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Ultrasound-guided epidural

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https://www.readbyqxmd.com/read/30086609/caudal-and-epidural-blocks-in-infants-and-small-children-historical-perspective-and-ultrasound-guided-approaches
#1
Hae Keum Kil
In infants and small children, ultrasound (US) provides ample anatomical information in combination with neuraxial block. We can measure the distance from the skin to the epidural space in the US image and can refer to it in the needle puncture. And we may detect the needle or a catheter during real-time US-guided epidural catheterization. In cases where direct needle or catheter visualization is difficult, US allows predicting successful puncture and catheterization using surrogate markers, such as dura mater displacement, epidural space widening due to drug injection, or mass movement of the drug within the caudal space...
August 8, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/30037303/should-we-assess-the-epidural-anaesthetic-spread-during-ultrasound-guided-thoracic-paravertebral-block
#2
Emanuele Piraccini, Giulia Biondi, Ruggero M Corso, Stefano Maitan
No abstract text is available yet for this article.
July 1, 2018: Tumori
https://www.readbyqxmd.com/read/30020155/an-update-on-regional-analgesia-for-rib-fractures
#3
Venkatesan Thiruvenkatarajan, Hillen Cruz Eng, Sanjib Das Adhikary
PURPOSE OF REVIEW: To provide an update on new strategies for pain management after rib fractures utilizing regional analgesia. RECENT FINDINGS: Pain management for patients with rib fractures can be very challenging. Traditionally, intravenous patient-controlled analgesia (IVPCA) with opioids, epidural, and paravertebral blocks have been used. These techniques, however, may be contraindicated or have limited application in certain patient populations. Recently, ultrasound-guided myofascial plane blocks such as the erector spinae plane (ESP) block and the serratus anterior plane (SAP) block have emerged as alternatives; providing excellent analgesia with minimal side effects...
July 16, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29994941/recent-developments-in-ultrasound-imaging-for-neuraxial-blockade
#4
Ki Jinn Chin
PURPOSE OF REVIEW: Recent research has shed further light on the place of ultrasound imaging in neuraxial blockade in routine clinical practice, its use in thoracic epidurals, and real-time ultrasound-guided techniques. RECENT FINDINGS: Compared with the conventional technique of surface landmark palpation, preprocedural ultrasound imaging minimizes technical difficulty associated with lumbar neuraxial blockade in patients with poor-quality surface landmarks. Novice practitioners are able to learn to employ the technique effectively...
July 9, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29983183/-ultrasound-guided-thoracic-paravertebral-block-for-closed-loop-ileostomy-repair-in-severe-copd-a-case-report
#5
Rocco D'Andrea, Guido Gambetti, Lorenzo Querci, Beatrice Amodei, Amedeo Bianchini
BACKGROUND AND OBJECTIVES: Ultrasound-guided thoracic paravertebral block is usually considered a good alternative to epidural thoracic for anesthesia and pain control in thoracic and breast surgery. Furthermore it has also been used during abdominal surgery lately, especially hepatic and renal surgery. However, its role is poorly defined in this context. The purpose of this report was to highlight the role of thoracic paravertebral block in providing effective anesthesia and analgesia during both the abdominal surgical intervention and pain control in post-operative period, avoiding possible complications which general anesthesia may arise, which are fairly common in patients with chronic obstructive pulmonary disease and similar comorbidities...
July 5, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29931665/risk-factors-for-the-development-of-horner-s-syndrome-following-interscalene-brachial-plexus-block-using-ropivacaine-for-shoulder-arthroscopy-a-randomised-trial
#6
Michał Stasiowski, Marek Zuber, Radosław Marciniak, Michał Kolny, Ewa Chabierska, Przemysław Jałowiecki, Aleksandra Pluta, Anna Missir
BACKGROUND: Horner's syndrome is comprised of a set of symptoms caused by a permanent or transient ipsilateral sympathetic trunk lesion or paralysis. It may occur after numerous pathologies in the cervical region, epidural, spinal anaesthesia, and interscalene, transscalene, supraclavicular, or infraclavicular brachial plexus block. The aim of this randomised, prospective clinical study was to evaluate the effect of the interscalene brachial plexus block (IBPB) technique on the occurrence rate of Horner's syndrome and identify contributing risk factors...
June 22, 2018: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29923954/is-a-retrolaminar-approach-to-the-thoracic-paravertebral-space-possible-a-human-cadaveric-study
#7
A Sassan Sabouri, Lane Crawford, Sarah K Bick, Ala Nozari, Thomas A Anderson
BACKGROUND AND OBJECTIVES: The retrolaminar block (RB) is used for truncal analgesia, but its mechanism of neural blockade remains obscure. We sought to learn the pattern of local anesthetic spread after thoracic RB using cadaveric models. METHODS: In 8 fresh cadavers, an ultrasound-guided T4 RB was performed with 20 mL of methylene blue 1% and bupivacaine 0.5%. For comparison, an RB at T9 in 1 cadaver and a T4 thoracic paravertebral block in another cadaver were performed...
June 19, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29794944/use-of-serratus-plane-block-for-repair-of-coarctation-of-aorta-a-report-of-3-cases
#8
Abhijit Biswas, Igor Luginbuehl, Elod Szabo, Monica Caldeira-Kulbakas, Mark W Crawford, Tobias Everett
OBJECTIVES: The practice of regional anesthesia techniques (thoracic, epidural, paravertebral) in pediatric cardiac surgery enhances perioperative outcomes such as improved perioperative analgesia, decreased stress response, early extubation, and shortened hospital stay. However, these blocks can be technically challenging and can be associated with unacceptable failure rate and complications in infants. For these reasons, regional anesthesia is sometimes avoided in pediatric cardiac surgery...
August 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29794943/erector-spinae-plane-block-versus-retrolaminar-block-a-magnetic-resonance-imaging-and-anatomical-study
#9
Sanjib Das Adhikary, Stephanie Bernard, Hector Lopez, Ki Jinn Chin
BACKGROUND AND OBJECTIVES: The erector spinae plane (ESP) and retrolaminar blocks are ultrasound-guided techniques for thoracoabdominal wall analgesia involving injection into the musculofascial plane between the paraspinal back muscles and underlying thoracic vertebrae. The ESP block targets the tips of the transverse processes, whereas the retrolaminar block targets the laminae. We investigated if there were differences in injectate spread between the 2 techniques that would have implications for their clinical effect...
May 23, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29730268/thoracic-paravertebral-block-versus-thoracic-epidural-analgesia-for-post-operative-pain-control-in-open-pancreatic-surgery-a-randomized-controlled-trial
#10
Jacob L Hutchins, Anthony J Grandelis, Alexander M Kaizer, Eric H Jensen
STUDY OBJECTIVE: The purpose of this study was to compare the efficacy of bilateral ultrasound guided thoracic paravertebral catheters to a thoracic epidural after open pancreatic surgery. DESIGN: This was a prospective non-blinded randomized controlled trial. SETTING: Academic hospital operating room, postoperative recovery area, and ward. PATIENTS: 53 patients aged 18 and above who had open pancreatic surgery. INTERVENTIONS: Patients received either bilateral thoracic paravertebral block at T8 with an infusion of 0...
August 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29512006/convolution-neural-networks-for-real-time-needle-detection-and-localization-in-2d-ultrasound
#11
Cosmas Mwikirize, John L Nosher, Ilker Hacihaliloglu
PURPOSE: We propose a framework for automatic and accurate detection of steeply inserted needles in 2D ultrasound data using convolution neural networks. We demonstrate its application in needle trajectory estimation and tip localization. METHODS: Our approach consists of a unified network, comprising a fully convolutional network (FCN) and a fast region-based convolutional neural network (R-CNN). The FCN proposes candidate regions, which are then fed to a fast R-CNN for finer needle detection...
May 2018: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/29457120/spread-of-injectate-in-ultrasound-guided-serratus-plane-block-a-cadaveric-study
#12
Tatsuya Kunigo, Takeshi Murouchi, Shuji Yamamoto, Michiaki Yamakage
Background: Serratus plane block is a thoracic truncal block that has been proposed as alternatives for analgesia such as epidural anesthesia and paravertebral block for the anterolateral chest wall. Previously, we performed the clinical study about optimal volume of the local anesthetic in serratus plane block. The primary aim of this study was to assess the pattern of distribution of dye into the serratus plane of cadavers after ultrasound-guided serratus plane injection. Findings: Ultrasound-guided serratus plane injection was performed at the level of the fourth rib on the mid-axillary line in nine adult Thiel-embalmed cadavers...
2018: JA clinical reports
https://www.readbyqxmd.com/read/29454333/comparative-study-of-ultrasound-guided-paravertebral-block-versus-intravenous-tramadol-for-postoperative-pain-control-in-percutaneous-nephrolithotomy
#13
Zehra Hatipoglu, Ersel Gulec, Mediha Turktan, Volkan Izol, Atilla Arıdogan, Yasemin Gunes, Dilek Ozcengiz
BACKGROUND: Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure for renal calculi, and nephrostomy tubes lead to postoperative pain after PCNL. Regional techniques (e.g., epidural analgesia and peripheral blocks) and opioids are applied for postoperative pain treatment. The aim of this study was to compare effectiveness of ultrasound-guided paravertebral block (PVB) and tramadol on postoperative pain in patients who underwent PCNL. METHOD: Fifty-three patients were included in this prospective randomized study...
February 17, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29445296/the-ultrasound-guided-retrolaminar-block-volume-dependent-injectate-distribution
#14
Marija Damjanovska, Tatjana Stopar Pintaric, Erika Cvetko, Kamen Vlassakov
Purpose: The ultrasound-guided retrolaminar block is one of the newer and simpler alternatives to the traditional, often technically challenging, paravertebral (PV) block. Its feasibility, safety, and efficacy have already been clinically demonstrated in patients with multiple rib fractures using higher volumes of local anesthetic, when compared with the traditional approach. The primary aim of this observational anatomical study was to assess the spread of local anesthetic from the retrolaminar injection point to the PV space and its volume dependence...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29428372/comparative-study-on-the-analgesic-effect-of-acute-ipsilateral-shoulder-pain-after-open-thoracotomy-between-preoperative-ultrasound-guided-suprascapular-nerve-block-snb-and-intraoperative-phrenic-nerve-infiltration-pni-in-cancer-lung-patients
#15
Bassel M Elfokery, Sahar A Tawfic, Abdelrahman M Abdelrahman, Dina N Abbas, Ikramy M Abdelghaffar
INTRODUCTION: Acute ipsilateral shoulder pain (ISP) is a common complaint in patients after thoracotomy. The incidence ranges from 21% to 97%. Unfortunately, clinical studies did not put enough focus on ISP post thoracic surgery. AIM OF THE WORK: This study was designed to compare the effectiveness of suprascapular nerve block (SNB) and phrenic nerve infiltration (PNI) for controlling ISP. PATIENTS AND METHODS: One hundred and thirty-five lung cancer patients (135) scheduled for open-lung surgery were randomly allocated into three equal groups; control group: received thoracic epidural with general anesthesia, suprascapular group: (SNB) one hour before the operation with 10 ml bupivacaine plus thoracic epidural with general anesthesia and phrenic nerve group: (PNI) was performed by the operating surgeon with 10 ml bupivacaine plus thoracic epidural with general anesthesia...
March 2018: Journal of the Egyptian National Cancer Institute
https://www.readbyqxmd.com/read/29415656/comparison-of-lumbar-plexus-block-using-the-short-axis-in-plane-method-at-the-plane-of-the-transverse-process-and-at-the-articular-process-a-randomized-controlled-trial
#16
Rui Lu, Chengcheng Shen, Chunyong Yang, Yan Chen, Juanjuan Li, Kaizhi Lu
BACKGROUND: Although the safety and effectiveness of the short-axis in-plane method has been confirmed for lumbar plexus block, the operation is difficult and has a high rate of epidural spread at the plane of the articular process. Therefore, we developed a new in-plane technique, called the beach chair method, which displays images from the transverse process. We compared the operative difficulty and incidence of epidural spread of the beach chair method with those of the control method (at the plane of the articular process) in this randomized controlled clinical trial...
February 7, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29398529/a-sonographic-investigation-for-the-development-of-ultrasound-guided-paravertebral-brachial-plexus-block-in-dogs-cadaveric-study
#17
Paolo Monticelli, Ella Fitzgerald, Jaime Viscasillas
OBJECTIVE: To describe a novel in-plane ultrasound (US)-guided approach to the sixth (C6), seventh (C7), eighth (C8) cervical and to the first thoracic (T1) spinal nerves. STUDY DESIGN: Prospective, descriptive, experimental anatomic study. ANIMALS: A total of seven canine Beagle cadavers. METHODS: Phase 1: One cadaver was used to define bony landmarks for the C6-T1 spinal nerves using computed tomography (CT) and magnetic resonance imaging...
March 2018: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29389653/accumulated-angle-factor-based-beamforming-to-improve-the-visualization-of-spinal-structures-in-ultrasound-images
#18
Bo Zhuang, Robert Rohling, Purang Abolmaesumi
In recent years, ultrasound has been increasingly used to guide needle insertion procedures for spinal anesthesia. The primary anatomical targets are facet joints and epidural spaces. For these procedures, accurate visualization of the spine anatomy is of critical importance. Challenges arising from the interactions between the ultrasound beam and spinal structures including tilt caused by specular reflections, off-axis interference, and reverberations often result in weakened and blurred vertebra surfaces...
February 2018: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/29374352/image-guidance-technologies-for-interventional-pain-procedures-ultrasound-fluoroscopy-and-ct
#19
REVIEW
Dajie Wang
Chronic pain is a common medical condition. Patients who suffer uncontrolled chronic pain may require interventions including spinal injections and various nerve blocks. Interventional procedures have evolved and improved over time since epidural injection was first introduced for low back pain and sciatica in 1901. One of the major contributors in the improvement of these interventions is the advancement of imaging guidance technologies. The utilization of image guidance has dramatically improved the accuracy and safety of these interventions...
January 26, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29332115/ultrasound-guided-transversus-abdominis-plane-block-postoperative-analgesia-in-children-with-spinal-dysraphism
#20
Eralp Çevikkalp, Koray Erbüyün, Serpil Erbüyün, Gülay Ok
Pediatric regional anesthesia is widely used to relieve postoperative pain after abdominal surgery. Commonly used techniques of regional anesthesia include lumbar epidural and caudal block. However, the use of central neuraxial blockade has limitations. It is contraindicated in patients with clotting abnormalities, spinal dysraphism with tethered cord syndrome, meningomyelocele, and following spinal surgery with instrumentation. Ultrasound guided transversus abdominis plane block is a new method of regional anesthesia that can be used in settings where central neuraxial blockade is contraindicated...
January 2018: Saudi Medical Journal
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