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Combined spinal epidural

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https://www.readbyqxmd.com/read/29339580/advantages-of-soft-subdural-implants-for-the-delivery-of-electrochemical-neuromodulation-therapies-to-the-spinal-cord
#1
Marco Capogrosso, Jérôme Gandar, Nathan Greiner, Eduardo Martin Moraud, Nikolaus Wenger, Polina Shkorbatova, Pavel E Мusienko, Ivan Minev, Stephanie P Lacour, Gregoire Courtine
We recently developed soft neural interfaces enabling the delivery of electrical and chemical stimulation to the spinal cord. These stimulations restored locomotion in animal models of paralysis. Soft interfaces can be placed either below or above the dura mater. Theoretically, the subdural location combines many advantages, including increased selectivity of electrical stimulation, lower stimulation thresholds, and targeted chemical stimulation through local drug delivery. However, these advantages have not been documented, nor have their functional impact been studied in-silico or in a relevant animal model of neurological disorders using a multimodal neural interface...
January 17, 2018: Journal of Neural Engineering
https://www.readbyqxmd.com/read/29330854/combined-spinal-epidural-vs-spinal-anaesthesia-for-caesarean-section-meta-analysis-and-trial-sequential-analysis
#2
REVIEW
M Klimek, R Rossaint, M van de Velde, M Heesen
Combined spinal-epidural and single-shot spinal anaesthesia are both used for caesarean section. It has been claimed in individual trials that combined spinal-epidural is associated with higher sensory spread and greater cardiovascular stability. We set out to gather all available evidence. We performed: a systematic literature search to identify randomised controlled trials comparing combined spinal-epidural with spinal anaesthesia for caesarean section: conventional meta-analysis; trial-sequential analysis; and assessment of trial quality using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system...
January 13, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29326765/pneumocephalus-following-combined-spinal-epidural-anaesthesia-for-total-knee-arthroplasty-a-case-report
#3
Y W Chew, V K Suppan, S R Ashutosh, M M Tew, J H Jimmy-Tan
The authors describe a case of pneumocephalus following epidural anaesthesia for total knee arthroplasty. Multiple attempts in locating the epidural space for the anaesthesia and the use of loss of resistance to air (LORA) technique were identified as the source of air entry. Supportive management was given including high flow oxygenation therapy and spontaneous reabsorption of air was noted five days after surgery. The presence of pneumocephalus should be kept in mind if patient develops neurological complications postoperatively following epidural anaesthesia...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29322504/a-randomised-controlled-trial-comparing-needle-movements-during-combined-spinal-epidural-anaesthesia-with-and-without-ultrasound-assistance
#4
A Chin, B Crooke, L Heywood, R Brijball, A M Pelecanos, W Abeypala
Ultrasound assistance for neuraxial techniques may improve technical performance; however, it is unclear which populations benefit most. Our study aimed to investigate the efficacy of neuraxial ultrasound in women having caesarean section with combined spinal-epidural anaesthesia, and to identify factors associated with improved technical performance. Two-hundred and eighteen women were randomly allocated to ultrasound-assisted or control groups. All the women had a pre-procedure ultrasound, but only women in the ultrasound group had this information conveyed to the anaesthetist...
January 10, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29311012/anesthetic-management-of-mosaic-turner-s-syndrome-posted-for-elective-cesarean-delivery-after-spontaneous-pregnancy
#5
K Kalopita, L Michala, C Theofanakis, D Valsamidis
Turner's syndrome, one of the most common sex chromosome abnormalities in females, is caused by loss of part or all of an X chromosome. We report a case of mosaic Turner's syndrome, posted for elective cesarean delivery under low-dose sequential combined spinal epidural anesthesia. The unique features of this case were the combination of an anticipated difficult airway and both short stature and scoliosis in the lumbar region. A titrated combined spinal-epidural technique was performed in order to avoid hemodynamic instability, which could have been exacerbated in the presence of cardiovascular deformities that accompany this syndrome in many cases...
November 26, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29300003/effects-of-inhalation-anesthesia-vs-total-intravenous-anesthesia-tiva-vs-spinal-epidural-anesthesia-on-deep-vein-thrombosis-after-total-knee-arthroplasty
#6
Lu-Yang Zhou, Wei Gu, Yun Liu, Zheng-Liang Ma
BACKGROUND The objective of the present study was to evaluate the varying efficacy of general anesthesia (GA), combined spinal-epidural anesthesia (CSEA), and total intravenous anesthesia (TIVA) on the occurrence of deep vein thrombosis (DVT) following total knee arthroplasty (TKA). MATERIAL AND METHODS From July 2013 to May 2015, a total of 197 cases of patients who had undergone TKA treatment at either the Drum Tower Hospital or Nanjing General Hospital of Nanjing Military Command were recruited to participate in the study...
January 4, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29284868/comparison-of-three-different-concentrations-0-2-0-5-and-0-75-epidural-ropivacaine-for-postoperative-analgesia-in-lower-limb-orthopedic-surgery
#7
Amitesh Pathak, Neeraj Yadav, Sati Nath Mohanty, Ekta Ratnani, Om Prakash Sanjeev
Introduction: Ropivacaine has been studied previously and holds promise as an agent that offers a safe, efficacious, and better recovery profile than other conventional agents such as bupivacaine. The aim of the present study was to compare the safety and efficacy of equal volume of different concentration of ropivacaine for epidural analgesia in patients undergoing major lower limb orthopedic surgery. Subjects and Methods: One hundred and fifty adult patients were randomized into three groups to receive single dose of equal volume of ropivacaine through epidural route in concentrations of 0...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284849/comparison-of-the-efficacy-and-safety-of-morphine-and-fentanyl-as-adjuvants-to-bupivacaine-in-providing-operative-anesthesia-and-postoperative-analgesia-in-subumblical-surgeries-using-combined-spinal-epidural-technique
#8
Owais Mushtaq Shah, Kharat Mohammad Bhat
Introduction: The combined spinal epidural (CSE) technique involves intentional subarachnoid blockade and epidural catheter placement during the same procedure to combine their individual best features, to reduce the total drug dosage and avoid their respective disadvantages. The addition of opioids to local anesthetics (bupivacaine) for CSE anesthesia (CSEA) is increasingly common to enhance the block. Neuraxial fentanyl is more potent and has shorter duration of action than morphine which provides prolonged anesthesia and analgesia, however at the cost of increased incidence of adverse effects like delayed respiratory depression...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29244699/acute-and-rapid-development-of-spontaneous-spinal-epidural-hematoma-associated-with-combined-aspirin-dipyridamole-therapy-a-case-report
#9
Kent Yamaguchi, Justin Mathew, James M Lhi, Don Young Park
CASE: Spontaneous spinal epidural hematoma (SSEH) is a known, although rare, clinical entity that may be challenging to diagnose. This case report describes the rapid development of a large SSEH in an elderly patient on aspirin-dipyridamole combination therapy after she shifted her position in bed. Magnetic resonance imaging obtained 4 hours after the onset of symptoms demonstrated a large spinal epidural hematoma that extended from T4 to L1. CONCLUSION: With early diagnosis, the patient was successfully treated with a laminectomy and evacuation of the hematoma, and there was full neurological recovery...
January 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29237658/emergency-salpingectomy-for-ruptured-ectopic-pregnancy-in-patient-with-melnick-needles-syndrome-a-rare-otopalatodigital-syndrome
#10
Mark Zachary Johnson, Cormac Francis Mullins, Declan Keane, Ingrid Browne
Melnick-Needles syndrome (M-NS) is a rare genetic disorder which primarily affects skeletal developments. M-NS may also affect the cardiorespiratory and renal systems. A 35 kg patient presented complaining of abdominal pain. Following a positive pregnancy test and ultrasound examination, she was diagnosed with a ruptured ectopic pregnancy. She had a significant background history of M-NS, obstructive sleep apnoea (with narrow gauge tracheostomy in situ), obstructive lung disease and scoliosis. She received fluid resuscitation, and the case was managed using an open salpingectomy and clot evacuation under combined spinal/epidural anaesthesia...
December 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29233569/continuous-adductor-canal-blocks-provide-superior-ambulation-and-pain-control-compared-to-epidural-analgesia-for-primary-knee-arthroplasty-a-randomized-controlled-trial
#11
Erdan Kayupov, Kamil Okroj, Adam C Young, Mario Moric, Timothy J Luchetti, Gilat Zisman, Asokumar Buvanendran, Tad L Gerlinger, Craig J Della Valle
BACKGROUND: Adductor canal blocks (ACBs) are an alternative to femoral nerve blocks that minimize lower extremity weakness. However, it is unclear whether this block will provide analgesia that is equivalent to techniques, such as epidural analgesia. The purpose of this randomized controlled trial was to compare continuous ACBs with epidural analgesia for primary total knee arthroplasty. METHODS: Following institutional review board approval, 145 patients were randomized to 1 of 3 groups: combined spinal-epidural (CSE), spinal + continuous ACB (CACB), or general + CACB...
November 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29207811/comparative-evaluation-of-ropivacaine-and-fentanyl-versus-ropivacaine-and-fentanyl-with-clonidine-for-postoperative-epidural-analgesia-in-total-knee-replacement-surgery
#12
Shivali Panwar, Preeti S Govind, Parag Jyoti Duarah, Hari Kishan Mahajan, Smita Anil Korde
Introduction: Clonidine an alpha 2 adrenoceptor agonist possesses analgesic properties and has been used as an adjuvant in epidural analgesia. The addition of clonidine to other analgesics may result in enhanced analgesia through additive mechanisms or synergistic mechanisms. The enhanced analgesia may lead to a decrease in the dosage of analgesic drugs along with reduction of side effects. Aim: The purpose of this study was to evaluate the effect of adding clonidine to epidural ropivacaine and fentanyl mixture in terms of quality of analgesia and side effects in patients of total knee replacement surgery...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29200112/epidemiology-treatment-and-complications-of-central-nervous-system-metastases
#13
Amy A Pruitt
PURPOSE OF REVIEW: Neurologic problems resulting from systemic cancer metastases to brain parenchyma, dura, spinal cord, and leptomeninges are among the most common types of consultations addressed by neurologists. With patients surviving longer from systemic cancer, along with the rapidly evolving therapeutic options, the treatment of these devastating complications has become both more effective and more complicated. This article reviews current patterns of metastatic disease and the increasingly nuanced landscape of evolving therapies, their complications, and their impact on quality of survival...
December 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29186582/safety-of-spinal-cord-stimulation-in-patients-who-routinely-use-anticoagulants
#14
Hirah Khan, Vignessh Kumar, Zohal Ghulam-Jelani, Sarah E McCallum, Ellie Hobson, Vishad Sukul, Julie G Pilitsis
Objective: We assess the safety of performing the epidural placement or revision of spinal cord stimulation (SCS) in patients whose anticoagulation has been held (termed "anticoagulant-suspended" patients) in accordance with the 2017 Neurostimulation Appropriateness Consensus Committee (NACC) guidelines. Subjects: Patients undergoing SCS were included in this institutional review board-approved study. Design: A retrospective analysis of a prospectively collected database was performed...
November 27, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29122701/predictors-of-quality-of-life-improvement-after-surgery-for-metastatic-tumors-of-the-spine-prospective-cohort-study
#15
Ori Barzilai, Lily McLaughlin, Mary-Kate Amato, Anne S Reiner, Shahiba Q Ogilvie, Eric Lis, Yoshiya Yamada, Mark H Bilsky, Ilya Laufer
BACKGROUND CONTEXT: Surgical decompression and stabilization followed by radiosurgery represents an effective method for local tumor control and neurologic preservation for patients with metastatic epidural spinal cord compression. We have previously demonstrated improvement in HrQOL after this combined modality treatment ("hybrid therapy"). PURPOSE: The current analysis focuses on delineation of patient-specific prognostic factors predictive of HrQOL change after combined surgery-SRS treatment of MESCC...
November 6, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29109653/combined-spinal-epidural-anesthesia-for-cesarean-section-in-a-parturient-with-congenitally-corrected-transposition-of-the-great-arteries
#16
Mohamed Mohamed Tawfik, Helmi Hafez, Mostafa Abdelkhalek, Nasser Sameh Allakkany
No abstract text is available yet for this article.
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29108403/epidemiology-of-septic-meningitis-associated-with-neuraxial-anesthesia-a-historical-review-and-meta-analysis
#17
Andres Zorrilla-Vaca, Ryan J Healy, Lucia Rivera-Lara, Michael C Grant, Lisa L Maragakis, Kevin Escandón-Vargas, Marek A Mirski
BACKGROUND: Neuraxial anesthesia in the form of spinal and epidural are two of the most frequent forms of regional anesthesia. We aimed to describe and compare the relevant epidemiological, clinical and microbiological characteristics of all reported cases of septic meningitis associated with the use of spinal and epidural anesthetics. METHODS: We performed a systematic review of septic meningitis associated with neuraxial anesthesia. We included all relevant case-reports and observational studies in which authors described septic meningitis in association with spinal, epidural or combined neuraxial anesthesia using local anesthetics...
November 6, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29090262/conus-medullaris-trauma-is-there-a-greater-risk-in-parturients
#18
Julie Verkooijen, Hilde Coppejans, Els Mertens, Vera Saldien, Marcel Vercauteren
BACKGROUND: There is some evidence that anaesthetists often perform neuraxial blocks at a higher lumbar interspace than intended. It may be questioned whether parturients are at greater risk for neurological damage when the dura is perforated at a more cephalad interspace than L2-L3. METHODS: Thirty-six patients scheduled for elective Caesarean delivery under CSE anaesthesia were selected for study. Using a B-D Durasafe Adjustable needle combination, the skin-to-epidural distance and the width of the epidural space were measured and matched with 36 female patients undergoing the same anaesthetic technique for orthopaedic procedures...
October 2017: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29081513/localization-of-the-primary-sites-of-involvement-in-the-spinal-sensory-and-motor-pathways-for-multilevel-mri-abnormalities-in-degenerative-cervical-myelopathy
#19
Nobuaki Tadokoro, Toshikazu Tani, Kazunobu Kida, Katsuhito Kiyasu, Yusuke Kasai, Masashi Kumon, Ryuichi Takemasa, Masahiko Ikeuchi
STUDY DESIGN: Exploratory clinical study. OBJECTIVES: To localize the sites of conduction block in the spinal sensory and motor pathways for minimizing the level of surgical intervention despite MRI evidence of compression at several levels in degenerative cervical myelopathy (DCM). SETTING: Kochi Medical School Hospital, Japan. METHODS: We analyzed 83 DCM patients (69 ± 12 years) who underwent serial intervertebral recording of both ascending (A-SCEPs) and descending spinal cord-evoked potentials (D-SCEPs) after epidural and transcranial stimulation, respectively, during surgery before decompression procedures...
October 30, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29080306/retrospective-analysis-of-obstetric-and-anesthetic-management-of-patients-with-placenta-accreta-spectrum-disorders
#20
Efrain Riveros-Perez, Cristina Wood
OBJECTIVE: To assess the management and maternal outcomes of placenta accreta spectrum (PAS) disorders. METHODS: A retrospective chart review was conducted of patients diagnosed with PAS disorders (placenta creta, increta, or percreta) who were treated at a US tertiary care center between February 1, 2011, and January 31, 2016. Obstetric management, anesthetic management, and maternal outcomes were analyzed. RESULTS: A total of 43 cases were identified; placenta previa was diagnosed among 33 (77%)...
October 28, 2017: International Journal of Gynaecology and Obstetrics
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