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Caudal block

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https://www.readbyqxmd.com/read/28345802/the-association-between-caudal-anesthesia-and-increased-risk-of-postoperative-surgical-complications-in-boys-undergoing-hypospadias-repair
#1
Brad M Taicher, Jonathan C Routh, John B Eck, Sherry S Ross, John S Wiener, Allison K Ross
INTRODUCTION: Recent reports have suggested that caudal anesthesia may be associated with an increased risk of postoperative surgical complications. We examined our experience with caudal anesthesia in hypospadias repair to evaluate for increased risk of urethrocutaneous fistula or glanular dehiscence. METHODS: All hypospadias repairs performed by a single surgeon in 2001-2014 were reviewed. Staged or revision surgeries were excluded. Patient age, weight, hypospadias severity, surgery duration, month and year of surgery, caudal anesthesia use, and postoperative complications were recorded...
March 27, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28345418/a-coaxial-dual-element-focused-ultrasound-probe-for-guidance-of-epidural-catheterization
#2
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/28337460/caudal-epidural-block-an-updated-review-of-anatomy-and-techniques
#3
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
https://www.readbyqxmd.com/read/28332251/measuring-the-depth-of-the-caudal-epidural-space-to-prevent-dural-sac-puncture-during-caudal-block-in-children
#4
Hyun Jeong Lee, Ji Young Min, Hyun Il Kim, Hyo-Jin Byon
BACKGROUND: Caudal blocks are performed through the sacral hiatus in order to provide pain control in children undergoing lower abdominal surgery. During the block, it is important to avoid advancing the needle beyond the sacrococcygeal ligament too much to prevent unintended dural puncture. This study used demographic data to establish simple guidelines for predicting a safe needle depth in the caudal epidural space in children. METHODS: A total of 141 children under 12 years old who had undergone lumbar-sacral magnetic resonance imaging were included...
March 23, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28306195/influence-of-caudal-block-on-postoperative-oliguria-in-infants-undergoing-bilateral-ureteroneocystostomy-a-retrospective-analysis
#5
Hyun Jeong Lee, Yong Seon Choi, Bon-Nyeo Koo, Sang Won Han, Young Eun Cho, Young Jae Im, Jae Hoon Lee
BACKGROUND: Caudal block has been widely used in children undergoing genitourinary surgery. However, the influence of caudal block on postoperative oliguria is unclear. AIM: The aim of this study was to assess the effect of caudal block on urinary flow through the reimplanted ureter after ureteroneocystostomy and the incidence of postoperative oliguria in infants. METHODS: This retrospective study analyzed the medical records of 121 infants aged less than 12 months who underwent bilateral ureteroneocystostomy for vesicoureteral reflux at a tertiary medical center...
March 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28298789/caudal-epidural-analgesia-in-pediatric-patients-comparison-of-0-25-levobupivacaine-and-0-25-ropivacaine-in-terms-of-motor-blockade-and-postoperative-analgesia
#6
P Praveen, R Remadevi, N Pratheeba
CONTEXT: Ropivacaine and Levo-Bupivacaine have been safely used for caudal anaesthesia in children, but there are limited studies comparing the efficacy of 0.25% Ropivacaine and 0.25% Levo-Bupivacaine for caudal anaesthesia in infraumbilical surgeries. AIMS: The aim of this study was to compare the incidence of motor blockade and postoperative analgesia with 0.25% ropivacaine and 0.25% levobupivacaine for the caudal block in children receiving infraumbilical surgery...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298787/caudal-levobupivacaine-supplemented-with-caudal-or-intravenous-clonidine-in-children-undergoing-infraumbilical-surgery-a-randomized-prospective-double-blind-study
#7
Laxmi Ramya Potti, Yatish Bevinaguddaiah, S Archana, Vinayak Seenappa Pujari, C Manjunath Abloodu
BACKGROUND: Caudal analgesia is the most popular regional anesthesia technique in pediatric population for intraoperative and postoperative analgesia. Clonidine, an α2 agonist, prolongs analgesia without causing significant respiratory depression after systemic or neuraxial administration. However, the most beneficial route of its administration is still controversial. Thus, we compared the effects of caudal and intravenous (i.v) clonidine on postoperative analgesia produced by caudal levobupivacaine in children undergoing infraumbilical surgery...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28275524/high-single-scrotal-incision-orchidopexy-as-the-standard-technique-in-infants-aged-6-24%C3%A2-months
#8
Ahmed Mohey, Tarek M Gharib, Rabea G Omar, Ahmed Sebaey, Basheer N Elmohamady, Wael Kandeel
OBJECTIVE: To prospectively investigate the effectiveness of high single scrotal-incision orchidopexy (HSSIO) for palpable undescended testis (PUDT) in infants aged 6-24 months. PATIENTS AND METHODS: From March 2012 to July 2014, 46 age range-restricted (6-24 months) infants with 57 PUDT underwent HSSIO after obtaining written consent from their parents. The exclusion criteria were ectopic, retractile testes and recurrent cases. All infants were examined before surgery in the outpatient department and after anaesthesia induction immediately before surgery...
March 2017: Arab Journal of Urology
https://www.readbyqxmd.com/read/28271175/tail-regeneration-affects-the-digestive-performance-of-a-mediterranean-lizard
#9
Kostas Sagonas, Niki Karambotsi, Aristoula Bletsa, Aikaterini Reppa, Panayiotis Pafilis, Efstratios D Valakos
In caudal autotomy, lizards shed their tail to escape from an attacking predator. Since the tail serves multiple functions, caudal regeneration is of pivotal importance. However, it is a demanding procedure that requires substantial energy and nutrients. Therefore, lizards have to increase energy income to fuel the extraordinary requirements of the regenerating tail. We presumed that autotomized lizards would adjust their digestion to acquire this additional energy. To clarify the effects of tail regeneration on digestion, we compared the digestive performance before autotomy, during regeneration, and after its completion...
April 2017: Die Naturwissenschaften
https://www.readbyqxmd.com/read/28256096/dexmedetomidine-sedation-combined-with-caudal-anesthesia-for-lower-abdominal-and-extremity-surgery-in-ex-preterm-and-full-term-infants
#10
Katrin Waurick, Cristina Sauerland, Christiane Goeters
BACKGROUND: Awake caudal anesthesia is a potentially attractive option, because the administration of general anesthesia is associated with a high rate of respiratory complications and hemodynamic disturbances and potential neurotoxic effects. To facilitate the caudal puncture and subsequent surgical intervention, additional sedatives are commonly administered. AIM: We aimed to establish a new, safe, and effective anesthetic procedure for very young children with comorbidities...
March 2, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28247084/anatomy-of-the-sacral-hiatus-and-its-clinical-relevance-in-caudal-epidural-block
#11
Hassan Bagheri, Figen Govsa
PURPOSE: Caudal epidural anesthesia (CEB) is widely used for the prevention of chronic lower back pain, the control of intraoperative analgesia such as genitourinary surgery and labor pain cases in sacral epidural space approach for the implementation of analgesia. CEB is an anesthetic solution used into the sacral canal via sacral hiatus (SH). For optimal access into the sacral epidural space, detailed anatomical landmarks of SH are required. This study aims at exploring the anatomical structures and differences of the SH by using the sacral bone as a guide point to failure criteria for reviewing the caudal epidural anesthesia and improving the criteria for success in practice...
February 28, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28243379/preemptive-caudal-ropivacaine-an-effective-analgesic-during-degenerative-lumbar-spine-surgery
#12
Shashwat Kumar, Jagannath Manickam Palaniappan, Anantha Kishan
STUDY DESIGN: This was a prospective, randomized, controlled trial comprising 60 patients undergoing lumbosacral spine (noninstrumentation/nonfusion) surgery. PURPOSE: The purpose of this study was to evaluate the efficacy of 0.2% ropivacaine (20 mL) administered alone as a single, preoperative, caudal epidural block injection versus that of intravenous analgesics in providing effective postoperative analgesia to patients undergoing lumbosacral spine surgery. OVERVIEW OF LITERATURE: Various studies have shown the effectiveness of a caudal epidural injection (bupivacaine or ropivacaine) in providing postoperative analgesia in combination with steroids or other analgesics...
February 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28235496/use-of-test-dose-allows-early-detection-of-subdural-local-anesthetic-injection-with-lumbar-plexus-block
#13
Bradley H Lee, Matthias Braehler
A 56year-old woman underwent a lumbar plexus block for a revision of a left total hip arthroplasty. During the block procedure, the needle was advanced over the transverse process and isolated quadriceps twitches were elicited. After administering a test dose of 3ml of 1.5% lidocaine, the patient developed loss of sensation in the L3-4 dermatomal distribution that progressed caudally to involve both legs followed by inability to move the left leg. The patient shortly thereafter became hypotensive and sensory block spread cephalad and peaked at C7 bilaterally suggesting possible subdural spread of local anesthetic...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28217052/topical-versus-caudal-ketamine-bupivacaine-combination-for-postoperative-analgesia-in-children-undergoing-inguinal-herniotomy
#14
Hala Saad Abdel-Ghaffar, Seham Mohamed Moeen, Ahmed Mohamed Moeen
BACKGROUND: Multiple studies claim that caudal administration of ketamine causes effective postoperative analgesia. The aim of this study was to assess the clinical effectiveness of ketamine after caudal or topical administration in pediatric patients undergoing inguinal herniotomy. PATIENTS AND METHODS: This randomized, comparative, double-blind study included eighty children (aged 6 months to 6 years) received either 1 ml/kg of 0.25% bupivacaine/ketamine 0.5 mg/kg for caudal analgesia (caudal group) or 0...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28188621/the-analgesic-efficacy-of-pre-operative-bilateral-erector-spinae-plane-esp-blocks-in-patients-having-ventral-hernia-repair
#15
K J Chin, S Adhikary, N Sarwani, M Forero
Laparoscopic ventral hernia repair is an operation associated with significant postoperative pain, and regional anaesthetic techniques are of potential benefit. The erector spinae plane (ESP) block performed at the level of the T5 transverse process has recently been described for thoracic surgery, and we hypothesised that performing the ESP block at a lower vertebral level would provide effective abdominal analgesia. We performed pre-operative bilateral ESP blocks with 20-30 ml ropivacaine 0.5% at the level of the T7 transverse process in four patients undergoing laparoscopic ventral hernia repair...
April 2017: Anaesthesia
https://www.readbyqxmd.com/read/28181346/comparison-of-caudal-ropivacaine-morphine-and-paravertebral-catheter-for-major-upper-abdominal-surgery-in-infants
#16
Makoto Sato, Takafumi Iida, Chika Kikuchi, Tomoki Sasakawa, Takayuki Kunisawa
BACKGROUND: The caudal epidural block is one of the most commonly used regional anesthetic techniques in children. Administration of morphine via caudal injection enables analgesia, even for upper abdominal surgery. The thoracic paravertebral block has also been successfully used to treat perioperative pain during upper abdominal procedures in pediatric patients. AIM: In the current study, we compared the two regional techniques for upper abdominal surgery in infants to determine whether one of them was preferable to the other...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28148768/variation-in-wall-shear-stress-in-channel-networks-of-zebrafish-models
#17
Woorak Choi, Hye Mi Kim, Sungho Park, Eunseop Yeom, Junsang Doh, Sang Joon Lee
Physiological functions of vascular endothelial cells (ECs) vary depending on wall shear stress (WSS) magnitude, and the functional change affects the pathologies of various cardiovascular systems. Several in vitro and in vivo models have been used to investigate the functions of ECs under different WSS conditions. However, these models have technical limitations in precisely mimicking the physiological environments of ECs and monitoring temporal variations of ECs in detail. Although zebrafish (Danio rerio) has several strategies to overcome these technical limitations, zebrafish cannot be used as a perfect animal model because applying various WSS conditions on blood vessels of zebrafish is difficult...
February 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28138164/comparison-of-preventive-analgesia-techniques-in-circumcision-cases-dorsal-penile-nerve-block-caudal-block-or-subcutaneous-morphine
#18
Ebru Canakci, Ozgur Yagan, Nilay Tas, Tugce Mutlu, Abdullah Cirakoglu, Erdal Benli
OBJECTIVE: To compare 3 different techniques of preventive analgesia before circumcision operations in male children between 6-12 years of age. Our objective was to investigate the duration and quality of postoperative analgesia in patients, who were subject to caudal block technique, dorsal penile nerve block or who were administered subcutaneous morphine. METHODS: The prospective, randomised, single-blind study was conducted at Ordu University Training and Research Hospital, Ordu, Turkey, from January 1 to June 30, 2015, and comprised boys aged 6-12 years, who were scheduled to undergo circumcision operation...
February 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28100519/paravertebral-block-in-paediatric-abdominal-surgery-a-systematic-review-and-meta-analysis-of-randomized-trials
#19
E A Page, K L Taylor
The increased popularity of paravertebral block (PVB) can be attributed to its relative safety and comparable efficacy when compared with epidural analgesia. It has thus been recommended for open cholecystectomy and other less painful surgeries such as inguinal herniorraphy and appendectomy. We performed a systematic review of PVB in paediatric abdominal conditions to assess its clinical efficacy and side effects compared with other analgesic therapies.A search of Medline, Embase, and Web of Science and hand-searching references from inception date to May 2016 was done...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28067707/dural-puncture-epidural-technique-improves-labor-analgesia-quality-with-fewer-side-effects-compared-with-epidural-and-combined-spinal-epidural-techniques-a-randomized-clinical-trial
#20
Anthony Chau, Carolina Bibbo, Chuan-Chin Huang, Kelly G Elterman, Eric C Cappiello, Julian N Robinson, Lawrence C Tsen
BACKGROUND: The dural puncture epidural (DPE) technique is a modification of the combined spinal epidural (CSE) technique, where a dural perforation is created from a spinal needle but intrathecal medication administration is withheld. The DPE technique has been shown to improve caudal spread of analgesia compared with epidural (EPL) technique without the side effects observed with the CSE technique. We hypothesized that the onset of labor analgesia would follow this order: CSE > DPE > EPL techniques...
February 2017: Anesthesia and Analgesia
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