrectomy at our hospital between May, 2015 and January, 2017 under combined spinal epidural combined anesthesia, were selected. The patients received PCIA after surgery. The patients were randomly divided into four groups, including the morphine (MOP group), nalbuphine 60 mg (N60 group), nalbuphine 80 mg (N80 group) and nalbuphine 100 mg (N100 group)...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29433962/does-intrathecal-morphine-in-spinal-anesthesia-have-a-role-in-modern-multimodal-analgesia-for-primary-total-joint-arthroplasty
#15
Jonathan W Cheah, David C Sing, Erik N Hansen, Pedram Aleshi, Thomas P Vail
BACKGROUND: Intrathecal morphine (ITM) combined with bupivacaine spinal anesthesia can improve postoperative pain, but has potential side effects of postoperative nausea/vomiting (PONV) and pruritus. With the use of multimodal analgesia and regional anesthetic techniques, postoperative pain control has improved significantly to a point where ITM may be avoided in total joint arthroplasty (TJA). METHODS: We performed a retrospective study of primary TJA patients who underwent a standardized multimodal recovery pathway and received bupivacaine neuraxial anesthesia with ITM vs bupivacaine neuraxial anesthesia alone (control)...
January 31, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29431275/burst-spinal-cord-stimulation-review-of-preclinical-studies-and-comments-on-clinical-outcomes
#16
REVIEW
Krishnan Chakravarthy, Alexander R Kent, Adil Raza, Fang Xing, Thomas M Kinfe
BACKGROUND: Burst spinal cord stimulation (SCS) technology uses a novel waveform that consists of closely packed high-frequency electrical impulses followed by a quiescent period. Within the growing field of neuromodulation, burst stimulation is unique in that it mimics the natural burst firing of the nervous system, in particular the thalamo-cingulate rhythmicity, resulting in modulation of the affective and attentional components of pain processing (e.g., medial thalamic pathways). STUDY DESIGN: A review of preclinical and clinical studies regarding burst SCS for various chronic pain states...
February 12, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29429882/mepivacaine-spinal-anesthesia-facilitates-rapid-recovery-in-total-knee-arthroplasty-compared-to-bupivacaine
#17
M Chad Mahan, Toufic R Jildeh, Troy N Tenbrunsel, Jason J Davis
BACKGROUND: Mepivacaine as a spinal anesthetic for rapid recovery in total knee arthroplasty (TKA) has not been assessed. The purpose of this study is to compare spinal mepivacaine vs bupivacaine for postoperative measures in patients undergoing primary TKA. METHODS: Retrospective review of a prospectively collected single-institution database was performed on 156 consecutive patients who underwent primary TKA. Fifty-three patients were administered mepivacaine and 103 patients were administered bupivacaine...
January 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29427348/the-effect-of-tramadol-on-sneeze-induced-urethral-continence-reflex-through-%C3%AE-opioid-receptors-in-the-spinal-cord-in-rats
#18
Asuka Ashikari, Minoru Miyazato, Ryu Kimura, Takuma Oshiro, Seiichi Saito
AIMS: We examined the efficacy of tramadol on the urethral reflex during sneezing, as well as the role of µ-opioid receptors in the spinal cord, in rats. METHODS: Forty-one female Sprague-Dawley rats were used. The rats were divided into normal female rats and rats with vaginal distension (VD), which mimics stress urinary incontinence (SUI) in humans. Under urethane anesthesia, the sneeze-induced amplitude of urethral responses (AUR) and baseline pressure (BP) were examined after intravenous injection of tramadol using a microtransducer-tipped catheter in both rat groups...
February 10, 2018: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29424008/prophylactic-granisetron-for-post-spinal-anesthesia-shivering-in-caesarean-section-a-randomized-controlled-clinical-study
#19
H S Abdel-Ghaffar, S M Moeen
BACKGROUND: The serotonergic system is known to be involved in control of post-anesthetic shivering. Our hypothesis was that prophylactic granisetrone (serotonin antagonist) might reduce incidence of post- spinal anesthesia shivering in cesarean section. METHODS: Parturient scheduled for elective Caesarean delivery under spinal anesthesia were allocated to receive 0.9% saline (Group I, n = 71), 1 mg granisetron (Group II, n = 69), or 0.7 mg granisetron (Group III, n = 72) before the spinal block...
February 8, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29421324/effects-of-propofol-anesthesia-on-the-processing-of-noxious-stimuli-in-the-spinal-cord-and-the-brain
#20
Gregor Lichtner, Ryszard Auksztulewicz, Evgeniya Kirilina, Helena Velten, Dionysios Mavrodis, Michael Scheel, Felix Blankenburg, Falk von Dincklage
Drug-induced unconsciousness is an essential component of general anesthesia, commonly attributed to attenuation of higher-order processing of external stimuli and a resulting loss of information integration capabilities of the brain. In this study, we investigated how the hypnotic drug propofol at doses comparable to those in clinical practice influences the processing of somatosensory stimuli in the spinal cord and in primary and higher-order cortices. Using nociceptive reflexes, somatosensory evoked potentials and functional magnet resonance imaging (fMRI), we found that propofol abolishes the processing of innocuous and moderate noxious stimuli at low to medium concentration levels, but that intense noxious stimuli evoked spinal and cerebral responses even during deep propofol anesthesia that caused profound electroencephalogram (EEG) burst suppression...
February 5, 2018: NeuroImage
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