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Epidural injection

Jean-Denis Laredo, Elisabeth Laemmel, Eric Vicaut
No abstract text is available yet for this article.
2016: RMD Open
Fei Wang, Qian Zhou, Lizu Xiao, Juan Yang, Donglin Xong, Disen Li, LiPing Liu, Sigdha Ancha, Jianguo Cheng
BACKGROUND: We demonstrated a combination of pulsed radiofrequency (PRF) and cervical nerve root block (CNRB) via a posterior approach was superior to a transforaminal epidural steroid injection through the anterolateral approach for cervical radicular pain in a previous study. This randomized trial was conducted to determine the comparative efficacy between CNRB, PRF, and CNRB + PRF for cervical radicular pain. METHODS: A prospective and randomized design was used in this study...
October 14, 2016: Pain Practice: the Official Journal of World Institute of Pain
Ji Hee Hong, Jung Hue Oh, Ki Bum Park
BACKGROUND: Thoracic epidural anesthesia is frequently used to maintain intraoperative and postoperative analgesia. Frequently, 3 ml of local anesthetic is used as a test dose, or for intermittent epidural injection. We assessed the extent of the spread of 3 ml of contrast medium in the thoracic epidural space and attempted to identify any correlating factors affecting the epidurography. METHODS: A total of 70 patients were enrolled in the study, and thoracic epidural catheterizations were performed under fluoroscopic guidance...
October 2016: Korean Journal of Pain
Alfred C Gellhorn, Pradeep Suri, Sean Rundell, Nathan Olafsen, M Jake Carlson, Steve Johnson, Adrielle Fry, Thiru Anaswammy, Christopher Gilligan, Bryan Comstock, Patrick Heagerty, Janna Friedly, Jeffrey G Jarvik
BACKGROUND: Minimal longitudinal data exist regarding the role of lumbar musculature in predicting back pain and function. In cross sectional study designs, there is often atrophy of the segmental multifidus muscle in subjects with low back pain compared with matched controls. However, the cross sectional design of these studies prevents drawing conclusions regarding whether lumbar muscle characteristics predict or modify future back pain or function. OBJECTIVE: The primary objective is to determine if the cross sectional area (CSA) of lumbar muscles predicts functional status or back pain at 6- or 12-month follow-up in older adults with spinal degeneration...
October 6, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Xiangdi Yu, Fangxiang Zhang
BACKGROUND: Pain during cesarean delivery is one of the more common reasons for a successful medicolegal claim. However, creating an extensive block area can result in hypotension, so determining the precise dose of local anesthetic is critical. OBJECTIVES: Investigate effects of parturient height on the median effective dose (ED50) of intrathecally-administered ropivacaine. DESIGN: Prospective cross-sectional analytic study. SETTING: Anesthesiology department in a provinicial hospital in China...
September 2016: Annals of Saudi Medicine
Serbülent Gökhan Beyaz
STUDY DESIGN: A cross-sectional study. OBJECTIVE: we compared the 12 month outcomes of fluoroscopically guided transforaminal epidural steroid injections with interlaminar epidural steroid injections for the treatment of chronic lumbar spinal pain. Chronic lower back pain is a multifactorial disorder with many possible etiologies. The lifetime prevalence of spinal pain is reportedly 65-80% in the neck and lower back. Epidural injection of corticosteroids is a commonly used intervention for managing chronic spinal pain...
September 30, 2016: Revista Brasileira de Anestesiologia
Duygu Tecer, Emre Adiguzel, Arif Kenan Tan, Mehmet Ali Taskaynatan
OBJECTIVE:  To explore the outcome differences of lumbar transforaminal epidural steroid injection (TFESI) according to magnetic resonance imaging (MRI) findings in patients with lumbar radicular pain. DESIGN:  Retrospective study. SETTING:  Single university-based interventional pain management unit. PATIENTS:  Fifty-nine patients who had lumbar radicular pain with a recent lumbar MRI and three-month follow-up were included...
October 2, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Stefan Hartveldt, Stein J Janssen, Kirkham B Wood, Thomas D Cha, Joseph H Schwab, Christopher M Bono, Louis G Jenis
STUDY DESIGN: Retrospective study. OBJECTIVE: To assess the relation between exposure to epidural steroid injection (ESI) before surgery and occurrence of surgical site infection (SSI) for degenerative lumbar spine conditions. SUMMARY OF BACKGROUND DATA: The effect of local ESI on the occurrence of SSI is controversial. METHODS: Patients who underwent surgery for degenerative lumbar spine conditions at two centers between 2005 and 2015 were identified...
October 1, 2016: Spine
Thomas T Klumpner, Elizabeth M S Lange, Heena S Ahmed, Paul C Fitzgerald, Cynthia A Wong, Paloma Toledo
STUDY OBJECTIVE: Programmed intermittent bolus injection of epidural anesthetic solution results in decreased anesthetic consumption and better patient satisfaction compared with continuous infusion, presumably by better spread of the anesthetic solution in the epidural space. It is not known whether the delivery speed of the bolus injection influences analgesia outcomes. The objective of this in vitro study was to determine the pressure generated by a programmed intermittent bolus pump at 4 infusion delivery speeds through open-ended, single-orifice and closed-end, multiorifice epidural catheters...
November 2016: Journal of Clinical Anesthesia
José Miguel Cardoso, Miguel Sá, Hugo Reis, Liliana Almeida, José Carlos Sampaio, Célia Pinheiro, Duarte Machado
INTRODUCTION AND OBJECTIVES: Quadratus Lumborum block was recently described and has already shown good results as an analgesic technique in abdominal surgeries, having the potential to significantly reduce opioids consumption and be a valid alternative to epidural catheter. We performed a type II Quadratus Lumborum block for analgesia in a septic patient having a sub-total gastrectomy. CASE REPORT: An 80 year-old, ASA III, male patient, weighting 50kg, with a history of arterial hypertension and hypercholesterolemia, diagnosed with sepsis due to purulent peritonitis was submitted to an open laparotomy...
September 26, 2016: Revista Brasileira de Anestesiologia
David M Dickerson, Ran Dai, Barbara M Scavone, William McDade
Reports exist of severe upper back pain of unknown etiology after administration of large volumes into the epidural space. We present a case of an otherwise healthy parturient who developed severe upper back and neck pain after receiving only a small volume of epidural medication. Magnetic resonance imaging revealed a congenitally narrowed spinal canal because of short pedicle syndrome. Epidural injectate occupies and compresses a percentage of the spinal canal and its neuronal contents. This may result in pain and epidural intolerance when continued injectate reaches a critical point, a threshold that is lower with shortened pedicles or congenital spinal stenosis...
September 28, 2016: Regional Anesthesia and Pain Medicine
Marco Lechmann, Andrea Rosskopf, Christine Ehrmann, Reto Sutter, Christian W A Pfirrmann, Cynthia K Peterson
OBJECTIVES: To determine whether specific MRI findings are related to outcomes after lumbar transforaminal epidural steroid injections (TFESI) and to assess the inter-rater reliability of imaging diagnosis. MATERIALS AND METHODS: A prospective outcomes study on 156 consecutive patients with 1-month follow-up outcomes data and MRI within 3 months of TFESI was conducted. Pain levels (numerical rating scale) (NRS) were recorded prior to injection. Overall 'improvement' was determined using the Patients Global Impression of Change (PGIC) scale and NRS data were collected at three time points post injection...
September 28, 2016: Skeletal Radiology
Samia Frioui Mahmoudi, Emna Toulgui, Sonia Jemni, Khalil Ben Jeddou, Mariem Gaddour, Afif Zaoui, Faycel Khachnaoui
OBJECTIVE: To talk through our observation and a review of the literature about radiological features and diagnostic difficulties of this particular form of disk migration. OBSERVATIONS: We report the case of a 29 year-old patient who presented following the wearing of a heavy load bilateral acute lombosciatalgies associated with a deficit of both lower limbs and urinary incontinence. Clinical examination revealed a motor deficit of sural triceps and foot relievers estimated1 in bilateral, hypoesthesia of the anterolateral side of the two legs and the feet, low bone tendon reflexes were abolished, anesthesia in the saddle, hypotonic anal sphincter and bladder distension...
September 2016: Annals of Physical and Rehabilitation Medicine
Laxmaiah Manchikanti, Alan D Kaye, Joshua A Hirsch
The Centers for Medicare and Medicaid Services (CMS) released the proposed 2017 Medicare physician fee schedule on July 7, 2016, addressing Medicare payments for physicians providing services either in an office or facility setting, which also includes payments for office expenses and quality provisions for physicians. This proposed rule occurs in the context of numerous policy changes, most notably related to the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) and its Merit-Based Incentive Payment System (MIPS)...
September 2016: Pain Physician
JiHee Hong, Sung Won Jung
BACKGROUND: Thoracic epidural anesthesia (TEA) is frequently used to maintain intraoperative analgesia. After injecting the initial bolus dose of epidural local anesthetics (LA), intermittent injection of LA through an epidural catheter is required to maintain the intraoperative analgesia. For intermittent epidural administration, usually 2 - 5 mL of LA has been used. However, no studies have suggested an optimal volume of LA of TEA for intermittent epidural administration of TEA. OBJECTIVE: We focused on identifying an optimal volume of LA of TEA using epidurography of the thoracic level with 2 different volumes of contrast dye...
September 2016: Pain Physician
Janna L Friedly, Todd Edwards, Danielle Lavallee, Zoya Bauer, Una Makris, Srdj Nedeljkovic, Pradeep Suri, Jeffrey J Jarvik
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Gregory Decker, Berdale Colorado
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Liza R Smigel, K Dean Reeves, John Lyftogt, David P Rabago
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Abhishek Patel, Eric R Helm
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Janna L Friedly, Bryan A Comstock, Christopher J Standaert, Srdj Nedeljkovic, David J Kennedy, David M Sibell, Pradeep Suri, Venu Akuthota, Thiru M Annaswamy, Zoya Bauer, Jeffrey J Jarvik
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
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