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https://www.readbyqxmd.com/read/28937423/deep-serratus-plane-catheter-for-management-of-acute-postthoracotomy-pain-after-descending-aortic-aneurysm-repair-in-a-morbidly-obese-patient-a-case-report
#1
Renuka M George, Maria Yared, Sylvia H Wilson
Regional procedures for postthoracotomy pain control have classically focused on paravertebral blocks and thoracic epidurals; however, these techniques may be challenging in an increasingly obese population and contraindicated with numerous anticoagulant and antiplatelet agents. While less studied, truncal blocks allow analgesic intervention for this growing patient cohort. This case report describes placement of a deep serratus anterior plane catheter in an intubated, morbidly obese patient with a lumbar drain who failed extubation secondary to acute postthoracotomy pain...
September 20, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28937422/placement-of-stimulating-epidural-catheter-for-a-patient-with-large-scapular-sarcoma-a-case-report
#2
James D Turner, Sean W Dobson, Robert S Weller, Christopher M Lack, Daryl S Henshaw
We report the use of continuous electrical stimulation to assist with the preoperative placement of a thoracic epidural which was used to provide postoperative analgesia in a patient undergoing excision of a large scapular sarcoma. The size of the sarcoma and the surrounding area required to maintain a sterile surgical field necessitated that the epidural catheter be inserted several vertebral interspaces caudal to the level of desired catheter tip termination. The use of electrical stimulation allowed for sequential intercostal muscle stimulation during threading, which enabled the placement of the catheter tip at the appropriate spinal level to optimize analgesia...
September 20, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28934781/posture-influences-the-extent-of-spread-of-contrast-medium-during-thoracic-epidurography-a-prospective-randomized-trial
#3
Ji Hee Hong, Sung Won Jung, Ji Hoon Park
BACKGROUND: Various factors influencing the distribution of sensory blockade in epidural anesthesia have been identified; however, reports on the effects of gravity and different postures in thoracic epidural anesthesia have been rare. Medications may be injected with the lateral decubitus or the neutral position; however, it is unclear whether the distribution range of medication is similar or significantly different between these 2 postures. OBJECTIVE: We focused on identifying the effect of different postures on the distribution of local anesthetics using epidurography at the thoracic level...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28928589/laparoscopic-cholecystectomy-under-segmental-thoracic-spinal-anesthesia-a-feasible-economical-alternative
#4
Aditya Kumar Kejriwal, Shaheen Begum, Gopal Krishan, Richa Agrawal
Laparoscopic surgery is normally performed under general anesthesia, but regional techniques like thoracic epidural and lumbar spinal have been emerging and found beneficial. We performed a clinical case study of segmental thoracic spinal anaesthesia in a healthy patient. We selected an ASA grade I patient undergoing elective laparoscopic cholecystectomy and gave spinal anesthetic in T10-11 interspace using 1 ml of bupivacaine 5 mg ml(-1) mixed with 0.5 ml of fentanyl 50 μg ml(-1). Other drugs were only given (systemically) to manage patient anxiety, pain, nausea, hypotension, or pruritus during or after surgery...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28924366/effects-of-dexmedetomidine-in-combination-with-fentanyl-based-intravenous-patient-controlled-analgesia-on-pain-attenuation-after-open-gastrectomy-in-comparison-with-conventional-thoracic-epidural-and-fentanyl-based-intravenous-patient-controlled-analgesia
#5
Na Young Kim, Tae Dong Kwon, Sun Joon Bai, Sung Hoon Noh, Jung Hwa Hong, Haeyeon Lee, Ki-Young Lee
Background: This study was investigated the effects of dexmedetomidine in combination with fentanyl-based intravenous patient-controlled analgesia (IV-PCA) on pain attenuation in patients undergoing open gastrectomy in comparison with conventional thoracic epidural patient-controlled analgesia (E-PCA) and IV-PCA. Methods: One hundred seventy-one patients who planned open gastrectomy were randomly distributed into one of the 3 groups: conventional thoracic E-PCA (E-PCA group, n = 57), dexmedetomidine in combination with fentanyl-based IV-PCA (dIV-PCA group, n = 57), or fentanyl-based IV-PCA only (IV-PCA group, n = 57)...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28924315/comparison-between-continuous-thoracic-epidural-block-and-continuous-thoracic-paravertebral-block-in-the-management-of-thoracic-trauma
#6
Shalendra Singh, Mathews Jacob, S Hasnain, Mathangi Krishnakumar
BACKGROUND: Postoperative pain is thought to be the single most important factor leading to ineffective ventilation and impaired secretion clearance after thoracic trauma. Effective pain relief can be provided by thoracic epidural analgesia but may have side effects or contraindications. Paravertebral block is an effective alternative method without the side effects of a thoracic epidural. We did this study to compare efficacy of thoracic epidural and paravertebral block in providing analgesia to thoracic trauma patients...
April 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28916861/predictors-of-adherence-to-enhanced-recovery-pathway-elements-after-laparoscopic-colorectal-surgery
#7
Juan Mata, Julio F Fiore, Nicolo Pecorelli, Barry L Stein, Sender Liberman, Patrick Charlebois, Liane S Feldman
INTRODUCTION: Enhanced recovery pathways (ERP) include a bundle of evidence-based preoperative, intraoperative, and postoperative interventions that together reduce morbidity and length of stay after colorectal surgery. Increased adherence with the bundle is associated with better postoperative outcomes, but adherence is lowest in the postoperative period. Identifying risk factors for lower adherence may help design quality improvement strategies. The aim of this study was to estimate the extent to which patient, procedural, and organizational factors predict adherence to postoperative ERP elements in laparoscopic colorectal surgery...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28914646/in-response-comment-on-assessing-the-utility-of-fluoroscopy-for-thoracic-epidural-catheter-placement-what-end-points-are-important
#8
Mark P Yeager, Michelle C Parra, Brian D Sites
No abstract text is available yet for this article.
September 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28913495/improvement-of-recovery-parameters-using-patient-controlled-epidural-analgesia-after-oncological-surgery-a-prospective-randomized-single-center-study
#9
Armeana Olimpia Zgâia, Cosmin Ioan Lisencu, Alexandru Rogobete, Cătălin Vlad, Patriciu Achimaş-Cadariu, Gabriel Lazăr, Maximilian Muntean, Florin Ignat, Vlad Ormindean, Alexandru Irimie
PURPOSE: The aim of this study was to compare patient-controlled epidural analgesia (PCEA) versus conventional opioid intravenous (IV) infusion after gastrointestinal cancer surgery regarding several post-surgery parameters of recovery. METHODS: One hundred and one patients were prospectively randomized to receive either thoracic/lumbar PCEA (PCEA group) or the standard analgesia technique used in our hospital, conventional IV infusion of morphine (IVMO group) after gastrointestinal cancer surgery...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28894679/management-of-thoracic-disc-herniations-via-posterior-unilateral-modified-transfacet-pedicle-sparing-decompression-with-segmental-instrumentation-and-interbody-fusion
#10
Daniel A Carr, Andrey A Volkov, David L Rhoiney, Pradeep Setty, Ryan J Barrett, Roderick Claybrooks, Peter L Bono, Doris Tong, Teck M Soo
STUDY DESIGN: Retrospective consecutive case series. OBJECTIVE: The objective of this case series was to demonstrate the safety of a modified transfacet pedicle-sparing decompression and instrumented fusion in patients with thoracic disc herniations (TDHs). METHODS: Consecutive patients undergoing operative management of TDH from July 2007 to December 2011 using a posterior unilateral modified transfacet pedicle-sparing approach were identified...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28890435/pain-control-in-thoracic-oncology
#11
Christine Peeters-Asdourian, Gilbert Massard, Paragi H Rana, Paul Van Houtte, Andrew P White, Bogdan Grigoriu, Dominique Lossignol, Mohammed Almalki, Jean Alexiou, Jean-Luc Engelholm, Jean-Paul Sculier
This review of pain management in lung cancer is based on the presentation of four cases of thoracic oncology patients with pain at various stages of their disease. The approach will be multidisciplinary, involving a thoracic oncologist, radiologist, thoracic and orthopaedic spine surgeon, radiation therapist, pain medicine specialist, and palliative care specialist. This multispecialty approach to the management of different painful presentations in thoracic oncology will demonstrate the complexity of each case and the improved patient outcomes which result from the involvement of different disciplines working in concert...
September 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28881110/endoscopic-spine-surgery
#12
REVIEW
Gun Choi, Chetan S Pophale, Bhupesh Patel, Priyank Uniyal
Surgical treatment of the degenerative disc disease has evolved from traditional open spine surgery to minimally invasive spine surgery including endoscopic spine surgery. Constant improvement in the imaging modality especially with introduction of the magnetic resonance imaging, it is possible to identify culprit degenerated disc segment and again with the discography it is possible to diagnose the pain generator and pathological degenerated disc very precisely and its treatment with minimally invasive approach...
September 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28878918/development-of-harlequin-syndrome-following-placement-of-thoracic-epidural-anesthesia-in-a-pediatric-patient-undergoing-nuss-procedure
#13
Ashley Lefevre, Gregory Schnepper
We report the development of Harlequin Syndrome following thoracic epidural placement in a pediatric patient. Unilateral facial flushing with contralateral pallor and anhidrosis is the clinical presentation. This syndrome is typically benign. When related to regional anesthesia, treatment involves reducing the local anesthetic infusion or stopping it altogether.
September 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28857802/paravertebral-block-does-not-reduce-cancer-recurrence-but-is-related-to-higher-overall-survival-in-lung-cancer-surgery-a-retrospective-cohort-study
#14
Eun Kyung Lee, Hyun Joo Ahn, Jae Ill Zo, Kyunga Kim, Dae Myung Jung, Joo Hyun Park
BACKGROUND: Postoperative analgesic methods are suggested to have an impact on long-term prognosis after cancer surgery through opioid-induced immune suppression. We hypothesized that regional analgesia that reduces the systemic opioid requirement would be related to lower cancer recurrence and higher overall survival compared to intravenous patient-controlled analgesia (PCA) for lung cancer surgery. METHODS: Records for all patients who underwent open thoracotomy for curative resection of primary lung cancer between 2009 and 2013 in a tertiary care hospital were retrospectively analyzed...
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28856110/the-analgesic-efficiency-of-ultrasound-guided-rectus-sheath-analgesia-compared-with-low-thoracic-epidural-analgesia-after-elective-abdominal-surgery-with-a-midline-incision-a-prospective-randomized-controlled-trial
#15
Hany Mahmoud Yassin, Ahmed Tohamy Abd Elmoneim, Hatem El Moutaz
BACKGROUND: Ultrasound-guided rectus sheath blockade has been described to provide analgesia for midline abdominal incisions. We aimed to compare thoracic epidural analgesia (TEA) and rectus sheath analgesia (RSA) with respect to safety and efficacy. METHODS: Sixty patients who underwent elective laparotomies through a midline incision were assigned randomly to receive either continuous TEA (TEA group, n = 31) or intermittent RSA (RSA group, n = 29). The number of patients who required analgesia, the time to first request analgesia, the interval and the cumulative morphine doses consumption during 72 hours postoperatively, and pain intensity using visual analog score (VAS) at rest and upon coughing were reported in addition to any side effects related to both techniques or administered drugs...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28846539/catheterization-in-an-ultrasound-guided-thoracic-paravertebral-block%C3%A2-using-thoracoscopy
#16
T Fujii, Y Shibata, Y Ban, A Shitaokoshi, K Nishiwaki
Thoracic paravertebral block (TPVB) is an efficient alternative to epidural anesthesia. The location of a catheter within the thoracic paravertebral space (TPVS) has been examined in the human cadaver studies, but it is unclear how it goes into the TPVS during catheterization. In this report, thoracoscopy was used to observe the thoracic cavity in real-time during a parasagittal in-plane approach of ultrasound-guided TPVB. During thoracoscopy, we observed whether a paravertebral catheter could be advanced caudally beyond the ribs into the neighboring TPVS...
March 2017: Asian J Anesthesiol
https://www.readbyqxmd.com/read/28844921/spinal-coccidioidomycosis-a-current-review-of-diagnosis-and-management
#17
Eduardo Martinez-Del-Campo, Samuel Kalb, Leonardo Rangel-Castilla, Karam Moon, Ana Moran, Omar Gonzalez, Hector Soriano-Baron, Nicholas Theodore
OBJECTIVE: Coccidioidomycosis is an invasive fungal disease that may present with extrathoracic dissemination. Patients with spinal coccidioidomycosis require unique medical and surgical management. The authors review the risk factors and clinical presentations, discuss the indications for surgical intervention, and evaluate outcomes and complications after medical and surgical management. METHODS: A review of the English-language literature was performed. Eighteen articles included the management of 140 patients with spinal coccidioidomycosis...
August 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28844912/the-relevance-of-postoperative-magnetic-resonance-image-in-evaluating-the-epidural-hematoma-after-thoracic-fixation-surgery
#18
Hong Kyung Shin, Il Choi, Sung Woo Roh, Seung Chul Rhim, Sang Ryong Jeon
BACKGROUND: It is difficult to evaluate the significant findings of epidural hematoma in magnetic resonance image (MRI) obtained immediately after thoracic posterior screw fixation (PSF). METHODS: Prospectively, an immediate postoperative MRI was performed in 10 patients who underwent thoracic PSF from April to December 2013. Additionally, we retrospectively analysed the MRI from three patients before hematoma evacuation out of 260 patients who underwent thoracic PSF from January 2000 to March 2013...
August 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28826919/surgical-treatment-for-spinal-dural-arteriovenous-fistulas-outcome-complications-and-prognostic-factors
#19
Jakub Wojciechowski, Przemysław Kunert, Arkadiusz Nowak, Tomasz Dziedzic, Tomasz Czernicki, Katarzyna Wójtowicz, Kamil Leśniewski, Andrzej Marchel
BACKGROUND AND PURPOSE: Spinal dural arteriovenous fistulas (SDAVFs) are rare, acquired pathology and they inevitably lead to severe disability if untreated. The aim of this study is to present the outcome and complications, and to find factors that may affect the outcome after surgical treatment. METHODS: Seventeen consecutive patients (men - 14, women - 3, age: 41-79) were retrospectively analyzed. The patients presented with paraparesis (88%), bladder symptoms (71%) and/or sensory disturbances (65%)...
July 10, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28826849/thoracic-epidural-anesthesia-reversed-myocardial-fibrosis-in-patients-with-heart-failure-caused-by-dilated-cardiomyopathy
#20
Dan Ma, Lei Liu, Hongwei Zhao, Ruiying Zhang, Fengxiang Yun, Lulu Li, Yang Wang, Renhai Qu, Pengfei Liu, Fengqi Liu
OBJECTIVE: To verify that high thoracic epidural anesthesia (TEA) could reverse myocardial fibrosis in heart failure caused by dilated cardiomyopathy (DCM). DESIGN: Hospitalized patients with DCM and heart failure. SETTING: Harbin Medical University, Harbin, Heilongjiang, China. PARTICIPANTS: Eight patients. INTERVENTIONS: 0.5% lidocaine was administered epidurally at the T4-T5 interspace for 4 weeks...
May 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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