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https://www.readbyqxmd.com/read/29914395/factors-promoting-or-inhibiting-normal-birth
#1
Samantha J Prosser, Adrian G Barnett, Yvette D Miller
BACKGROUND: In response to rising rates of medical intervention in birth, there has been increased international interest in promoting normal birth (without induction of labour, epidural/spinal/general anaesthesia, episiotomy, forceps/vacuum, or caesarean section). However, there is limited evidence for how best to achieve increased rates of normal birth. In this study we examined the role of modifiable and non-modifiable factors in experiencing a normal birth using retrospective, self-reported data...
June 18, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29913693/treatment-of-post-dural-puncture-headache-using-epidural-injection-of-fibrin-sealant-as-an-alternative-to-autologous-epidural-blood-patch-case-report
#2
Joseph Atallah, Emmanuel Gage, Jonathan Koning, Joan Duggan, Vicki Ramsey-Williams, Samuel Scott, Daniel Gaudin, Mazin Sarhan
Background Post dural puncture headache (PDPH) is an iatrogenic cause of patient morbidity in pain management after spinal or epidural anaesthesia, as well as after diagnostic lumbar puncture. Most patients respond to conservative treatment or to epidural blood patch, yet limited options for effective treatment are available for patients who fail these treatments or present with theoretical contraindication. Case report We present a case of a patient with previously diagnosed human immunodeficiency virus and hepatitis C, who presented with signs of PDPH, which placed him at a theoretical risk of meningeal seeding of the virus during the blood patching procedure...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29864216/continuous-intravenous-perioperative-lidocaine-infusion-for-postoperative-pain-and-recovery-in-adults
#3
REVIEW
Stephanie Weibel, Yvonne Jelting, Nathan L Pace, Antonia Helf, Leopold Hj Eberhart, Klaus Hahnenkamp, Markus W Hollmann, Daniel M Poepping, Alexander Schnabel, Peter Kranke
BACKGROUND: The management of postoperative pain and recovery is still unsatisfactory in a number of cases in clinical practice. Opioids used for postoperative analgesia are frequently associated with adverse effects, including nausea and constipation, preventing smooth postoperative recovery. Not all patients are suitable for, and benefit from, epidural analgesia that is used to improve postoperative recovery. The non-opioid, lidocaine, was investigated in several studies for its use in multimodal management strategies to reduce postoperative pain and enhance recovery...
June 4, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29847969/postdural-puncture-headache-and-epidural-blood-patch-in-a-large-obstetric-anaesthesia-population
#4
Blanca Martínez, Enrique Canser, Alberto Alonso, Eduardo Alonso, Elena Gredilla, Jesús Díez, Fernando Gilsanz
OBJECTIVE: Postdural puncture headache (PDPH) is the most common serious complication in obstetric anesthesia. We show the incidence of accidental dural puncture (ADP), PDPH, epidural blood patch (EBP) and associated morbidity following a protocol established in an obstetric anesthesia department. METHODS: An observational, prospective, analytical study performed in 66,540 epidural labor analgesia procedures. The objective is to describe the incidence of ADP, PDPH and EBP in a large obstetric anesthesia population, as well as morbidity associated with ADP and EBP...
March 2018: Asian Journal of Anesthesiology
https://www.readbyqxmd.com/read/29800126/the-feasibility-of-extubation-in-the-operating-room-after-bilateral-lung-transplantation-in-adult-emphysema-patients-an-observational-retrospective-study
#5
Valentina Assenzo, Cristina Assenzo, Rosalinda Filippo, Morgan Le Guen, Edouard Sage, Antoine Roux, Marc Fischler, Ngai Liu
OBJECTIVES: We introduced an extubation strategy for emphysema patients after bilateral lung transplantation. Patients who met the extubation criteria were extubated in the operating room (OR) followed by non-invasive ventilation, and the other patients were extubated in the intensive care unit (ICU). The primary objective was to determine the extubation rate. The secondary outcomes were to determine the factors allowing for extubation in the OR and the postoperative course. METHODS: This study is a single-centre retrospective database analysis of 96 patients...
May 23, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29794308/reducing-risk-of-spinal-haematoma-from-spinal-and-epidural-pain-procedures
#6
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/29792060/warfarin-monitoring-with-viscoelastic-haemostatic-assays-thrombin-generation-coagulation-factors-and-correlations-to-owren-and-quick-prothrombin-time
#7
Caroline U Nilsson, Karin Strandberg, Peter Reinstrup
The anticoagulant warfarin is commonly monitored with prothrombin time (PT). Viscoelastic haemostatic assays (VHA) are primarily used in situations of acute bleeding to guide haemostatic therapy. Much research has focused on VHA monitoring of new oral anticoagulants. However, many patients are still anticoagulated with warfarin and effect of warfarin anticoagulation on VHA is uncertain. The aim of this study was to assess warfarin anticoagulation on three different VHA and compare these findings with prothrombin time (PT), coagulation factor analyses and a thrombin generation assay (TGA)...
May 23, 2018: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/29756750/validation-of-the-pmd100tm-and-its-noltm-index-to-detect-nociception-at-different-infusion-regimen-of-remifentanil-in-patients-under-general-anaesthesia
#8
Pierre-André Stöckle, Marco Julien, Rami Issa, Elizabeth Décary, Véronique Brulotte, Pierre Drolet, Margaret Henri, Madeleine Poirier, Jean-François Latulippe, Marc Dorais, Olivier Verdonck, Louis-Philippe Fortier, Philippe Richebé
BACKGROUND: The NOL index is based on multiparametric analysis of heart rate (HR), skin conductance, wave plethysmography, and their time derivative. Our objective was to evaluate the NOL to detect standardized nociceptive stimuli with various remifentanil dosages under general anaesthesia. METHODS: A prospective, observational study at a single center (NCT02602379) included 40 ASA I to III patients undergoing laparotomy under remifentanil-desflurane anaesthesia with epidural analgesia...
May 14, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29744250/area-under-the-curve-of-finger-photoplethysmography-as-an-evaluation-measure-for-sympathetic-activity-during-lumbar-epidural-anaesthesia
#9
Slobodan Mihaljevic, Milenko Bevanda, Kresimir Reiner, Krunoslav Sporcic, Ljiljana Mihaljevic, Marko Cacic
Objective: To detect changes in finger photoplethysmography after administration of epidural anaesthesia as a surrogate method for evaluating autonomic nervous system activity. Methods: We included a total of 46 patients scheduled for elective surgical procedures under lumbar epidural anaesthesia. A Biopac SS4LA pulse plethysmograph transducer was used for photoplethysmography recording, and the device was placed on the first toe of the right leg. The first standard lead of the electrocardiogram was simultaneously measured with the finger photoplethysmography...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29732465/risk-factors-for-postoperative-ileus-following-elective-laparoscopic-right-colectomy-a-retrospective-multicentric-study
#10
Lise Courtot, Bertrand Le Roy, Ricardo Memeo, Thibault Voron, Nicolas de Angelis, Nicolas Tabchouri, Francesco Brunetti, Anne Berger, Didier Mutter, Johan Gagniere, Ephrem Salamé, Denis Pezet, Mehdi Ouaïssi
PURPOSE: Postoperative ileus (POI) is associated with an elevated risk of other complications and increases the economic impact on healthcare services. The aim of this study was to identify pre-, intra- and postoperative risk factors associated with the development of POI following elective laparoscopic right colectomy. METHODS: Between 2004 and 2016, 637 laparoscopic right colectomies were performed. Data were analysed retrospectively thanks to the CLIHMET database...
May 7, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29720750/newer-regional-analgesia-interventions-fascial-plane-blocks-for-breast-surgeries-review-of-literature
#11
REVIEW
Rakesh Garg, Swati Bhan, Saurabh Vig
Surgical resection of the primary tumour with axillary dissection is one of the main modalities of breast cancer treatment. Regional blocks have been considered as one of the modalities for effective perioperative pain control. With the advent of ultrasound, newer interventions such as fascial plane blocks have been reported for perioperative analgesia in breast surgeries. Our aim is to review the literature for fascial plane blocks for analgesia in breast surgeries. The research question for initiating the review was 'What are the reported newer regional anaesthesia techniques (fascial plane blocks) for female patients undergoing breast surgery and their analgesic efficacy?...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29709077/use-of-platelet-transfusions-prior-to-lumbar-punctures-or-epidural-anaesthesia-for-the-prevention-of-complications-in-people-with-thrombocytopenia
#12
REVIEW
Lise J Estcourt, Reem Malouf, Sally Hopewell, Carolyn Doree, Joost Van Veen
BACKGROUND: People with a low platelet count (thrombocytopenia) often require lumbar punctures or an epidural anaesthetic. Lumbar punctures can be diagnostic (haematological malignancies, subarachnoid haematoma, meningitis) or therapeutic (spinal anaesthetic, administration of chemotherapy). Epidural catheters are placed for administration of epidural anaesthetic. Current practice in many countries is to correct thrombocytopenia with platelet transfusions prior to lumbar punctures and epidural anaesthesia, in order to mitigate the risk of serious procedure-related bleeding...
April 30, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29707356/the-role-of-local-anaesthetic-techniques-in-eras-protocols-for-thoracic-surgery
#13
REVIEW
Seamus Crumley, Stefan Schraag
The use of enhanced recovery after surgery (ERAS), as in other surgical specialties, is an emerging concept in cardio-thoracic surgery but there is still a lack of effective protocols to reduce the burden of surgery on the patient, shorten the period of postoperative recovery, and reduce the likelihood of chronic pain developing. The use of local anaesthetic (LA) techniques, such as thoracic epidural analgesia (TEA) and paravertebral blocks (PVB), as an adjunct to anaesthesia are considered key components, though there is little data for direct comparison of the techniques...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29694674/local-anaesthetics-and-regional-anaesthesia-versus-conventional-analgesia-for-preventing-persistent-postoperative-pain-in-adults-and-children
#14
REVIEW
Erica J Weinstein, Jacob L Levene, Marc S Cohen, Doerthe A Andreae, Jerry Y Chao, Matthew Johnson, Charles B Hall, Michael H Andreae
BACKGROUND: Regional anaesthesia may reduce the rate of persistent postoperative pain (PPP), a frequent and debilitating condition. This review was originally published in 2012 and updated in 2017. OBJECTIVES: To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of PPP beyond three months in adults and children undergoing elective surgery. SEARCH METHODS: We searched CENTRAL, MEDLINE, and Embase to December 2016 without any language restriction...
April 25, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29661417/postoperative-delirium-in-total-knee-and-hip-arthroplasty-patients-a-study-of-perioperative-modifiable-risk-factors
#15
S M Weinstein, L Poultsides, L R Baaklini, E E Mörwald, C Cozowicz, J N Saleh, M B Arrington, J Poeran, N Zubizarreta, S G Memtsoudis
BACKGROUND: Postoperative delirium continues to pose major clinical difficulties. While unmodifiable factors (e.g. age and comorbidity burden) are commonly studied risk factors for delirium, the role of modifiable factors, such as anaesthesia type and commonly used perioperative medications, remains understudied. This study aims to evaluate the role of modifiable factors for delirium after hip and knee arthroplasties. METHODS: We performed a retrospective study of 41 766 patients who underwent hip or knee arthroplasties between 2005 and 2014 at a single institution...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29620988/a-simple-guide-to-regional-anaesthesia
#16
E M Valsamis, S Wade, C Thornhill, C Carey, D Ricketts
Regional anaesthesia is widely used in modern anaesthetic practice for perioperative and postoperative analgesia. In the operating theatre, regional anaesthesia is used both on its own and in combination with other techniques (general anaesthesia and sedation). Regional anaesthesia is now a core skill set in anaesthetic training. This article provides a basic outline of regional anaesthesia for surgeons and other non-anaesthetic staff working with anaesthetists, reviewing preparation, consent, basic and specialist equipment, central neuraxial blocks (spinal, epidural and caudal), trunk blocks, upper limb blocks (interscalene, supraclavicular, infraclavicular and axillary) and lower limb blocks (femoral, fascia iliaca, sciatic, popliteal and ankle)...
April 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29576110/haematoma-and-abscess-after-neuraxial-anaesthesia-a-review-of-647-cases
#17
REVIEW
E M E Bos, J Haumann, M de Quelerij, W P Vandertop, C J Kalkman, M W Hollmann, P Lirk
Although rare, spinal haematoma and abscess after central neuraxial blocks may cause severe permanent neurological injury. Optimal treatment and outcome remain unclear. In order to identify possible predisposing patient characteristics and describe the ensuing clinical course, we searched Medline, Embase, and the Cochrane Library for reports of spinal haematomas and abscesses associated with central neuraxial blocks. Extracted data included patient characteristics, symptoms, treatment, and outcome. We analysed 409 reports, including 647 patients (387 patients with spinal haematoma and 260 patients with spinal abscess)...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29497531/blood-patch-for-the-treatment-of-post-dural-puncture-tinnitus
#18
Wei Jia, Fiqry Fadhlillah
Audiometric disturbances are recognised as potential complications after spinal or epidural anaesthesia; however, incidences of tinnitus occur less frequently. We report a case of a patient with severe bilateral tinnitus post-lumbar puncture who was treated with an epidural blood patch. A 40-year-old ASA I lady (a medically fit patient with no known medical problem) presented with ongoing bilateral severe tinnitus for 6 days after a lumbar puncture. Venous blood (18 mL) was injected into the epidural space using a 16G needle...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29491521/erector-spinae-plane-block-may-aid-weaning-from-mechanical-ventilation-in-patients-with-multiple-rib-fractures-case-report-of-two-cases
#19
Amar Nandhakumar, Amritha Nair, V Kiran Bharath, Sriraam Kalingarayar, Balaji P Ramaswamy, D Dhatchinamoorthi
Uncontrolled pain in patients with rib fracture leads to atelectasis and impaired cough which can progress to pneumonia and respiratory failure necessitating mechanical ventilation. Of the various pain modalities, regional anaesthesia (epidural and paravertebral) is better than systemic and oral analgesics. The erector spinae plane block (ESPB) is a new modality in the armamentarium for the management of pain in multiple rib fractures, which is simple to perform and without major complications. We report a case series where ESPB helped in weaning the patients from mechanical ventilation...
February 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29486879/clinical-comparison-of-the-effects-of-isoflurane-or-propofol-anaesthesia-on-mean-arterial-blood-pressure-and-ventilation-in-dogs-undergoing-orthopaedic-surgery-receiving-epidural-anaesthesia
#20
R Bustamante, D Aguado, R Cediel, I A Gómez de Segura, S Canfrán
The aim of this study was to compare the effects on mean arterial pressure (MAP) and ventilation of propofol total IV anaesthesia (TIVA) and isoflurane as anaesthetic maintenance in healthy dogs undergoing orthopaedic surgery, with epidural anaesthesia. Dogs were premedicated IM with dexmedetomidine (4μg/kg) and methadone (0.3mg/kg), induced with IV propofol (0.65-5mg/kg) and randomly assigned to be maintained with isoflurane (group I) or propofol (group P). Isoflurane end-tidal concentration (EtISO) and propofol infusion rate were adjusted during the surgery to maintain a suitable anaesthetic depth...
March 2018: Veterinary Journal
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