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Combined spinal epidural

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https://www.readbyqxmd.com/read/28210635/combined-spinal-epidural-for-vaginal-delivery-in-a-parturient-with-takayasu-s-arteritis
#1
Sean Patrick Clifford, Paul Brian Mick, Brian Matthew Derhake
Takayasu's arteritis is a rare, progressive panendarteritis involving all layers of the arterial wall. This disease includes variable involvement of the aorta and its major branches. The most common complication with this condition is severe, uncontrolled hypertension, often leading to end organ dysfunction. We describe the management of a 27-year-old woman diagnosed with Takayasu's arteritis that presented in labor with intense pain and underwent a combined spinal-epidural for anesthetic management. Per literature review, a combined spinal-epidural technique for planned vaginal delivery has not been described for a laboring Takayasu patient...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28207315/diagnosis-of-lumbosacral-diskospondylosis-in-a-bucking-bull-assisted-by-high-definition-thermal-and-nuclear-scintigraphic-imaging
#2
Marc Caldwell, Thomas Passler, Ram C Purohit, David Pascoe, Dwight F Wolfe
CASE DESCRIPTION An 8-year-old Brahman-cross bull was evaluated for left hind limb lameness of 2 months' duration. The lameness was first noticed during a rodeo bucking performance, immediately after the bull appeared to land inappropriately on the affected limb. CLINICAL FINDINGS Physical examination findings revealed left hind limb lameness, ataxia, and left-sided epaxial muscle atrophy. Palpation per rectum along the lumbar portion of the vertebral column revealed evidence of exostosis of the ventral aspect...
March 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28203020/-effect-of-continuous-femoral-nerve-block-combined-with-periarticular-local-infiltration-analgesia-on-early-operative-functional-recovery-after-total-knee-arthroplasty-a-randomized-double-blind-controlled-study
#3
Y Deng, T L Jiang, X X Yang, M Li, J Wang, X Y Guo
OBJECTIVE: To investigate the effects of early rehabilitation training after total knee arthroplasty surgery by continuous femoral nerve block (CFNB) with or without periarticular local infiltration analgesia (PLIA). METHODS: In this randomized, double-blind, controlled study, 100 patients under-going primary unilateral total knee arthroplasty in patients with knee osteoarthritis were enrolled. All the patients received CFNB for postoperative analgesia before combined spinal epidural anesthesia...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28196505/clinicopathologic-characteristics-and-prognostic-factors-for-primary-spinal-epidural-lymphoma-report-on-36-chinese-patients-and-review-of-the-literature
#4
Le Xiong, Ling-Min Liao, Jian-Wu Ding, Zhi-Lin Zhang, An-Wen Liu, Long Huang
BACKGROUND: Due to the uncommon nature of primary spinal epidural lymphomas (PSELs), there has been little research looking at prognostic indicators for the tumor. To our knowledge, this is the largest study to evaluate possible clinical and pathologic prognostic factors in PSEL patients. METHODS: We retrospectively reviewed 130 cases of PSEL, including 36 Chinese patients and 94 published case reports from 1985 to 2015. Patient treatment regimens included surgery (S; n = 119), surgery followed by chemotherapy (S + CT; n = 25), surgery followed by radiotherapy (S + RT; n = 26), and surgery followed by chemotherapy and radiotherapy (S + CT + RT; n = 50)...
February 14, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28187806/diagnosis-and-management-of-spinal-cord-emergencies
#5
E P Flanagan, S J Pittock
Most spinal cord injury is seen with trauma. Nontraumatic spinal cord emergencies are discussed in this chapter. These myelopathies are rare but potentially devastating neurologic disorders. In some situations prior comorbidity (e.g., advanced cancer) provides a clue, but in others (e.g., autoimmune myelopathies) it may come with little warning. Neurologic examination helps distinguish spinal cord emergencies from peripheral nervous system emergencies (e.g., Guillain-Barré), although some features overlap...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186472/clinical-presentation-and-treatment-outcomes-of-spinal-epidural-arteriovenous-fistulas
#6
Deena M Nasr, Waleed Brinjikji, Michelle J Clarke, Giuseppe Lanzino
OBJECTIVE Spinal epidural arteriovenous fistulas (SEDAVFs) constitute a rare but treatable cause of vascular myelopathy and are a different subtype from the more common Type I spinal dural AVFs. The purpose of this study was to review a consecutive series of SEDAVFs from a single institution and report on the clinical presentations, functional status, and treatment outcomes. METHODS The authors identified all SEDAVFs treated at their institution from 2005 to 2015. SEDAVFs were defined as spinal AVFs in which the fistulous connection occurred in the epidural venous plexus...
February 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28102539/determination-of-the-median-effective-dose-ed50-of-spinal-chloroprocaine-in-labour-analgesia
#7
M Coppens, S Anssens, A Parashchanka, K Roelens, E Deschepper, S De Hert, P F Wouters
The primary goal of this study was to determine the median effective dose (ED50 ) of spinal chloroprocaine for labour analgesia. Thirty-eight parturients requesting neuraxial analgesia were enrolled. Doses of 1% chloroprocaine were determined by the technique of up-down sequential allocation, with an initial dose of 20 mg and steps of 2 mg. The chloroprocaine spinal dose was given as the spinal component of a combined spinal-epidural, which was then supplemented with an epidural dose of 7.5 μg sufentanil in 7 ml saline...
January 19, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28101445/comparison-of-percutaneous-vertebroplasty-with-and-without-interventional-tumor-removal-for-spinal-metastatic-tumor-without-epidural-involvement
#8
Yan Su, Zhong-Zhen Sun, Long-Xiang Shen, Jian Ding, Zheng-Yu Xu, Yi-Min Chai, Wen-Qi Song, Dong Chen, Chun-Gen Wu
AIM: To evaluate the efficacy of percutaneous vertebroplasty (PVP) combined with interventional tumor removal (ITR) in providing pain relief, reducing disability, and improving functional performance in patients with malignant vertebral compression fractures without epidural involvement. METHODS: Patients with malignant vertebral compression fractures (n=58) were treated with either PVP+ITR (n=31, group A) or PVP alone (n=27, group B). A 14 G needle was inserted into the vertebral body, and the tract was sequentially dilated with working cannulae...
March 2017: Journal of Bone Oncology
https://www.readbyqxmd.com/read/28100669/the-preventive-value-of-epidural-calcitonin-in-patients-with-lower-limb-amputation
#9
Ayman A Yousef, Amr M Aborahma
BACKGROUND:  Postamputation pain is highly prevalent after limb amputation with neuropathic nature; calcitonin may effectively relieve many neuropathic pain states. DESIGN:  Double-blind randomized multicenter study. SETTING:  Our study hypothesis is to evaluate the preventive value of epidural calcitonin on postoperative pain, grade of phantom pain, and the development of allodynia and hyperalgesia in patients undergoing lower limb amputation...
January 18, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28099175/two-for-one-a-case-report-of-intravenous-lipid-emulsion-to-treat-local-anesthetic-systemic-toxicity-in-term-pregnancy
#10
Jonathan Dun-Chi Lin, Eellan Sivanesan, Terese T Horlocker, Andres Missair
Combined spinal-epidural (CSE) analgesia is a frequently used method of labor analgesia. Although it is considered safe and effective, CSE can be complicated by local anesthetic systemic toxicity (LAST), a potentially life-threatening condition. We present a case of LAST that developed in a primigravida 50 minutes after uneventful placement of a CSE. Her symptoms resolved within 10 minutes of administering intralipid emulsion. She subsequently underwent cesarean delivery under spinal anesthesia for failure to progress without sequelae in the mother or infant...
January 17, 2017: A & A Case Reports
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
#11
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
https://www.readbyqxmd.com/read/28041314/spinal-stereotactic-body-radiotherapy-following-intralesional-curettage-with-separation-surgery-for-initial-or-salvage-chordoma-treatment
#12
Dennis T Lockney, Timothy Shub, Benjamin Hopkins, Natalie A Lockney, Nelson Moussazadeh, Eric Lis, Yoshiya Yamada, Adam M Schmitt, Daniel S Higginson, Ilya Laufer, Mark Bilsky
OBJECTIVE Chordoma is a rare malignant tumor for which en bloc resection with wide margins is advocated as primary treatment. Unfortunately, due to anatomical constraints, en bloc resection to achieve wide or marginal margins is not feasible for many patients as the resulting morbidity would be prohibitive. The objective of this study was to evaluate the efficacy of intralesional curettage and separation surgery followed by spinal stereotactic body radiation therapy (SBRT) in patients with chordomas in the mobile spine...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28026887/combined-spinal-epidural-anesthesia-with-hypobaric-ropivacaine-in-sitting-position-significantly-increases-the-incidence-of-hypotension-in-parturients-undergoing-cesarean-section
#13
Zhendong Xu, Fuyi Shen, Yueqi Zhang, Yiyi Tao, Xiubing Chen, Zhiqiang Liu
AIM: Maternal position during induction of combined spinal-epidural anesthesia (CSEA) may affect hemodynamics and block characteristics. This study aimed to assess whether the sitting position is more likely to induce hypotension and higher block level than the lateral position in CSEA with hypobaric ropivacaine. METHODS: Ninety American Society of Anesthesiologists physical status I and II parturients undergoing elective cesarean section were randomized into three groups: the sitting, left-lateral, and right-lateral position groups...
December 27, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28017175/anesthesia-for-cesarean-section-in-a-patient-with-isolated-unilateral-absence-of-a-pulmonary-artery
#14
Tomonori Furuya, Ryoji Iida, Jyumpei Konishi, Jitsu Kato, Takahiro Suzuki
BACKGROUND AND OBJECTIVES: Congenital unilateral absence of a pulmonary artery (UAPA) is a rare anomaly. Although there are several reports regarding pregnancy in patients with unilateral absence of a pulmonary artery, there are no case reports describing anesthesia for Cesarean section in a patient with unilateral absence of a pulmonary artery. CASE REPORT: We present a patient with unilateral absence of a pulmonary artery who underwent Cesarean sections twice at the ages of 24 and 26 years under spinal anesthesia for surgery and epidural analgesia for postoperative pain relief...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28013485/influence-of-saline-based-hydroxyethyl-starch-on-umbilical-cord-blood-electrolytes
#15
Tomoaki Yatabe, Atsushi Nishigaki, Takahiko Tamura, Masataka Yokoyama
Hydroxyethyl starch (HES) is widely used to prevent and treat spinal anesthesia-induced hypotension during cesarean section. However, the use of saline-based HES may lead to hyperchloremia. This study aimed to clarify the effects of saline-based HES on umbilical cord chloride level at delivery. We retrospectively analyzed 93 consecutive single-pregnancy patients who underwent cesarean section with combined spinal-epidural anesthesia. The patients were divided into two groups, depending on the use of 6% HES 130/0...
December 24, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/28003695/anaesthesia-for-foetoscopic-laser-ablation-a-retrospective-study
#16
Vaishali Kumbhar, M Radhika, Parameswara Gundappa, Jayashree Simha, Prathima Radhakrishnan
BACKGROUND AND AIMS: Twin pregnancy with monochorionic placenta may be associated with arteriovenous vascular anastomosis of the placental vessels resulting in twin-to-twin transfusion syndrome (TTTS) and twin reversed arterial perfusion syndrome (TRAP). Foetoscopic LASER ablation (FLA) is the treatment of choice in reducing foetal mortality related to this. METHODS: A retrospective review of medical records of 41 FLA procedures for TTTS and TRAP were analysed for anaesthetic management...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28002168/nitrous-oxide-during-labor-maternal-satisfaction-does-not-depend-exclusively-on-analgesic-effectiveness
#17
Michael G Richardson, Brandon M Lopez, Curtis L Baysinger, Matthew S Shotwell, David H Chestnut
BACKGROUND: Evidence on the analgesic effectiveness of nitrous oxide for labor pain is limited. Even fewer studies have looked at patient satisfaction. Although nitrous oxide appears less effective than neuraxial analgesia, it is unclear whether labor analgesic effectiveness is the most important factor in patient satisfaction. We sought to compare the relationship between analgesic effectiveness and patient satisfaction with analgesia in women who delivered vaginally using nitrous oxide, neuraxial analgesia (epidural or combined spinal-epidural [CSE]), or both (neuraxial after a trial of nitrous oxide)...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27965310/rare-cause-of-back-pain-staphylococcus-aureus-vertebral-osteomyelitis-complicated-by-recurrent-epidural-abscess-and-severe-sepsis
#18
Louise Dunphy, Shabnam Iyer, Christopher Brown
An epidural abscess represents a rare acute medical emergency, with a reported incidence of 2.5/10 000 hospital admissions annually. The clinical features include fever, spinal pain, radiating nerve root pain and leg weakness. When sepsis is present, prompt recognition is required to initiate appropriate antimicrobial therapy and surgical decompression. We present the case of a man aged 68 years presenting to the emergency department with a 3-day history of fever, low back, right hip and leg pain. He was hypoxic, tachycardic and hypotensive...
December 13, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27935769/fluoroscopically-guided-epidural-injections-of-the-cervical-and-lumbar-spine
#19
Euddeum Shim, Joon Woo Lee, Eugene Lee, Joong Mo Ahn, Yusuhn Kang, Heung Sik Kang
Advances in imaging and the development of injection techniques have enabled spinal intervention to become an important tool in managing chronic spinal pain. Epidural steroid injection (ESI) is one of the most widely used spinal interventions; it directly delivers drugs into the epidural space to relieve pain originating from degenerative spine disorders-central canal stenoses and neural foraminal stenoses-or disk herniations. Knowledge of the normal anatomy of the epidural space is essential to perform an effective and safe ESI and to recognize possible complications...
December 9, 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27932148/low-dose-spinal-block-with-continuous-epidural-infusion-for-renal-transplantation-in-a-patient-with-alport-syndrome-a-case-report
#20
F Gobbi, G Sales, P Bretto, P P Donadio, L Brazzi
OBJECTIVE: We aim to describe management of a patient receiving renal transplantation for chronic renal failure due to Alport syndrome with low dose of intrathecal bupivacaine and continuous epidural infusion of local anesthetic. CASE REPORT: A 38-years-old man with chronic renal failure secondary to Alport syndrome underwent kidney transplantation. Because of a high risk of respiratory and cardiovascular complications related to the patient's baseline lung disease and abnormalities in heart conduction, we selected combined spinal-epidural anesthesia...
November 2016: Transplantation Proceedings
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