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Caudal epidural

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https://www.readbyqxmd.com/read/28728944/ultrasound-guided-thoracic-paravertebral-block-cadaveric-study-in-foxes-vulpes-vulpes
#1
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
#2
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
#3
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...
July 14, 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
#4
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
#5
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
#6
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
#7
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
#8
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)
https://www.readbyqxmd.com/read/28567221/the-use-of-contrast-in-caudal-epidural-injections-under-image-intensifier-guidance-is-it-necessary
#9
Kamil Naidoo, Sulaiman Alazzawi, Alexander Montgomery
BACKGROUND: We investigated the value of using contrast as an additional aid to confirm the accuracy of needle placement for caudal epidural injections under intraoperative image intensifier guidance. METHODS: A total of 252 consecutive patients were included in this study. Their mean age was 46.7 years (range, 32 to 76 years). There were 133 males (53%) and 119 females (47%) over a 12-month period. RESULTS: Of the 252 consecutive procedures, the contrast enhanced image intensifier confirmed accurate needle placement on first attempt in 252 cases (100%)...
June 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28560030/thoracolumbar-epidural-anaesthesia-with-0-5-bupivacaine-with-or-without-methadone-in-goats
#10
Priscila Dos Santos Silva, Paulo Fantinato-Neto, André Nicolai Elias Silva, Eduardo Harry Birgel Junior, Adriano Bonfim Carregaro
BACKGROUND: Epidural anaesthesia is one of the most commonly used locoregional techniques in ruminants. The lumbosacral epidural technique is reasonably easy to perform and requires low volumes of local anaesthetic drug to allow procedures caudal to the umbilicus. However, surgical procedures in the flank of the animal would require an increased volume of drugs. The anaesthetized area provided by thoracic epidural technique is larger than the lumbosacral technique; however the former is rather challenging to perform...
2017: Irish Veterinary Journal
https://www.readbyqxmd.com/read/28551594/awake-caudal-anaesthesia-in-neonates-young-infants-for-improved-patient-safety
#11
Wan Yen Lim, Sujani Anuruddhika Wijeratne, Evangeline Hua Ling Lim
Caudal epidural block in a conscious infant is a recognised technique that allows the avoidance of general anaesthesia and risks associated with it. It is also technically easier to perform reliably compared with an awake subarachnoid block in skilled hands.(1) While local anaesthetic systemic toxicity is a rare complication of caudal anaesthesia, this case illustrates the potential for caudal anaesthesia done awake in enhancing patient safety through early recognition of local anaesthetic systemic toxicity...
May 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28535546/cost-utility-analysis-of-lumbar-interlaminar-epidural-injections-in-the-treatment-of-lumbar-disc-herniation-central-spinal-stenosis-and-axial-or-discogenic-low-back-pain
#12
Laxmaiah Manchikanti, Vidyasagar Pampati, Ramsin M Benyamin, Joshua A Hirsch
BACKGROUND: Cost utility or cost effective analysis continues to take center stage in the United States for defining and measuring the value of treatments in interventional pain management. Appropriate cost utility analysis has been performed for caudal epidural injections, percutaneous adhesiolysis, and spinal cord stimulation. However, the literature pertaining to lumbar interlaminar epidural injections is lacking, specifically in reference to cost utility analysis derived from randomized controlled trials (RCTs) with a pragmatic approach in a practical setting...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28532673/-neuraxial-anesthesia-in-patients-with-multiple-sclerosis-a-systematic-review
#13
Helmar Bornemann-Cimenti, Nikki Sivro, Frederike Toft, Larissa Halb, Andreas Sandner-Kiesling
BACKGROUND AND OBJECTIVES: Current guidelines for neuraxial analgesia in patients with multiple sclerosis are ambiguous and offer the clinician only a limited basis for decision making. This systematic review examines the number of cases in which multiple sclerosis has been exacerbated after central neuraxial analgesia in order to rationally evaluate the safety of these procedures. METHODS: A systematic literature search with the keywords "anesthesia or analgesia" and "epidural, peridural, caudal, spinal, subarachnoid or intrathecal" in combination with "multiple sclerosis" was performed in the databases PubMed and Embase, looking for clinical data on the effect of central neuraxial analgesia on the course of multiple sclerosis...
May 19, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28444433/boundaries-of-the-thoracic-paravertebral-space-potential-risks-and-benefits-of-the-thoracic-paravertebral-block-from-an-anatomical-perspective
#14
Esther A C Bouman, Judith M Sieben, Andrea J R Balthasar, Elbert A Joosten, Hans-Fritz Gramke, Maarten van Kleef, Arno Lataster
PURPOSE: Thoracic paravertebral block (TPVB) may be an alternative to thoracic epidural analgesia. A detailed knowledge of the anatomy of the TPV-space (TPVS), content and adnexa is essential in understanding the clinical consequences of TPVB. The exploration of the posterior TPVS accessibility in this study allows (1) determination of the anatomical boundaries, content and adnexa, (2) description of an ultrasound-guided spread of low and high viscous liquid. METHODS: In two formalin-fixed specimens, stratification of the several layers and the 3D-architecture of the TPVS were dissected, observed and photographed...
April 25, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28384946/a-randomized-controlled-clinical-trial-to-determine-the-effectiveness-of-caudal-epidural-steroid-injection-in-lumbosacral-sciatica
#15
Jaydeep Nandi, Abhishek Chowdhery
INTRODUCTION: Caudal epidural steroid injection have been a part of nonsurgical management of lumbosacral sciatica since last half a century but various randomized controlled trials fail to provide convincing evidence in favour of its effectiveness. AIM: To assess the efficacy of caudal epidural steroid injection in patients of lumbosacral sciatica in comparison to placebo. MATERIALS AND METHODS: The study consisted of patients of sciatica caused by lumbosacral disc prolapse (observed on Magnetic Resonance Imaging (MRI) scan)...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28379464/filum-terminale-needle-placement-during-caudal-epidural-steroid-injection
#16
Ryan R Ramsook, David Spinner, Rajiv R Doshi
Objective. : Caudal epidural steroid injections (ESIs) are commonly used to treat lumbar radicular pain. Touhy needles are placed under live fluoroscopic guidance to ensure epidural administration of medication. This is a case report of direct needle and catheter placements into and through the filum terminale during a caudal approach to the epidural space. Design. : Single case report. Setting. : Beth Israel Deaconess Medical Center...
March 30, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28352498/traumatic-cervical-nerve-root-avulsion-with-pseudomeningocele-formation
#17
Ali S Haider, Ian T Watson, Suraj Sulhan, Dean Leonard, Eliel N Arrey, Umair Khan, Phu Nguyen, Kennith F Layton
Cervical nerve root avulsion is a well-documented result of motor vehicle collision (MVC), especially when occurring at high velocities. These avulsions are commonly traction injuries of nerve roots that may be accompanied by a tear in the meninges through the vertebral foramina with associated collections of cerebrospinal fluid (CSF), thereby resulting in a pseudomeningocele. We present a case of a 19-year-old male who experienced an MVC and was brought to the emergency department (ED) with right arm paralysis and other injuries...
February 14, 2017: Curēus
https://www.readbyqxmd.com/read/28345418/a-coaxial-dual-element-focused-ultrasound-probe-for-guidance-of-epidural-catheterization
#18
Guo-Chung Dong, Li-Chen Chiu, Chien-Kun Ting, Jia-Ruei Hsu, Chih-Chung Huang, Yin Chang, Gin-Shin Chen
Ultrasound guidance for epidural block has improved clinical blind-trial problems but the design of present ultrasonic probes poses operating difficulty of ultrasound-guided catheterization, increasing the failure rate. The purpose of this study was to develop a novel ultrasonic probe to avoid needle contact with vertebral bone during epidural catheterization. The probe has a central circular passage for needle insertion. Two focused annular transducers are deployed around the passage for on-axis guidance. A 17-gauge insulated Tuohy needle containing the self-developed fiber-optic-modified stylet was inserted into the back of the anesthetized pig, in the lumbar region under the guidance of our ultrasonic probe...
March 1, 2017: Ultrasonic Imaging
https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#19
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting.:  Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective.:  To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
October 6, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28337460/caudal-epidural-block-an-updated-review-of-anatomy-and-techniques
#20
REVIEW
Sheng-Chin Kao, Chia-Shiang Lin
Caudal epidural block is a commonly used technique for surgical anesthesia in children and chronic pain management in adults. It is performed by inserting a needle through the sacral hiatus to gain entrance into the sacral epidural space. Using conventional blind technique, the failure rate of caudal epidural block in adults is high even in experienced hands. This high failure rate could be attributed to anatomic variations that make locating sacral hiatus difficult. With the advent of fluoroscopy and ultrasound in guiding needle placement, the success rate of caudal epidural block has been markedly improved...
2017: BioMed Research International
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