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Combined spinal epidural

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https://www.readbyqxmd.com/read/28893015/comparison-of-efficacy-and-safety-of-unilateral-spinal-anaesthesia-with-sequential-combined-spinal-epidural-anaesthesia-for-lower-limb-orthopaedic-surgery
#1
Jyoti Sandeep Magar, Kishori Dhaku Bawdane, Rahul Patil
INTRODUCTION: Orthopaedic anaesthesia plan requires customi-zation as per patient's need for safe outcome. Sequential Combined Spinal Epidural Anaesthesia (Sequential CSEA) and Unilateral Single Shot Spinal anaesthesia (Unilateral SA), both have advantages over conventional spinal anaesthesia that they provide longer lasting block with less hypotension. AIM: To compare safety and efficacy of unilateral spinal anaesthesia with sequential combined spinal epidural anaesthesia for lower limb orthopaedic surgery ...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28891544/comparison-of-epidrum-epi-jet-and-loss-of-resistance-syringe-techniques-for-identifying-the-epidural-space-in-obstetric-patients
#2
S Kartal, B Kösem, H Kılınç, H Köşker, S Karabayırlı, N K Çimen, R I Demircioğlu
BACKGROUND: Identifying the epidural space is essential during epidural anesthesia (EA). Pressure of the epidural space in pregnancy is higher than that in nonpregnant woman. Loss of resistance (LOR) method is the most commonly preferred method for identifying the epidural space. Epidrum and Epi-Jet are recently innovated supporting devices that facilitate identifying process for epidural space. In this study we aimed to compare Epidrum, Epi-Jet, and LOR methods in identifying the epidural space, feasibility of technique...
August 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28891203/effects-of-epidural-volume-extension-by-saline-injection-on-the-efficacy-and-safety-of-intrathecal-local-anaesthetics-systematic-review-with-meta-analysis-meta-regression-and-trial-sequential-analysis
#3
REVIEW
M Heesen, S Weibel, M Klimek, R Rossaint, L R Arends, P Kranke
Epidural volume extension, a modification of combined spinal-epidural anaesthesia, involves the epidural injection of saline in order to increase the spread of drugs given intrathecally. Results from individual studies have so far been contradictory and we aimed to gather the available evidence for this technique. We performed a systematic literature search for randomised, controlled trials comparing epidural volume extension after spinal injection with a control group without epidural injection in patients undergoing surgery...
September 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28890806/postlaminectomy-membrane-with-dynamic-spinal-cord-compression-disclosed-with-computed-tomographic-myelography-a-case-report-and-literature-review
#4
Takahiro Kitahara, Junya Hanakita, Toshiyuki Takahashi
INTRODUCTION: It has been hypothesized that postoperative epidural scar, postlaminectomy membrane, may be responsible for late neurological deterioration after cervical laminectomy in some cases, but there is a lack of radiological studies in the literature showing the clinical significance of postlaminectomy membrane. We describe a rare case with radiological evidence of dynamic spinal cord compression caused by the postlaminectomy membrane, which may have been related to neurological deterioration...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28881116/surgical-roles-for-spinal-involvement-of-hematological-malignancies
#5
Sang-Il Kim, Young-Hoon Kim, Kee-Yong Ha, Jae-Won Lee, Jin-Woo Lee
OBJECTIVE: Patients with hematological malignancies frequently encounter spine-related symptoms, which are caused by disease itself or process of treatment. However, there is still lack of knowledge on their epidemiology and clinical courses. The purpose of this article is to review clinical presentations and surgical results for spinal involvement of hematologic malignancies. METHODS: From January 2011 to September 2014, 195 patients (98 males and 97 females) suffering from hematological malignancies combined with spinal problems were retrospectively analyzed for clinical and radiological characteristics and their clinical results...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28875709/continuous-epidural-infusion-versus-programmed-intermittent-epidural-bolus-for-labor-analgesia-optimal-configuration-of-parameters-to-reduce-physician-administered-top-ups
#6
Carlos Delgado, Christopher Ciliberto, Laurent Bollag, Margaret Sedensky, Ruth Landau
BACKGROUND AND OBJECTIVES: Programmed intermittent epidural bolus (PIEB) is a delivery mode associated with decreased local analgesia dosing, motor block, and physician-administered top-ups (PATU) during labor analgesia. We hypothesized that PIEB delivery at different settings will result in fewer PATU for labor analgesia than the same hourly volume of a continuous epidural infusion (CEI). METHODS: 'Before and after' study design of combined-spinal epidural (CSE) for labor, with bupivacaine 0...
September 6, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28860857/preventing-nausea-and-vomiting-in-women-undergoing-regional-anesthesia-for-cesarean-section-challenges-and-solutions
#7
REVIEW
Yvonne Jelting, Christian Klein, Thomas Harlander, Leopold Eberhart, Norbert Roewer, Peter Kranke
BACKGROUND: Intraoperative nausea and vomiting (IONV) or postoperative nausea and vomiting (PONV) affecting women undergoing regional anesthesia for cesarean section is an important clinical problem since these techniques are used widely. There are burdens of literature about IONV/PONV and several in parturient and cesarean. However, it needs more attention. The underlying mechanisms of IONV and PONV in the obstetrical setting mainly include hypotension due to sympathicolysis during neuraxial anesthesia, bradycardia owing to an increased vagal tone, the visceral stimulation via the surgical procedure and intravenously administered opioids...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28851292/combined-spinal-epidural-anesthesia-for-cesarean-delivery-in-a-patient-with-cor-triloculare-biventriculare
#8
Yuan Han, Zhenfeng Zhang, Qingchun Sun, Ke Ding, Liu Han, Mengmeng Dong, Yifan Xu, Lei Ge
BACKGROUND: Cor triloculare biventriculare accounts for approximately 0.31% of cases of congenital heart disease (CHD). Moreover, people with cor triloculare biventriculare always have shorter life spans, and cases of gestation are rare. There have been various related reports of cor triloculare biventriculare in recent years. CASE PRESENTATION: We described an emergency cesarean section of a 30-year-old, 38-weeks-pregnant woman suffering from cardiac insufficiency and fetal distress...
August 29, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28840071/chronic-thoracolumbar-subdural-empyema-case-report-and-surgical-management
#9
Azam Basheer, Mohamed Macki, Morenikeji Buraimoh, Asim Mahmood
BACKGROUND: Spinal cord abscesses and spinal subdural empyemas are rare and difficult to treat. CASE DESCRIPTION: A 35-year-old male presented to an outside institution with 2 months of progressive low back pain, weakness, and bowel incontinence; he was diagnosed with an L4 epidural abscess that was poorly managed. When the patient presented to our institution, magnetic resonance imaging (MRI) revealed a well-organized chronic subdural abscess at the thoracolumbar junction...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28834913/abdominal-girth-and-vertebral-column-length-aid-in-predicting-intrathecal-hyperbaric-bupivacaine-dose-for-elective-cesarean-section
#10
Chang-Na Wei, Qing-He Zhou, Li-Zhong Wang
Currently, there is no consensus on how to determine the optimal dose of intrathecal bupivacaine for an individual undergoing an elective cesarean section. In this study, we developed a regression equation between intrathecal 0.5% hyperbaric bupivacaine volume and abdominal girth and vertebral column length, to determine a suitable block level (T5) for elective cesarean section patients.In phase I, we analyzed 374 parturients undergoing an elective cesarean section that received a suitable dose of intrathecal 0...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28833337/maternal-body-mass-index-and-regional-anaesthesia-use-at-term-prevalence-and-complications
#11
Frances M Biel, Nicole E Marshall, Jonathan M Snowden
BACKGROUND: There is an evidence gap regarding the use of regional anaesthesia (epidural, spinal, or combined epidural/spinal anaesthesia) and associated complications by maternal body mass index (BMI). We examine associations between regional anaesthesia, mode of delivery, and regional anaesthesia complications by pre-pregnancy BMI categories among term deliveries. METHODS: Retrospective cohort study of births in California, 2007-2010, utilizing linked birth certificate data and patient discharge data...
August 22, 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/28820759/thromboprophylaxis-in-spinal-surgery
#12
William P Mosenthal, David C Landy, Haroutioun H Boyajian, Olumuyiwa A Idowu, Lewis L Shi, Edwin Ramos, Michael J Lee
STUDY DESIGN: Systematic review and meta-analysis OBJECTIVE.: Determine the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) in spinal surgery patients receiving no thromboprophylaxis, mechanoprophylaxis, and chemoprophylaxis. SUMMARY OF BACKGROUND DATA: The incidence of thromboembolic complications after spinal surgery is not well established. While a variety of effective mechanical and chemical thromboprophylaxis interventions exist, their role in spinal surgery remains unclear...
August 17, 2017: Spine
https://www.readbyqxmd.com/read/28816824/analysis-of-the-relationship-between-the-epidural-spinal-cord-compression-escc-scale-and-paralysis-caused-by-metastatic-spine-tumors
#13
Hiroshi Uei, Yasuaki Tokuhashi, Masafumi Maseda
STUDY DESIGN: A retrospective, single-institute, and radiographic study. OBJECTIVE: To evaluate the relationship between the epidural spinal cord compression (ESCC) scale and the severity of metastatic spine tumor-induced paralysis. SUMMARY OF BACKGROUND DATA: The ESCC scale is used to evaluate the grade of spinal cord compression on T2-weighted magnetic resonance imaging (MRI). However, few studies have investigated the relationship between such MRI findings and paralysis...
August 14, 2017: Spine
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
#14
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/28794536/combined-spinal-epidural-anaesthesia-in-a-case-of-primigravida-with-coarctation-of-aorta-with-severe-hypertension-for-elective-lower-segment-caesarean-section
#15
Nupur Dua, Bk Ashok Kumar, S Chaya, Tejal N Jivrajani
No abstract text is available yet for this article.
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28794527/the-effect-of-addition-of-dexamethasone-to-levobupivacaine-in-parturients-receiving-combined-spinal-epidural-for-analgesia-for-vaginal-delivery
#16
Amr Samir Wahdan, Ahmed Ibrahim El-Sakka, Hassan Mostafa Ismail Gaafar
BACKGROUND AND AIMS: Regional analgesia is commonly used for the relief of labour pain, Prolongation of analgesia can be achieved by adjuvant medications. The aim of this randomised controlled trial was to evaluate the efficacy of intrathecal levobupivacaine with dexamethasone for labour analgesia. METHODS: A total of 80 females were included in this study, all were primigravidas undergoing vaginal delivery with cervical dilatation ≥4 cm and 50% or more effacement...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28767472/intrathecal-migration-of-an-epidural-catheter-while-using-a-programmed-intermittent-epidural-bolus-technique-for-labor-analgesia-maintenance-a-case-report
#17
Francesca Betti, Brendan Carvalho, Edward T Riley
We describe a case of intrathecal migration of a wire-reinforced epidural catheter in a parturient who received epidural labor analgesia. Epidural analgesia was initiated with a combined-spinal epidural technique and maintained by programmed intermittent epidural boluses. Epidural catheter aspiration after insertion was negative for cerebrospinal fluid. The patient's response to the first four doses of local anesthetic was consistent with epidural drug delivery. After the fifth dose, she developed a complete lower extremity motor block, hypotension, and high sensory blockade...
August 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28744777/-recent-standards-in-management-of-obstetric-anesthesia
#18
REVIEW
Maximiliaan van Erp, Clemens Ortner, Stefan Jochberger, Klaus Ulrich Klein
The following article contains information not only for the clinical working anaesthesiologist, but also for other specialists involved in obstetric affairs. Besides a synopsis of a German translation of the current "Practice Guidelines for Obstetric Anaesthesia 2016" [1], written by the American Society of Anesthesiologists, the authors provide personal information regarding major topics of obstetric anaesthesia including pre-anaesthesia patient evaluation, equipment and staff at the delivery room, use of general anaesthesia, peridural analgesia, spinal anaesthesia, combined spinal-epidural anaesthesia, single shot spinal anaesthesia, and programmed intermittent epidural bolus...
July 25, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28741272/an-up-down-determination-of-the-required-seated-duration-after-intrathecal-injection-of-bupivacaine-and-fentanyl-for-the-prevention-of-hypotension-during-cesarean-delivery
#19
Albert Moore, Eva El-Mouallem, Aly El-Bahrawy, Ian Kaufman, Mahmoud Moustafa, Simone Derzi, Roupen Hatzakorzian, William Lipishan
PURPOSE: A prolonged seated time after intrathecal injection of hyperbaric bupivacaine and morphine is related to the incidence of hypotension during Cesarean delivery, but results in a high incidence of pain during peritoneal closure. We conducted this study to determine the effect of the addition of intrathecal fentanyl on the relationship between seated time and hypotension and intraoperative analgesia requirements. METHODS: Women undergoing Cesarean delivery were randomized to receive an intrathecal injection of either 11...
July 24, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28701185/case-report-perioperative-management-of-caesarean-section-for-a-parturient-with-mitochondrial-myopathy
#20
Qiang Zheng, Penghui Wei, Jinfeng Zhou, Haipeng Zhou, Fucheng Ji, Wenxi Tang, Jianjun Li
BACKGROUND: Mitochondrial myopathies represent a group of disorders caused by mitochondrial defects that disrupt energy production. Most patients have issues from infancy to early childhood. Pregnancy in women with mitochondrial myopathy is uncommon and the management for these parturients is full of challenges. CASE PRESENTATION: A 36-year-old woman with mitochondrial myopathy was scheduled for caesarean section under a combined spinal-epidural anaesthesia and multi-model analgesia...
July 12, 2017: BMC Anesthesiology
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