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spinal anaesthesia

Denise McCarthy, John McNamara, John Galbraith, Frank Loughnane, George Shorten, Gabriella Iohom
BACKGROUND: Local infiltration analgesia (LIA) is an effective pain management technique following total knee arthroplasty (TKA). OBJECTIVE: To investigate if LIA provides better analgesia for patients undergoing unilateral TKA than intrathecal morphine. DESIGN: Randomised controlled trial. SETTING: Single tertiary referral centre. PATIENTS: Consecutive American Society of Anesthesiologists Physical Status I to III patients scheduled to undergo unilateral TKA were randomised to two groups...
January 10, 2019: European Journal of Anaesthesiology
Sukhman Shergill, Ursula Galway
No abstract text is available yet for this article.
December 2018: Indian Journal of Anaesthesia
Nitu Puthenveettil, Sunil Rajan, Anish Mohan, Jerry Paul, Lakshmi Kumar
Background and Aims: Post-dural puncture headache (PDPH) is a consequence of spinal and epidural anaesthesia in approximately 1% of obstetric patients. The gold standard for its treatment is epidural blood patch. Sphenopalatine ganglion block (SPGB) has been proposed as a non-invasive intervention with minimal adverse effect. The primary objective of this study was to assess the efficacy of SPGB for treatment of PDPH. Secondary objectives were to assess onset of analgesia, duration of block and adverse effects...
December 2018: Indian Journal of Anaesthesia
Bigna S Buddeberg, Oliver Bandschapp, Thierry Girard
Neuraxial analgesia and anaesthesia are widely used in obstetric anaesthesia. The most frequent complication after neuraxial blocks is post dural puncture headache. It can occur after unintentional dural puncture during epidural procedures or after spinal anaesthesia. Unintentional dural puncture occurs in 0.15-1.5% of labour epidural analgesia and 50-80% of these women develop post dural puncture headache. The headache is typically orthostatic in nature and can be so incapacitating that the mother becomes bedbound and is no longer able to care for herself and her newborn child...
January 4, 2019: Minerva Anestesiologica
Sherif Abdallah Mohamed, Ayman Mohamed Hussam, Sarah Ahmed Abdallah, Khaled Abdelfattah Sarhan, Abdelkhalek Mahmoud Shaban
BACKGROUND: One of the important and predicted physiological effects of spinal anaesthesia is hypotension. A range of strategies including mechanical interventions, intravenous fluids and vasoconstrictor drugs have been used to minimise or prevent spinal anaesthesia-induced hypotension. Observational studies suggest that ondansetron reduces the incidence of post-spinal hypotension (PSH) and support the use of combined fluid preloading and vasoconstrictors for this purpose (but with limited doses) to avoid side effects as fluid overload and tachycardia respectively...
December 20, 2018: Open Access Macedonian Journal of Medical Sciences
Adugna Aregawi, Tsehay Terefe, Wossenyeleh Admasu, Leulayehu Akalu
Background: Opinions are controversial regarding the use of general and spinal anesthesia in pre-eclamptic mothers undergoing Caesarean section. Some studies recommended avoiding spinal anesthesia in pre-eclamptic patients because of concern for sudden severe hypotension, while other studies support the use of spinal anesthesia as first choice reasoning less post-operative morbidity and mortality. This study aims to compare maternal outcome among pre-eclamptic women undergone caesarian delivery under general and spinal anesthesia...
July 2018: Ethiopian Journal of Health Sciences
F Joubert, P Gillois, H Bouaziz, E Marret, G Iohom, P Albaladejo
BACKGROUND: Patients on either antiplatelet or anticoagulant therapy may need procedures performed under peripheral nerve blocks in preference to general anaesthesia techniques. The risk of bleeding associated with peripheral nerve blocks under these circumstances remains unknown. This systematic review evaluates the incidence of bleeding complications following peripheral nerve blocks in patients receiving antiplatelet and/or anticoagulant medication. METHOD: All English, French and Spanish publications on peripheral nerve blocks in patients receiving antiplatelet and/or anticoagulant medication, from 1978 to 2018 from various sources including Pubmed, were reviewed...
December 23, 2018: Anaesthesia, Critical Care & Pain Medicine
Kaori Moriuchi, Yoshitsugu Chigusa, Eiji Kondoh, Ryusuke Murakami, Yusuke Ueda, Haruta Mogami, Masaki Mandai
A caesarean section (CS) is a major risk factor for a venous thromboembolism, and enoxaparin, a low-molecular-weight heparin, has been widely used for thromboprophylaxis. However, it remains unclear whether an enoxaparin thromboprophylaxis has an acceptable safety profile when given early after CS compared to delayed administration, especially in the presence of an epidural catheter. This study aimed to survey cases in which enoxaparin administration was performed within 24 hours of CS and to evaluate patient outcomes with or without epidural anaesthesia...
December 22, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Mikko Tuomas Rantasalo, Riku Palanne, Katarina Juutilainen, Pekka Kairaluoma, Rita Linko, Elina Reponen, Teemu Helkamaa, Anne Vakkuri, Klaus T Olkkola, Rami Madanat, Noora Kati Annukka Skants
INTRODUCTION: Total knee arthroplasty is a highly effective treatment for end-stage knee osteoarthritis, and it is usually performed under spinal or general anaesthesia with or without a surgical tourniquet. Some debate about the preferred mode of anaesthesia regarding patient outcomes remains. The aim of this study, which compares general and spinal anaesthesia with and without a tourniquet on the outcomes of total knee arthroplasty, is to determine the optimal type of anaesthesia regimen and assess the effect of a tourniquet on the patient's recovery following total knee arthroplasty...
December 22, 2018: BMJ Open
Stanley Sau-Ching Wong, Liting Sun, Qiu Qiu, Pan Gu, Qing Li, Xiao-Min Wang, Chi Wai Cheung
BACKGROUND: Total intravenous anaesthesia with propofol has been shown to reduce postoperative pain in some clinical studies, but knowledge of its underlying analgesic mechanism remains limited. In this study, we compared the analgesic effects of propofol versus isoflurane in an animal model of postoperative pain and evaluated its underlying molecular mechanisms. METHODS: Plantar incision was made in the hind paws of rats under general anaesthesia with 2.5% of inhalational isoflurane (isoflurane group) or intravenous infusion of propofol (1...
December 20, 2018: European Journal of Pain: EJP
Diego Sarotti, Andrea Cattai, Paolo Franci
OBJECTIVES: The aim of this retrospective study was to describe the spinal anaesthesia technique and evaluate the incidence of perioperative complications in cats. METHODS: The anaesthetic records of cats of American Society of Anaesthesiologists physical status I, II and III, which received general and spinal anaesthesia (SA) for different surgeries between 2012 and 2016, were examined. SA was administered through a 25 G Quincke needle, using an isobaric solution of bupivacaine and morphine at the level of either the L7 -S1 interspaces (sternal recumbency) or the L5 -6 /L6 -7 interspaces (lateral recumbency)...
December 19, 2018: Journal of Feline Medicine and Surgery
Muhammet Sadık Bilgen, Osman Yaray, Müren Mutlu, Ahmet İdil Çakır, Ömer Faruk Bilgen
INTRODUCTION: We have developed an accelerated clinical pathway involving outpatient surgery for patients undergoing total knee arthroplasty (TKA) who are healthy enough for early discharge. METHODS: Between March 2014 and April 2015, 89 TKAs were performed at a single institution by a single orthopaedic surgeon. 31 patients met the inclusion criteria for the study. All patients received 2 g tranexamic acid and 750 mg cefuroxime sodium intravenously 30 minutes prior to surgery...
December 17, 2018: Singapore Medical Journal
Volker Gebhardt, Sebastian Hausen, Christel Weiss, Marc D Schmittner
PURPOSE: Knee arthroscopies are regularly carried out in an outpatient setting. The purpose of this retrospective analysis was to investigate the impact of different local anaesthetics for spinal anaesthesia on operating room efficiency (perioperative process times) and postoperative recovery. This study aims to determine the optimal LA for SPA in patients undergoing knee arthroscopy at a day-surgery centre. METHODS: Anaesthesia records of all patients undergoing knee arthroscopy under spinal anaesthesia from 2010 until 2017 were analysed...
December 14, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Sumitra G Bakshi, Raghuveer Singh P Gehdoo
Background and Aims: Post-dural puncture headache (PDPH) is one of the complications following spinal anaesthesia (SA) and accidental dural puncture (ADP). In our institute, we routinely practice epidural analgesia (EA) for supra-major surgeries. Our previous audit on EA revealed 4% incidence of ADP. This lead us to a clinical initiative to follow-up patients with dural puncture (DP) to note the incidence, presentation, associated symptoms and treatment of PDPH. Herewith, we present the retrospective analysis over a 2-year period...
November 2018: Indian Journal of Anaesthesia
Chitra Rajeswari Thangaswamy, Pankaj Kundra, Savitri Velayudhan, Lakshmi Narasimhan Aswini, P Veena
Background and Aims: In category 1 caesarean section (CS), there is limited evidence regarding superior anaesthetic technique. Hence, this study was designed to study the influence of anaesthetic technique on the maternal and foetal outcome. Methods: Patient characteristics, indication for CS, decision-to-delivery interval (DDI), uterine incision-to-delivery time (UIDT), cord blood pH, Apgar scores and neonatal and maternal outcome were noted. Composite endpoint (Apgar score <7, umbilical cord blood pH <7...
November 2018: Indian Journal of Anaesthesia
Lutz Kaufner, A Karekla, A Henkelmann, S Welfle, K von Weizsäcker, L Hellmeyer, C von Heymann
BACKGROUND: Maternal hypotension is a common side effect of spinal anaesthesia for Caesarean section. The combination of colloid coloading and vasopressors was considered our standard for its prevention and treatment. As the safety of hydroxyethyl starch is under debate, we replaced colloid with crystalloid coloading. OBJECTIVE: We hypothesize that the mean blood pressure drop is greater when coloading with crystalloids. DESIGN: Prospective, observational clinical trial...
December 6, 2018: Journal of Anesthesia
Susana Manrique, Nerea Maiz, Irene García, Montserrat Pascual, Remei Perera, Silvia Arévalo, Carles Giné, José Andrés Molino, Manuel López, Domingo Blanco, Miriam de Nadal, Elena Carreras
BACKGROUND: Prenatal myelomeningocele repair by open surgery can improve the neurological prognosis of children with this condition. A shift towards a fetoscopic approach seems to reduce maternal risks and improve obstetric outcomes. OBJECTIVE: The aim of this study was to report on the anaesthetic management of women undergoing prenatal open or fetoscopic surgery for neural tube defects. DESIGN: A retrospective cohort study. SETTING: Prenatal myelomeningocele repair research group, Vall d'Hebron University Hospital, Spain...
November 30, 2018: European Journal of Anaesthesiology
Csenge Szeverényi, Zoltán Csernátony, Ágnes Balogh, Tünde Simon, Zoltán Kekecs, Katalin Varga
INTRODUCTION AND AIM: Hip and knee replacement surgery is very demanding for patients. Medication consumption is further increased by perioperative anxiety. Besides pain killer and anxiolytic medications, patients' recovery can be enhanced by applying therapeutic suggestions, which are easily applicable during the patient-physician communication. METHOD: In our prospective, randomized, controlled study we examined the effects of positive suggestions on patients undergoing hip or knee arthroplasty in spinal anaesthesia...
December 2018: Orvosi Hetilap
Laura Mc Loughlin, Orla Young
Cranial nerve palsy is a rare but recognised complication of epidural anaesthesia, most commonly presenting as diplopia secondary to abducens nerve palsy. While upper cranial nerve palsies have been documented on numerous occasions, lower cranial nerve palsies, including recurrent laryngeal nerve palsy, are exceedingly rare. This case describes a 37-year-old female who, following epidural anaesthesia for spontaneous vaginal delivery of her first child, presented with dysphonia. Flexible laryngoscopy confirmed a left vocal cord palsy, and computed tomography ruled out any mass lesions along the course of the recurrent laryngeal nerve...
2018: Case Reports in Otolaryngology
M Heesen, K Rijs, N Hilber, W D Ngan Kee, R Rossaint, C van der Marel, M Klimek
BACKGROUND: Phenylephrine is the preferred vasopressor for the prevention and treatment of spinal anaesthesia-induced hypotension during caesarean section, because studies on low-risk elective patients found it to have a less detrimental effect on umbilical artery pH compared with ephedrine. However, limited data exist from high-risk parturients and parturients with uteroplacental insufficiency. METHODS: We systematically searched for randomised, controlled, double-blinded trials of these two vasopressors in high-risk caesarean sections...
October 19, 2018: International Journal of Obstetric Anesthesia
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