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https://www.readbyqxmd.com/read/29457112/anesthetic-management-during-a-cesarean-section-in-a-patient-with-cleidocranial-dysplasia-a-case-report
#1
Yumiko Nishio, Teruyuki Hiraki, Hiroko Taniguchi, Kazuo Ushijima
Background: Cleidocranial dysplasia is a type of skeletal dysplasia, which is primarily characterized by delayed ossification of skeletal structures. It causes facial and oral abnormalities, resulting in difficult airway management and neuraxial anesthesia. Case presentation: The patient was a 24-year-old primipara (height 138 cm, weight 42 kg) with a hypoplastic right clavicle, patent fontanelles, dental malalignment, and a high palate. She was diagnosed with cleidocranial dysplasia at birth, although gene examination has not been performed...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29455214/an-overview-of-complications-affecting-the-central-nervous-system-following-bariatric-surgery
#2
Azra Zafar, Ismail A Khatri
Bariatric surgery has been considered as an effective treatment for morbid obesity. Apart from procedures related complications, a broad spectrum of neurological disorders affecting any part of neuraxis has been reported following BS. Central nervous system complications, although less common than peripheral nervous system complications, carry significant morbidity and potential mortality. Encephalopathy, behavioral and psychiatric disorders, myelopathy and optic neuropathy are the most frequently reported CNS complications...
January 2018: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/29454959/exophytic-cerebral-hemispheric-low-grade-glioma-an-unusual-growth-pattern-of-a-common-central-nervous-system-tumour
#3
Suyash Singh, Kuntal Kanti Das, Sushila Jaiswal, Raj Kumar
BACKGROUND: Exophytic growth (EG), where in the tumor mass grows beyond the neuraxial boundary formed by pia mater, remains a rare pattern of glioma growth. It has been described in gliomas at several locations like the brainstem, cerebellum, suprasellar area, spinal cord and the insula. However, EG in hemispheric grade 2 astrocytomas, particularly affecting the convexity subarachnoid space, as against the more spacious basal subarachnoid space, is exceedingly rare. To the best of our knowledge, there is only one such case reported in the English literature...
February 15, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29433962/does-intrathecal-morphine-in-spinal-anesthesia-have-a-role-in-modern-multimodal-analgesia-for-primary-total-joint-arthroplasty
#4
Jonathan W Cheah, David C Sing, Erik N Hansen, Pedram Aleshi, Thomas P Vail
BACKGROUND: Intrathecal morphine (ITM) combined with bupivacaine spinal anesthesia can improve postoperative pain, but has potential side effects of postoperative nausea/vomiting (PONV) and pruritus. With the use of multimodal analgesia and regional anesthetic techniques, postoperative pain control has improved significantly to a point where ITM may be avoided in total joint arthroplasty (TJA). METHODS: We performed a retrospective study of primary TJA patients who underwent a standardized multimodal recovery pathway and received bupivacaine neuraxial anesthesia with ITM vs bupivacaine neuraxial anesthesia alone (control)...
January 31, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29416450/evaluation-of-the-neurotoxicity-of-intrathecal-dexmedetomidine-on-rat-spinal-cord-electromicroscopic-observations
#5
Dilek Ozdamar, Huban Dayioglu, Ihsan Anik, Seyhun Solakoglu, Mine Solak, Kamil Toker
Background: Spinal administration of dexmedetomidine has been proposed as an adjuvant in spinal anesthesia. However, there is limited information about its possible neurotoxic effect after its neuraxial administration. Potential spinal neurotoxicity should be investigated in animals before administering drugs through the spinal cord. Our aim was to investigate the neurotoxic effects of intrathecal dexmedetomidine in rats. Methods: Two groups were performed: the dexmedetomidine (D) group (n = 10) received 10 μg (0...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29408781/extradural-petromastoid-calcifying-pseudoneoplasm-of-the-neuraxis-capnon-case-report-and-literature-review
#6
Eric S Nussbaum, Chris Hilton, Archie Defillo, William McDonald, Theodore Passe, Kevin M Kallmes, Leslie A Nussbaum
BACKGROUND: Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a very rare tumor with fewer than 70 cases reported in the literature. In general, this tumor occurs intracranially either within the brain parenchyma or in an extra-axial location, but it has also been described within the spine as an extra-axial lesion. CASE DESCRIPTION: We describe an unusual case of intracranial-extradural CAPNON involving the mastoid region. This may be only the second such case reported in the literature, as one patient with CAPNON has been reported involving the sinonasal region...
January 12, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29408298/from-hypothermia-to-cephalo-somatic-anastomoses-the-legacy-of-robert-white-1926-2010-at-case-western-reserve-university-of-cleveland
#7
REVIEW
Sunil Manjila, Vilakshan Alambyan, Gagandeep Singh, Priyanka Satish, Robert T Geertman
Dr. Robert J. White (1926-2010) was an eminent neurosurgeon and bioethicist, renowned for his classic work in hypothermia and pioneering mammalian head transplant experiments. He founded the Division of Neurosurgery at the Cleveland Metropolitan General Hospital (currently MetroHealth Medical Center, a level 1 Trauma County Hospital) and eventually became the youngest full Professor at the Case Western Reserve University in Cleveland, Ohio. With over 500 research papers to his credit, he founded the Brain Research Laboratory at what was then the Cleveland Metropolitan General Hospital which was also home to future leaders in Neurosurgery, Neurosciences and allied specialties...
February 2, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29406172/the-impact-of-neuraxial-clonidine-on-postoperative-analgesia-and-perioperative-adverse-effects-in-women-having-elective-caesarean-section-a-systematic-review-and-meta-analysis
#8
REVIEW
T K Allen, B M Mishriky, R Y Klinger, A S Habib
Neuraxial clonidine improves postoperative analgesia in the general surgical population. The efficacy and safety of neuraxial clonidine as a postoperative analgesic adjunct in the Caesarean section population still remains unclear. This systematic review and meta-analysis aims to evaluate the effect of perioperative neuraxial clonidine on postoperative analgesia in women having Caesarean section under neuraxial anaesthesia. We included randomized controlled trials comparing the analgesic efficacy of the perioperative administration of neuraxial clonidine alone or in combination with a local anaesthetic and/or opioids in women having elective Caesarean section under neuraxial anaesthesia when compared with placebo...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29398999/the-fascia-iliaca-block-as-the-primary-intraoperative-anesthesia-for-hip-fracture-surgery-a-preliminary-study
#9
Joseph J Ruzbarsky, Elizabeth B Gausden, Elan M Goldwyn, Isaac P Lowenwirt, Vitaly Kotlyar
Background: Early surgical intervention for hip fractures in the elderly has proven efficacious. However, surgical delays commonly occur in this patient population due to comorbid conditions that put these patients at a high risk for hypotension-related complications of general or neuraxial anesthesia or anticoagulants that delay the safe use of neuraxial anesthesia. Questions/Purposes: The questions/purposes of this study are (1) to investigate if a fascia iliaca block in conjunction with light to moderate sedation could provide adequate analgesia throughout open surgery for intertrochanteric hip fractures (AO/OTA 31-1) without requiring conversion to general anesthesia with airway support and (2) to assess its perioperative complication profile...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/29398197/clinical-presentation-and-treatment-paradigms-in-patients-with-hereditary-hemorrhagic-telangiectasia-and-spinal-vascular-malformations
#10
Ilyas Eli, Nicholas T Gamboa, Evan J Joyce, Min S Park, Philipp Taussky, Richard H Schmidt, William T Couldwell, Jamie McDonald, Kevin J Whitehead, M Yashar S Kalani
Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder that causes angiodysplasia and results in mucocutaneous telangiectasias and arteriovenous malformations of organs. Although central nervous system vascular malformations can occur anywhere along the neuraxis, spinal vascular malformations are rare. We present our experience with the presentation and management of spinal vascular malformations in patients with HHT. Of the more than 800 patients with the diagnosis of HHT screened at our institution from 1995 through 2017, four patients with spinal vascular malformations (age range 1 month-77 years; 2 male, 2 female) were identified, three of whom came to clinical attention after significant neurological deterioration from previously unknown malformations...
February 2, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29388247/association-between-provider-type-and-cesarean-birth-in-healthy-nulliparous-laboring-women-a-retrospective-cohort-study
#11
Nicole S Carlson, Elizabeth J Corwin, Teri L Hernandez, Elizabeth Holt, Nancy K Lowe, K Joseph Hurt
BACKGROUND: Term nulliparous women have the greatest variation across hospitals and providers in cesarean rates and therefore present an opportunity to improve quality through optimal care. We evaluated associations between provider type and mode of birth, including examination of intrapartum management in healthy, laboring nulliparous women. METHODS: Retrospective cohort study using prospectively collected perinatal data from a United States academic medical center (2005-2012)...
January 31, 2018: Birth
https://www.readbyqxmd.com/read/29380588/neuraxial-anesthesia-and-septic-meningitis-please-be-reminded
#12
Gilda Cinnella, Antonella Cotoia
No abstract text is available yet for this article.
January 29, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29369958/epidural-hematoma-following-cessation-of-a-direct-oral-anticoagulant-a-case-report
#13
Jessica E Burjorjee, Rachel Rooney, Melanie Jaeger
OBJECTIVE: In this case report, we describe a case of epidural hematoma following epidural analgesia in a patient with recent cessation of a direct oral anticoagulant (DOAC). CASE REPORT: An 89-year-old woman requiring upper abdominal surgery presented with multiple comorbidities, including a prior cerebrovascular accident resulting in a left-sided hemiparesis and atrial fibrillation requiring anticoagulation with rivaroxaban. In accordance with our departmental guidelines at the time of procedure, rivaroxaban was discontinued 4 days preoperatively...
January 24, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29369957/plasma-ropivacaine-concentrations-following-local-infiltration-analgesia-in-total-knee-arthroplasty-a-pharmacokinetic-study-to-determine-safety-following-fixed-dose-administration
#14
Reuben J Miller, Andrew J Cameron, Julian Dimech, Robert J Orec, Nicholas J Lightfoot
BACKGROUND AND OBJECTIVES: The primary aim of this study was to examine the pharmacokinetics of ropivacaine in patients undergoing elective total knee arthroplasty with local infiltration analgesia as the primary analgesic method. We also sought to determine the incidence of biochemical toxicity through measurement of plasma ropivacaine concentrations over the first 24 hours postoperatively. METHODS: This was a prospective, observational study of 15 patients undergoing elective total knee arthroplasty...
January 24, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29361418/target-engagement-and-histopathology-of-neuraxial-resiniferatoxin-in-dog
#15
Tyler M Hockman, Alvaro F Cisternas, Bryan Jones, Mark T Butt, Kent G Osborn, Joanne J Steinauer, Shelle A Malkmus, Tony L Yaksh
OBJECTIVE: To evaluate target engagement of intracisternally (IC) delivered TRPV1 agonist, resiniferatoxin (RTX), as measured by primary afferent and dorsal horn substance P immunoreactivity (sP-IR), histopathology and thermal escape latencies in dogs. STUDY DESIGN: Prospective experimental trial. ANIMALS: Fourteen adult male Beagle dogs, weighing 10.3-13.2 kg; 11 dogs surviving to scheduled euthanasia. METHODS: Anesthetized dogs were randomly assigned to be administered IC RTX (3...
December 5, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29352812/usefulness-of-a-visual-aid-in-achieving-optimal-positioning-for-spinal-anesthesia-a-randomized-trial
#16
Usha Gurunathan, Shakeel Meeran Kunju, Karen Elizabeth Hay, Sharyn van Alphen
BACKGROUND: Optimal patient positioning is perceived as an essential factor to increase the success of performing neuraxial blockade. The primary objective of this study was to evaluate the benefit of using a visual image in addition to verbal instructions in order to optimize positioning for spinal block. METHODS: This was a prospective randomized controlled trial on 85 adult patients undergoing lower limb joint replacements at a tertiary academic hospital. Group 1(n = 43) randomized to receive standardized verbal instructions; Group 2 (n = 42) received standardized verbal instructions in conjunction with visual aids to achieve positioning for spinal anesthesia...
January 20, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29352624/anesthetic-management-of-two-parturients-with-cerebral-palsy-and-prior-selective-dorsal-rhizotomy
#17
C M Aiudi, E E Sharpe, K W Arendt, J J Pasternak, H P Sviggum
Selective dorsal rhizotomy is a surgical spine procedure used to reduce spasticity in patients with upper motor neuron dysfunction caused by conditions such as cerebral palsy. The optimal anesthetic approach for obstetric patients who have undergone a selective dorsal rhizotomy is unknown. The use and efficacy of neuraxial anesthesia in these patients has not been described. We describe the use of neuraxial anesthesia in two patients with prior selective dorsal rhizotomy. Unless contraindicated for other reasons, a neuraxial anesthetic approach appears to be an effective option in patients with a history of a selective dorsal rhizotomy...
December 15, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29351097/effect-of-epidural-infusion-bolus-delivery-rate-on-the-duration-of-labor-analgesia-a-randomized-clinical-trial
#18
Elizabeth M S Lange, Cynthia A Wong, Paul C Fitzgerald, Wilmer F Davila, Suman Rao, Robert J McCarthy, Paloma Toledo
BACKGROUND: Programmed intermittent boluses of local anesthetic have been shown to be superior to continuous infusions for maintenance of labor analgesia. High-rate epidural boluses increase delivery pressure at the catheter orifice and may improve drug distribution in the epidural space. We hypothesized that high-rate drug delivery would improve labor analgesia and reduce the requirement for provider-administered supplemental boluses for breakthrough pain. METHODS: Nulliparous women with a singleton pregnancy at a cervical dilation of less than or equal to 5 cm at request for neuraxial analgesia were eligible for this superiority-design, double-blind, randomized controlled trial...
January 19, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29344649/effects-of-intrathecal-bupivacaine-on-the-nr2b-camkii%C3%AE-creb-signaling-pathway-in-the-rat-lumbar-spinal-cord
#19
Liyan Zhao, Yonghai Zhang, Fan Yang, Di Zhu, Ningkang Li, Li Zhao, Na Li, Jianqiang Yu, Hanxiang Ma
Neuraxial anesthesia produces an anesthetic-sparing, sedative effect. The mechanism underlying this effect potentially involves decreased spinal afferent input. However, the neurochemical mechanisms at the spinal level remain unknown. The N‑methyl‑D‑aspartate receptor 2B subunit/calcium‑calmodulin‑dependent protein kinase II α/cAMP response element‑binding protein (NR2B/CaMKIIα/CREB) signaling pathway serves an important role in regulating the transmittance of peripheral noxious stimulation to supraspinal regions in the process of nociception...
January 17, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29332115/ultrasound-guided-transversus-abdominis-plane-block-postoperative-analgesia-in-children-with-spinal-dysraphism
#20
Eralp Çevikkalp, Koray Erbüyün, Serpil Erbüyün, Gülay Ok
Pediatric regional anesthesia is widely used to relieve postoperative pain after abdominal surgery. Commonly used techniques of regional anesthesia include lumbar epidural and caudal block. However, the use of central neuraxial blockade has limitations. It is contraindicated in patients with clotting abnormalities, spinal dysraphism with tethered cord syndrome, meningomyelocele, and following spinal surgery with instrumentation. Ultrasound guided transversus abdominis plane block is a new method of regional anesthesia that can be used in settings where central neuraxial blockade is contraindicated...
January 2018: Saudi Medical Journal
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