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Caudal epidural

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https://www.readbyqxmd.com/read/28937422/placement-of-stimulating-epidural-catheter-for-a-patient-with-large-scapular-sarcoma-a-case-report
#1
James D Turner, Sean W Dobson, Robert S Weller, Christopher M Lack, Daryl S Henshaw
We report the use of continuous electrical stimulation to assist with the preoperative placement of a thoracic epidural which was used to provide postoperative analgesia in a patient undergoing excision of a large scapular sarcoma. The size of the sarcoma and the surrounding area required to maintain a sterile surgical field necessitated that the epidural catheter be inserted several vertebral interspaces caudal to the level of desired catheter tip termination. The use of electrical stimulation allowed for sequential intercostal muscle stimulation during threading, which enabled the placement of the catheter tip at the appropriate spinal level to optimize analgesia...
September 20, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28934781/posture-influences-the-extent-of-spread-of-contrast-medium-during-thoracic-epidurography-a-prospective-randomized-trial
#2
Ji Hee Hong, Sung Won Jung, Ji Hoon Park
BACKGROUND: Various factors influencing the distribution of sensory blockade in epidural anesthesia have been identified; however, reports on the effects of gravity and different postures in thoracic epidural anesthesia have been rare. Medications may be injected with the lateral decubitus or the neutral position; however, it is unclear whether the distribution range of medication is similar or significantly different between these 2 postures. OBJECTIVE: We focused on identifying the effect of different postures on the distribution of local anesthetics using epidurography at the thoracic level...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28928587/unexpected-complication-after-caudal-epidural-steroid-injection-hiccup
#3
Ayhan Kaydu, Ebru Tarıkçı Kılıç, Erhan Gökçek, Mehmet Salim Akdemir
Persistent hiccup is uncommon, and the mechanism is poorly understood. We present the case of a 43-year-old male patient referred to the Algology department due to chronic back pain who developed what we believe a rare case of persistent hiccup secondary to caudal epidural steroid injection (CESI). The causes of hiccup are many and include electrolyte derangement, nutritional deficiencies, gastrointestinal disorders and instrumentation, cardiovascular disorders, renal impairment, central nervous system disorders, and drugs; however, the cause may be unknown...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28920043/short-term-analgesic-effects-of-5-dextrose-epidural-injections-for-chronic-low-back-pain-a-randomized-controlled-trial
#4
Liza Maniquis-Smigel, Kenneth Dean Reeves, Howard Jeffrey Rosen, John Lyftogt, Cassie Graham-Coleman, An-Lin Cheng, David Rabago
BACKGROUND: Hypertonic dextrose injection (prolotherapy) is reported to reduce pain including non-surgical chronic low back pain (CLBP), and subcutaneous injection of 5% dextrose is reported to reduce neurogenic pain, hyperalgesia and allodynia. The mechanism in both cases is unclear, though a direct effect of dextrose on neurogenic pain has been proposed. This study assessed the short-term analgesic effects of epidural 5% dextrose injection compared with saline for non-surgical CLBP...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28882370/caudal-epidural-anesthesia-in-mares-after-bicarbonate-addition-to-a-lidocaine-epinephrine-combination
#5
Patricia C Duarte, Cahuê F R Paz, Alvaro P L Oliveira, Thairê P Maróstica, Leticia O Cota, Rafael R Faleiros
OBJECTIVE: To investigate the nociceptive and clinical effects of buffering a lidocaine-epinephrine solution with sodium bicarbonate in caudal epidural block in mares. STUDY DESIGN: Prospective randomized controlled trial. ANIMALS: Six mixed-breed mares weighing 350-440 kg. METHODS: Each animal was administered two caudal epidural injections, 72 hours apart, using different solutions prepared immediately before injection...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28846539/catheterization-in-an-ultrasound-guided-thoracic-paravertebral-block%C3%A2-using-thoracoscopy
#6
T Fujii, Y Shibata, Y Ban, A Shitaokoshi, K Nishiwaki
Thoracic paravertebral block (TPVB) is an efficient alternative to epidural anesthesia. The location of a catheter within the thoracic paravertebral space (TPVS) has been examined in the human cadaver studies, but it is unclear how it goes into the TPVS during catheterization. In this report, thoracoscopy was used to observe the thoracic cavity in real-time during a parasagittal in-plane approach of ultrasound-guided TPVB. During thoracoscopy, we observed whether a paravertebral catheter could be advanced caudally beyond the ribs into the neighboring TPVS...
March 2017: Asian J Anesthesiol
https://www.readbyqxmd.com/read/28803750/motor-cortex-and-spinal-cord-neuromodulation-promote-corticospinal-tract-axonal-outgrowth-and-motor-recovery-after-cervical-contusion-spinal-cord-injury
#7
N Zareen, M Shinozaki, D Ryan, H Alexander, A Amer, D Q Truong, N Khadka, A Sarkar, S Naeem, M Bikson, J H Martin
Cervical injuries are the most common form of SCI. In this study, we used a neuromodulatory approach to promote skilled movement recovery and repair of the corticospinal tract (CST) after a moderately severe C4 midline contusion in adult rats. We used bilateral epidural intermittent theta burst (iTBS) electrical stimulation of motor cortex to promote CST axonal sprouting and cathodal trans-spinal direct current stimulation (tsDCS) to enhance spinal cord activation to motor cortex stimulation after injury. We used Finite Element Method (FEM) modeling to direct tsDCS to the cervical enlargement...
August 10, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28799128/the-influence-of-epidural-catheter-on-the-incidence-of-intravascular-injection-during-caudal-block
#8
Jin Young Lee, Sung Hyun Lee, Woo Seog Sim, Duk Kyung Kim, Sang Hoon Lee, Hyo Min Yun, Hue Jung Park
OBJECTIVE: The aim of this study was to analyze the influence of epidural catheters on the incidence of intravascular injection and to identify possible predictors of intravascular injection in patients undergoing a caudal block using fluoroscopy. METHODS: A total of 154 patients scheduled to receive a caudal block were randomized into group N (those without epidural catheter) or group C (those with epidural catheter). Demographic and clinical data were recorded and analyzed...
August 10, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28796547/do-superior-or-inferior-interlaminar-approach-or-bevel-orientation-predispose-to-nonepidural-needle-penetration
#9
Nicholas A Koontz, Richard H Wiggins, Gregory J Stoddard, Lubdha M Shah
OBJECTIVE: There is a paucity of evidence-based literature regarding the advantages and disadvantages of the interlaminar approach and needle bevel orientation for performing a lumbar interlaminar epidural steroid injection (ESI). The purpose of this study was to determine if superior versus inferior lamina approach, needle bevel tip orientation, or both may predispose to inadvertent nonepidural penetration during lumbar interlaminar ESI. SUBJECTS AND METHODS: A prospective study was performed of patients with low back pain with or without radicular pain or neurogenic claudication referred for lumbar interlaminar ESI...
August 10, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28795472/does-ultrasound-guidance-add-accuracy-to-continuous-caudal-epidural-catheter-placements-in-neonates-and-infants
#10
Vrushali C Ponde, Vinit V Bedekar, Ankit P Desai, Kiran A Puranik
BACKGROUND: Caudo-lumbar and caudo-thoracic epidural anesthesia is an established technique that carries a low risk of dural puncture or spinal cord trauma in infants. Traditionally catheter advancement is based on external measurements. However, malpositioning of catheters are known to occur. We hypothesized that caudal-epidural catheters inserted under real-time ultrasound guidance may be more accurate than the accuracy of the measurements traditionally used for their placement. METHODS: We studied 25 patients, aged 2 days to 5 months, posted for abdominal or thoracic surgery, receiving general anesthesia followed by caudo-epidural continuous block...
October 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28767640/efficacy-and-safety-of-3-different-anesthesia-techniques-used-in-total-hip-arthroplasty
#11
Chengwei Liang, Jionglin Wei, Xiaoxi Cai, Weilong Lin, Yongqian Fan, Fengjian Yang
BACKGROUND This study compared the efficacy and safety of 3 different anesthesia techniques used in total hip arthroplasty (THA). MATERIAL AND METHODS We allocated 198 patients preparing to undertake THA into 3 groups: general anesthesia group (GA group, n=66), caudal epidural anesthesia group (CEA group, n=66), and spinal-epidural anesthesia group (SEA group, n=66). We compared postoperative adverse effects occurring in patients of the 3 anesthesia groups. The Visual Analog Scale (VAS) score, Minimum Mental State Examination (MMSE) score, and β-amyloid (Aβ) expression were calculated to determine the effects of different anesthesia on the postoperative pain and cognitive dysfunction of patients...
August 2, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28758078/contrast-spread-in-the-superoposterior-approach-of-transforaminal-epidural-steroid-injections-for-lumbosacral-radiculopathy
#12
Young Cheol Jeong, Chung Ho Lee, Seok Kang, Joon Shik Yoon
OBJECTIVE: To observe the contrast spread in superoposterior transforaminal epidural steroid injection (SP TFESI) and investigate the correlation between spread patterns and efficacy. METHODS: Thirty-one patients with lumbosacral radiculopathy underwent single-level TFESI under fluoroscopy. The final needle tip position was targeted toward the SP quadrant of the intervertebral foramen. To observe the spread, 1 mL of contrast material was injected, followed by a steroid injection...
June 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28728944/ultrasound-guided-thoracic-paravertebral-block-cadaveric-study-in-foxes-vulpes-vulpes
#13
Paolo Monticelli, Ian Jones, Jaime Viscasillas
OBJECTIVE: To describe an ultrasound-guided thoracic paravertebral block in canidae. STUDY DESIGN: Prospective, experimental, cadaveric study. ANIMALS: Twelve thawed fox cadavers. METHODS: A 15 MHz linear transducer was used to visualize the paravertebral space at the level of the fifth thoracic vertebrae. Iohexol (300 mg mL(-1)) at 0.2 mL kg(-1) was injected into the right and left paravertebral spaces under ultrasound guidance using a Tuohy needle...
March 22, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28720990/selective-nerve-root-blocks-vs-caudal-epidural-injection-for-single-level-prolapsed-lumbar-intervertebral-disc-a-prospective-randomized-study
#14
Sudhir Singh, Sanjiv Kumar, Gaurav Chahal, Reetu Verma
BACKGROUND: Chronic lumbar radiculopathy has a lifetime prevalence of 5.3% in men and 3.7% in women. It usually resolves spontaneously, but up to 30% cases will have pronounced symptoms even after one year. AIMS: A prospective randomized single-blind study was conducted to compare the efficacy of caudal epidural steroid injection and selective nerve root block in management of pain and disability in cases of lumbar disc herniation. METHODS: Eighty patients with confirmed single-level lumbar disc herniation were equally divided in two groups: (a) caudal epidural and (b) selective nerve root block group, by a computer-generated random allocation method...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28707454/interventions-for-postoperative-pain-in-children-an-overview-of-systematic-reviews
#15
REVIEW
Krste Boric, Svjetlana Dosenovic, Antonia Jelicic Kadic, Marijan Batinic, Marija Cavar, Marjan Urlic, Nikolina Markovina, Livia Puljak
The aim of this study was to conduct an overview of systematic reviews that summarizes the results about efficacy and safety from randomized controlled trials involving the various strategies used for postoperative pain management in children. We searched the Cochrane Database of Systematic Reviews, CINAHL, Database of Reviews of Effect, Embase, MEDLINE, and PsycINFO from the earliest date to January 24, 2016. This overview included 45 systematic reviews that evaluated interventions for postoperative pain in children...
September 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28663652/clonidine-as-an-adjuvant-in-fluoroscopic-guided-transforaminal-epidural-steroid-injection-in-a-patient-of-chronic-lumbosacral-radiculopathy
#16
Nandita Mehta, Misbah Salaria, A Q Salaria
Transforaminal epidural steroid injection (TFESI) is a minimally invasive modality used to treat patients with lumbosacral radiculopathy secondary to prolapsed intervertebral disc or spinal canal stenosis. In this case report, we describe the management of a patient with chronic lumbosacral radiculopathy secondary to intervertebral disc herniation which was seen as a right paracentral disc protrusion at levels L4-L5, L5-S1 causing thecal sac indentation, effacement of the right lateral recess and right exiting nerve root impingement as was seen on the magnetic resonance image...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28663633/comparing-the-efficacy-of-caudal-with-intravenous-dexamethasone-in-the-management-of-pain-following-lumbosacral-spine-surgeries-a-randomized-double-blinded-controlled-study
#17
Sandhya Kalappa, Raghavendra Biligiri Sridhar, Saraswathi Nagappa
BACKGROUND: The challenge in providing analgesia for spine surgeries is to provide extended postoperative pain relief and simultaneously allow early neurological assessment and mobilization. Our study aimed to evaluate the analgesic efficacy of intravenous versus caudal dexamethasone in lumbosacral spine surgeries. MATERIALS AND METHODS: In this prospective double-blind study, a total of 96 patients undergoing lumbosacral spine surgery were randomized into three groups to receive 25 ml of preemptive caudal epidural injection of either injection ropivacaine 0...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28655957/comparison-of-analgesic-efficacy-of-caudal-dexmedetomidine-versus-caudal-tramadol-with-ropivacaine-in-paediatric-infraumbilical-surgeries-a-prospective-randomised-double-blinded-clinical-study
#18
Savita Gupta, Rashmi Sharma
BACKGROUND AND AIMS: Caudal epidural analgesia is commonly practised regional block technique in children undergoing infraumbilical surgeries but has a short duration of action after single shot local anaesthetic injection. The aim of this study was to compare ropivacaine 0.25% with dexmedetomidine and tramadol in caudal anaesthesia in paediatric infraumbilical surgeries. METHODS: In a randomised, prospective, double-blinded study, sixty children (1-8 years) belonging to American Society of Anesthesiologists' physical status I or II scheduled for infraumbilical surgeries were included...
June 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28652808/persistent-cauda-equina-syndrome-after-caudal-epidural-injection-under-severe-spinal-stenosis-a-case-report
#19
Young Tak Seo, Hyun Ho Kong, Goo Joo Lee, Heui Je Bang
Caudal epidural injection (CEI) is one of the most common treatments for low-back pain with sciatica. CEI rarely leads to neurologic complications. We report a case of persistent cauda equina syndrome after CEI. A 44-year-old male patient with severe L4 and L5 spinal ste-nosis underwent CEI for low-back pain and sciatica. The CEI solution consisted of bupivacaine, hyaluronidase, triamcinolone acetonide, and normal saline. He experienced motor weakness and sensory loss in both lower extremities and neurogenic bladder for more than 1 year after the procedure...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28614233/discordant-lumbar-epidural-hematoma-after-caudal-steroid-injection-a-case-report-care-compliant
#20
Jung Ju Choi, Young Jin Chang, Wol Seon Jung, Kyung Cheon Lee, Ju Ho Kim, Youn Yi Jo
RATIONALE: Caudal epidural injection is one of the conventional treatments of chronic back pain. Even though spinal epidural hematoma after caudal epidural injection is rare but it can cause serious neurologic complication. PATIENT CONCERNS: An 83-year-old woman taking cilostazol received caudal epidural steroid injection because of her chronic back pain. Six hours later, she experienced an acute hip pain which worsened with time. DIAGNOSIS: Magnetic resonance image showed acute cord compression due to a spinal epidural hematoma at L2-S1 level with concomitant central canal compromise at L2/3, L3/4 level...
June 2017: Medicine (Baltimore)
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