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Caudal block

Chang Amber Liu, Jinghu Sui, Charles J Coté, Thomas A Anderson
BACKGROUND AND OBJECTIVES: Caudal anesthesia is a common and effective regional anesthesia technique in pediatric patients. The addition of epinephrine to local anesthetics in caudal anesthesia is a frequent practice; however, changes in hemodynamic and cardiac parameters produced by epinephrine in caudal anesthesia are not well studied. Using data collected with the ICON noninvasive cardiac output monitor, we examined the hemodynamic changes associated with the administration of epinephrine containing local anesthetics during caudal anesthesia in children...
October 11, 2016: Regional Anesthesia and Pain Medicine
Chandni Sinha, Bindey Kumar, Umesh Kumar Bhadani, Ajeet Kumar, Amarjeet Kumar, Alok Ranjan
BACKGROUND: Caudal block is a reliable regional analgesic technique for pediatric urogenital surgeries. Various adjuvants have been tried to enhance the duration of action of bupivicaine. Though clonidine is extensively used as an adjuvant in caudal anaesthesia, it can have troublesome adverse effects like bradycardia, hypotension and sedation. Lately dexamethasone has become popular as an adjuvant in paediatric caudals due to its safety profile. AIM: The aim of this study was to compare dexamethasone and clonidine coadministered with bupivicaine caudally in paediatric patients undergoing urogenital surgeries in terms of analgesia and adverse effects...
September 2016: Anesthesia, Essays and Researches
Depinder Kaur, Saurabh Anand
BACKGROUND: Efficacy of caudal bupivacaine plus ketamine on postoperative pain in children. AIMS: The aim of this study was to compare the analgesic efficacy and safety of caudal block with mixture of bupivacaine and ketamine to bupivacaine alone for postoperative analgesia in pediatric patients undergoing infraumbilical surgery. SETTINGS AND DESIGN: A prospective randomized study was conducted in a tertiary care teaching hospital. STATISTICAL ANALYSIS: Data were collected; mean value and standard deviation were computed for age, weight, duration of surgery, and duration of analgesia...
September 2016: Anesthesia, Essays and Researches
Jianguo Zhuang, Xiuping Gao, Franklin Gao, Fadi Xu
We tested the hypothesis that mu-opioid receptors (MORs) in the caudomedial nucleus tractus solitarius (cmNTS) are important for the ventilatory responses to stimulation of bronchopulmonary C-fibers (PCFs), the carotid body-mediated hypoxia, and hypercapnia independent of the carotid body. First, we used immunohistochemistry to map MORs distribution in the caudal medulla. Then we compared the effects of intra-cmNTS microinjection of DAMGO (a MOR agonist) with or without a combination of CTAP (a MOR antagonist) on the ventilatory responses to: 1) right atrial injection of capsaicin (to stimulation of PCFs) and 2) acute hypoxia (HVR, to stimulate the carotid body) in awake intact rats; and 3) hypercapnia (HCVR) in the carotid body ablated rats...
October 12, 2016: Respiratory Physiology & Neurobiology
S D Adhikary, K El-Boghdadly, Z Nasralah, N Sarwani, A M Nixon, K J Chin
We performed bilateral transmuscular quadratus lumborum blocks in six cadavers using iodinated contrast and methylene blue. Computed tomography imaging was performed in four cadavers and anatomical dissection was completed in five. This demonstrated spread to the lumbar paravertebral space in 63% of specimens, laterally to the transversus abdominis muscle in 50% and caudally to the anterior superior iliac spine in 63% of specimens. There was no radiographic evidence of spread to the thoracic paravertebral space...
October 12, 2016: Anaesthesia
Jairo A Diaz, Mauricio F Murillo, Jhonan A Mendoza, Ana M Barreto, Lina S Poveda, Lina K Sanchez, Laura C Poveda, Katherine T Mora
Emergent biological responses develop via unknown processes dependent on physical collision. In hypoxia, when the tissue architecture collapses but the geometric core is stable, actin cytoskeleton filament components emerge, revealing a hidden internal order that identifies how each molecule is reassembled into the original mold, using one common connection, i.e., a fractal self-similarity that guides the system from the beginning in reverse metamorphosis, with spontaneous self-assembly of past forms that mimics an embryoid phenotype...
2016: American Journal of Stem Cells
Yoon-Jung Shon, Jin Huh, Sung-Sik Kang, Seung-Kil Bae, Ryeong-Ah Kang, Duk-Kyung Kim
OBJECTIVE: To compare the effects of saddle, lumbar epidural and caudal blocks on anal sphincter tone using anorectal manometry. METHODS: Patients undergoing elective anorectal surgery with regional anaesthesia were divided randomly into three groups and received a saddle (SD), lumbar epidural (LE), or caudal (CD) block. Anorectal manometry was performed before and 30 min after each regional block. The degree of motor blockade of the anal sphincter was compared using the maximal resting pressure (MRP) and the maximal squeezing pressure (MSP)...
September 29, 2016: Journal of International Medical Research
Na Wang, Yaowen Fu, Haichun Ma, Jinguo Wang, Yang Gao
OBJECTIVE: To compare caudal block with intrarectal local anesthesia plus periprostatic nerve block for transrectal ultrasound guided prostate biopsy. METHODS: One hundred and ninety patients scheduled for transrectal ultrasound guided prostate biopsy were randomized equally into Group-A who received caudal block (20 ml 1.2% lidocaine) and Group-B who received intrarectal local anesthesia (0.3% oxybuprocaine cream) plus periprostatic nerve block (10 ml 1% lidocaine plus 0...
July 2016: Pakistan Journal of Medical Sciences Quarterly
Yong-Jun Ahn, Joon-Shik Shin, Jinho Lee, Yoon Jae Lee, Me-Riong Kim, Ki Byung Park, Jun-Hwan Lee, Kyung-Min Shin, In-Hyuk Ha
OBJECTIVES: To assess medical care and costs of the 3 highest prevalence lumbar disorders-non-specific low back pain (nLBP), intervertebral disc disorder (IDD) and spinal stenosis (SS)-from national billing data to provide basic information for standards of appropriate management. DESIGN: Retrospective analysis of National Health Insurance National Patient Sample data provided by the Korean Health Insurance Review and Assessment Service (HIRA). SETTING: 2011 claims data from all medical institutions which filed billing statements to HIRA...
September 12, 2016: BMJ Open
Taylan Akkaya, Derya Özkan, Hayri Kertmen, Zeki Şekerci
AIM: The purpose of this study was to compare the results of ultrasound- and fluoroscopy-guided caudal epidural steroid injections in postlaminectomy patients. MATERIAL AND METHODS: Of the 30 postlaminectomy patients who were randomly divided into two groups, Group I (n=15) received ultrasound-guided and Group II (n=15) fluoroscopy-guided caudal epidural local anesthetic and steroid injection, and each patient's time to performed block was recorded. The patients' Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and satisfaction with the therapy during the 3-month follow-up were evaluated...
December 28, 2015: Turkish Neurosurgery
Jiwon An, Youn-Woo Lee, Woo Young Park, Sungchul Park, Hyungbae Park, Ji Won Yoo, Jong Bum Choi
PURPOSE: Anatomic variations complicate surface landmark-guided needle placement, thereby increasing nerve blockade failure rate. However, little is understood about how anatomic distances change under different clinical conditions. As the cricoid cartilage is an easy and accurate landmark, we investigated changes in distance between the sixth or seventh cervical transverse processes (C6TP or C7TP) and the cricoid cartilage in neutral and extended supine positions. METHODS: Forty-two patients (16 men, 26 women) were included in this study...
August 30, 2016: Journal of Anesthesia
Jessica A Fawley, Mackenzie E Hofmann, Michael C Andresen
UNLABELLED: Most craniosensory afferents have unmyelinated axons expressing TRP Vanilloid 1 (TRPV1) receptors in synaptic terminals at the solitary tract nucleus (NTS). Neurotransmission from these synapses is characterized by substantial asynchronous EPSCs following action potential-synched EPSCs and high spontaneous rates that are thermally sensitive. The present studies blocked voltage-activated calcium channels (CaV) using the nonselective CaV blocker Cd(2+) or the specific N-type blocker ω-conotoxin GVIA to examine the calcium dependence of the synchronous, asynchronous, spontaneous, and thermally gated modes of release...
August 24, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Nitin Sethi, Deepanjali Pant, Amitabh Dutta, Archna Koul, Jayashree Sood, Parul T Chugh
STUDY OBJECTIVE: We conducted this study to compare the efficacy of caudal epidural block (CEB) vs ultrasonography-guided transversus abdominis plane (TAP) block for providing postoperative pain relief in children scheduled for lower abdominal surgery. Whereas the primary objective was to compare the duration of postoperative analgesia, the secondary objectives included comparative assessment (TAP vs CEB) of quality of pain relief in the first 24hours postoperatively and rescue analgesia requirements...
September 2016: Journal of Clinical Anesthesia
Khoa N Nguyen, Heather S Byrd, Jonathan M Tan
AIM: Caudal epidural anesthesia has been shown to reduce stress response and shorten the time to extubation in children after cardiac surgery. Combined with general anesthesia, regional anesthesia has been proven to be safe and efficacious in the pediatric population. It is not known, however, whether the use of caudal anesthesia actually reduces postoperative pain scores and decreases postoperative opioid use. METHODS: We retrospectively analyzed the charts of 199 children who underwent repair for atrial septal defect (ASD), ventricular septal defect (VSD), and Tetralogy of Fallot (TOF) at a major academic children's hospital between 2010 and 2013...
November 2016: Paediatric Anaesthesia
Pinar Kendigelen, Ayse Cigdem Tutuncu, Senol Emre, Fatis Altindas, Guner Kaya
BACKGROUND AND OBJECTIVES: Postoperative pain management after hypospadias surgery is often challenging. Caudal block is used for analgesia but has limitations. This study compares the analgesic efficiency of pudendal block with that of caudal block in pediatric patients undergoing hypospadias repair surgery. METHODS: This prospective, double-blind, randomized, controlled study enrolled 84 patients receiving pudendal block or caudal block before hypospadias surgery...
September 2016: Regional Anesthesia and Pain Medicine
Kristyna Markova, Magdalena Uzlikova, Pavla Tumova, Klara Jirakova, Guy Hagen, Jaroslav Kulda, Eva Nohynkova
The spindle assembly checkpoint (SAC) joins the machinery of chromosome-to-spindle microtubule attachment with that of the cell cycle to prevent missegregation of chromosomes during mitosis. Although a functioning SAC has been verified in a limited number of organisms, it is regarded as an evolutionarily conserved safeguard mechanism. In this report, we focus on the existence of the SAC in a single-celled parasitic eukaryote, Giardia intestinalis. Giardia belongs to Excavata, a large and diverse supergroup of unicellular eukaryotes in which SAC control has been nearly unexplored...
October 2016: European Journal of Cell Biology
Hakan Sirinoglu, Nebil Yesiloglu, Burak Ersoy
Severe septal deviation is a challenging deformity usually treated using aggressive surgical methods, and extracorporeal septoplasty (ECS) is a commonly used method for this issue. However, this method has severe risks and complications such as the recurrent deformity or nasal saddling. In this article, we present an alternative solution to ECS procedure for the correction of severe septal deviation. Sixteen patients with severe c- or s-shaped septal deviation with a mean age of 26.5 years were included in the study...
August 2016: Facial Plastic Surgery: FPS
Khalid R Alzaben, Omar Q Samarah, Salameh S Obeidat, Oday Halhouli, Murad Al Kharabsheh
Charcot-Marie-Tooth disease comprises a group of disorders characterized by progressive muscle weakness and wasting. Reviewing the anaesthetic literature produced conflicting reports about the best anaesthetic options for patients with CMTD; as they are at increased risk of prolonged response to muscle relaxants, malignant hyperthermia and risks of regional anaesthesia. We present a case of the successful use of total intravenous anaesthesia with dexmedetomidine and propofol combined with caudal block using bupivacaine mixed with dexmedetomidine without any complications, for a 17 year old male patient with Charcot Marie-Tooth disease who underwent a lower limb orthopedic surgery...
June 2016: Middle East Journal of Anesthesiology
Masahiro Takahashi, Hiroshi Takahara, Takanobu Wakabayashi
We experienced two cases of end-of-life cancer patients with perineal pain, whose pain was relieved by 5 ml absolute ethanol caudal block. Although the first injection was ineffective, the second injection resulted in significant relief of pain in both cases. Although the indication should be carefully considered, alcohol caudal block is an analgesic method worth considering for the end-of-life cancer patients complaining of perineal pain.
June 2016: Masui. the Japanese Journal of Anesthesiology
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