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https://www.readbyqxmd.com/read/29912877/low-cost-three-dimensional-printed-phantom-for-neuraxial-anesthesia-training-development-and-comparison-to-a-commercial-model
#1
Azad Mashari, Mario Montealegre-Gallegos, Jelliffe Jeganathan, Lu Yeh, Joshua Qua Hiansen, Massimiliano Meineri, Feroze Mahmood, Robina Matyal
METHODS: Anonymized CT DICOM data was segmented to create a 3D model of the lumbar spine. The 3D model was modified, placed inside a digitally designed housing unit and fabricated on a desktop 3D printer using polylactic acid (PLA) filament. The model was filled with an echogenic solution of gelatin with psyllium fiber. Twenty-two staff anesthesiologists performed a spinal and epidural on the 3D printed simulator and a commercially available Simulab phantom. Participants evaluated the tactile and ultrasound imaging fidelity of both phantoms via Likert-scale questionnaire...
2018: PloS One
https://www.readbyqxmd.com/read/29910631/clonidine-versus-other-adjuncts-added-to-local-anesthetics-for-pediatric-neuraxial-blocks-a-systematic-review-and-meta-analysis
#2
REVIEW
Yang Yang, Ling-Yu Yu, Wen-Sheng Zhang
Background: Clonidine is a common adjunct to local anesthetics for pediatric neuraxial block; however, the pros and cons between clonidine and other adjuncts remain unclear. Thus, we performed this meta-analysis of randomized controlled trials to assess the efficacy and adverse effects between clonidine and other adjuncts added to local anesthetics. Materials and methods: The systematic search, data extraction, critical appraisal, and pooled analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29901585/abdominal-peripheral-nerve-block-as-the-only-anesthetic-technique-for-totally-extraperitoneal-endoscopic-inguinal-hernia-repair-two-case-reports
#3
Woojin Kwon, Seunguk Bang, Hyojung Soh, Won Jun Jeong, Sang Chul Lee, Byung Jo Choi
RATIONALE: Laparoscopic totally extraperitoneal (TEP) inguinal hernia repair is a rapidly evolving, minimally invasive treatment modality for inguinal hernia. Compared with open hernia repair, this method requires a smaller incision, has cosmetic advantages, and facilitates rapid recovery and early return to daily activities because of less postoperative pain. Because general anesthesia is essential for TEP hernia repair, it cannot be performed on patients who have an increased risk of developing complications when placed under general anesthesia...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29894394/improving-clinical-proficiency-using-a-3-dimensionally-printed-and-patient-specific-thoracic-spine-model-as-a-haptic-task-trainer
#4
Jeffrey Bortman, Yanick Baribeau, Jelliffe Jeganathan, Yannis Amador, Faraz Mahmood, Marc Shnider, Muneeb Ahmed, Philip Hess, Robina Matyal
BACKGROUND AND OBJECTIVES: Advanced haptic simulators for neuraxial training are expensive, have a finite life, and are not patient specific. We sought to demonstrate the feasibility of developing a custom-made, low-cost, 3-dimensionally printed thoracic spine simulator model from patient computed tomographic scan data. This study assessed the model's practicality, efficiency as a teaching tool, and the transfer of skill set into patient care. METHODS: A high-fidelity, patient-specific thoracic spine model was used for the study...
June 11, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29889119/targeting-toll-like-receptor-4-tlr4-emerging-therapeutic-target-for-persistent-pain-states
#5
Kelly Bruno, Sarah A Woller, Yury I Miller, Tony L Yaksh, Mark Wallace, Graham Beaton, Krishnan Chakravarthy
Toll-like receptors (TLRs) are a family of pattern-recognition receptors that initiate signaling in innate and adaptive immune pathways. The highly conserved family of transmembrane proteins are comprised of an extracellular domain that recognizes exogenous and endogenous danger molecules and an ectodomain that activates downstream pathways in response. Recent studies suggest that continuous activation or dysregulation of TLR signaling may contribute to chronic disease states. The receptor is located not only on inflammatory cells (meningeal and peripheral macrophages) but on neuraxial glia (microglia and astrocytes), schwann cells, fibroblasts, dorsal root ganglia and dorsal horn neurons...
June 7, 2018: Pain
https://www.readbyqxmd.com/read/29887886/anesthesiologists-preferences-regarding-visitor-presence-during-placement-of-neuraxial-labor-analgesia
#6
Sangeeta Kumaraswami, Suryanarayana Pothula, Mario Anthony Inchiosa, Keshar Paul Kubal, Micah Alexander Burns
Introduction: Neuraxial labor analgesia has become an integral part of modern obstetric anesthetic practice. Presence of a familiar person during its placement may be beneficial to the patient. A survey was sent to anesthesiologists practicing obstetric anesthesia in the USA to determine their views. Methods: The survey queried the following: existence of a written policy; would they allow a visitor; visitor's view, sitting or standing; reasons to allow or not allow a visitor; and influence by other staff on the decision...
2018: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/29878899/do-hospitals-performing-frequent-neuraxial-anesthesia-for-hip-and-knee-replacements-have-better-outcomes
#7
Stavros G Memtsoudis, Jashvant Poeran, Nicole Zubizarreta, Ashley Olson, Crispiana Cozowicz, Eva E Mörwald, Edward R Mariano, Madhu Mazumdar
BACKGROUND: Neuraxial anesthesia is increasingly recommended for hip/knee replacements as some studies show improved outcomes on the individual level. With hospital-level studies lacking, we assessed the relationship between hospital-level neuraxial anesthesia utilization and outcomes. METHODS: National data on 808,237 total knee and 371,607 hip replacements were included (Premier Healthcare 2006 to 2014; 550 hospitals). Multivariable associations were measured between hospital-level neuraxial anesthesia volume (subgrouped into quartiles) and outcomes (respiratory/cardiac complications, blood transfusion/intensive care unit need, opioid utilization, and length/cost of hospitalization)...
June 7, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29858103/-calcifying-pseudoneoplasm-of-the-neuraxis
#8
Mathilde Duchesne, Quoc Dat Nguyen, Anne Guyot, Isabelle Pommepuy, François Caire, François Labrousse
Calcifying pseudoneoplasms of the neuraxis (CAPNON) are rare lesions of the central nervous system. To date, about 60 cases have been reported in literature. We present a case that had the peculiarity to occur in a pregnant woman. At 32 weeks of gestation, a 26-year-old woman was hospitalized to explore nocturnal epigastralgia. During the hospitalisation, the patient presented generalised seizures. As an eclampsia had been suspected, a caesarean delivery was performed. Post-operatively, the patient harboured memory disorders and neuro-imaging explorations were done...
May 29, 2018: Annales de Pathologie
https://www.readbyqxmd.com/read/29851691/novel-treatment-using-intravenous-dantrolene-sodium-for-postoperative-exacerbated-spasticity-in-multiple-sclerosis-a-case-report
#9
Emily L Sturgill, Robert L Wittwer
Patients with upper motor neuron disease, such as multiple sclerosis, can present with severe spasticity in the perioperative period. In most cases, this can be managed with a combination of preoperative oral medications, regional or neuraxial anesthetic techniques, and intravenous muscle relaxants. We describe the clinical presentation of a patient with multiple sclerosis and the successful use of intravenous dantrolene sodium postoperatively for the treatment of exacerbated spasticity refractory to traditional management...
May 29, 2018: A&A practice
https://www.readbyqxmd.com/read/29848107/continuous-local-bupivacaine-wound-infusion-with-neuraxial-morphine-reduces-opioid-consumption-after-cesarean-delivery
#10
Michael Zaretsky, Cristina Wood, Traci Nivens, Gerald McLaughlin, Jeannie Zuk, Zhaoxing Pan, Franklin Chow
BACKGROUND: As a part of a quality improvement program, maternal postoperative opioid use and pain scores were compared between those receiving continuous infusion of bupivacaine for local incisional pain control with multimodal pain management and neuraxial morphine versus multimodal pain management with neuraxial morphine alone. OBJECTIVE: We compared postoperative opioid use and pain scores between the multimodal pain management group with neuraxial morphine and the group receiving multimodal pain management, neuraxial morphine, and continuous infusion of bupivacaine for local incisional pain control...
May 30, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29847387/readiness-for-discharge-after-foot-and-ankle-surgery-using-peripheral-nerve-blocks-a-randomized-controlled-trial-comparing-spinal-and-general-anesthesia-as-supplements-to-nerve-blocks
#11
Jacques T YaDeau, Kara G Fields, Richard L Kahn, Vincent R LaSala, Scott J Ellis, David S Levine, Leonardo Paroli, Thuyvan H Luu, Matthew M Roberts
BACKGROUND: Neuraxial anesthesia is often viewed as superior to general anesthesia but may delay discharge. Comparisons do not typically use multimodal analgesics and nerve blockade. Combining nerve blockade with general anesthesia may reduce pain, opioid consumption, and nausea. We hypothesized that general anesthesia (with nerve blocks) would lead to earlier readiness for discharge, compared to spinal anesthesia (with nerve blocks). METHODS: All patients underwent ambulatory foot and ankle surgery, with a predicted case duration of 1-3 hours...
May 25, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29846203/reply-to-the-letter-to-the-editor-incidence-of-neuraxial-abnormalities-is-approximately-8-among-patients-with-adolescent-idiopathic-scoliosis-a-meta-analysis
#12
Michael Faloon, Nikhil Sahai, Todd P Pierce, Conor J Dunn, Kumar Sinha, Ki Soo Hwang, Arash Emami
No abstract text is available yet for this article.
May 24, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29808972/anesthesia-and-analgesia-for-total-knee-arthroplasty-a-narrative-review
#13
Ellen M Soffin, Stavros G Memtsoudis
BACKGROUND: The demand for total knee arthroplasty (TKA) is rising worldwide. Controversy persists in the literature regarding the benefits of general vs. neuraxial anesthesia and which anesthetic is associated with the best outcomes. Likewise, the abundance of analgesic options for post-TKA pain have led to debate regarding the safest, most effective regimens. METHODS: In this narrative review, we evaluated a selection of recent publications regarding anesthetic and analgesic choices for TKA...
May 28, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29808071/use-of-trans-cutaneous-electric-nerve-stimulation-tens-can-alleviate-labour-pain-and-delay-the-use-of-neuraxial-analgesia
#14
Muhammad Osama
No abstract text is available yet for this article.
April 2018: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/29794942/major-laparoscopic-intraperitoneal-surgery-performed-with-combined-bilateral-subcostal-transversus-abdominal-plane-block-and-celiac-plexus-block-intravenous-sedation-without-tracheal-intubation-a-feasibility-study-of-3-cases
#15
Azeddine Taleb, MʼHamed Boumadani, Paul J Zetlaoui, Dan Benhamou
OBJECTIVES: Major abdominal surgery usually requires general anesthesia with tracheal intubation and may be supplemented with neuraxial anesthesia to provide intraoperative and postoperative pain relief. Attempts at using only neuraxial anesthesia for major abdominal surgery have often been shown to be poorly effective. This report demonstrates that laparoscopic colonic surgical procedures can be performed with ultrasound-guided blocks (bilateral transversus abdominal plane block and celiac plexus block) and intravenous sedation, while avoiding general or neuraxial anesthesia...
May 23, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29794308/reducing-risk-of-spinal-haematoma-from-spinal-and-epidural-pain-procedures
#16
Harald Breivik, Hilde Norum, Christian Fenger-Eriksen, Seppo Alahuhta, Gísli Vigfússon, Owain Thomas, Michael Lagerkranser
BACKGROUND AND AIMS: Central neuraxial blocks (CNB: epidural, spinal and their combinations) and other spinal pain procedures can cause serious harm to the spinal cord in patients on antihaemostatic drugs or who have other risk-factors for bleeding in the spinal canal. The purpose of this narrative review is to provide a practise advisory on how to reduce risk of spinal cord injury from spinal haematoma (SH) during CNBs and other spinal pain procedures. Scandinavian guidelines from 2010 are part of the background for this practise advisory...
April 25, 2018: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29790120/changes-in-the-augmentation-index-and-postoperative-orthostatic-intolerance-in-orthopedic-surgery-a-prospective-cohort-study
#17
Stavros G Memtsoudis, Eva E Mörwald, Kara Fields, Crispiana Cozowicz, Nigel E Sharrock, Mathias Opperer, Ottokar Stundner, Angie Zhang, George Go, Thomas Danninger
BACKGROUND: Postoperative orthostatic intolerance (OI) can be a major obstacle to early ambulation and its determinants are poorly understood. We aimed to study postoperative changes in vascular tone and their potential association with OI in various orthopedic surgical settings. METHODS: In this prospective cohort study, 350 patients undergoing total joint arthroplasty under neuraxial anesthesia or spine surgery under general anesthesia were enrolled. We determined the augmentation index (AI) as a measure of vascular tone and studied symptoms of OI using a validated questionnaire at various postoperative time points...
May 22, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29782401/is-neuraxial-anesthesia-appropriate-for-cesarean-delivery-in-all-cases-of-morbidly-adherent-placenta
#18
Mohamed Mohamed Tawfik, Mohamed Ahmed Tolba, Sarah Salah Moawad, Khalid Samir Ismail, Mohamed Elsayed Taman
No abstract text is available yet for this article.
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782398/benefit-and-harm-of-adding-epinephrine-to-a-local-anesthetic-for-neuraxial-and-locoregional-anesthesia-a-meta-analysis-of-randomized-controlled-trials-with-trial-sequential-analyses
#19
Clément Tschopp, Martin R Tramèr, Alexis Schneider, Maroun Zaarour, Nadia Elia
BACKGROUND: This systematic review examines the benefit and harm of adding epinephrine to local anesthetics for epidural, intrathecal, or locoregional anesthesia. METHODS: We searched electronic databases to October 2017 for randomized trials comparing any local anesthetic regimen combined with epinephrine, with the same local anesthetic regimen without epinephrine, reporting on duration of analgesia, time to 2 segments regression, or any adverse effects. Trial quality was assessed using the Cochrane risk of bias tool and a random-effects model was used...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29781912/letter-to-the-editor-incidence-of-neuraxial-abnormalities-is-approximately-8-among-patients-with-adolescent-idiopathic-scoliosis-a-meta-analysis
#20
Hai-Qiang Wang, Jun Zhang, Xin He, Fu-Jun Luan
No abstract text is available yet for this article.
May 17, 2018: Clinical Orthopaedics and related Research
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