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https://www.readbyqxmd.com/read/28298789/caudal-epidural-analgesia-in-pediatric-patients-comparison-of-0-25-levobupivacaine-and-0-25-ropivacaine-in-terms-of-motor-blockade-and-postoperative-analgesia
#1
P Praveen, R Remadevi, N Pratheeba
CONTEXT: Ropivacaine and Levo-Bupivacaine have been safely used for caudal anaesthesia in children, but there are limited studies comparing the efficacy of 0.25% Ropivacaine and 0.25% Levo-Bupivacaine for caudal anaesthesia in infraumbilical surgeries. AIMS: The aim of this study was to compare the incidence of motor blockade and postoperative analgesia with 0.25% ropivacaine and 0.25% levobupivacaine for the caudal block in children receiving infraumbilical surgery...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298756/comparison-of-postoperative-pain-after-epidural-anesthesia-using-0-5-0-75-ropivacaine-and-0-5-bupivacaine-in-patients-undergoing-lower-limb-surgery-a-double-blind-study
#2
Tripat Kaur Bindra, Rajvinder Singh, Ruchi Gupta
BACKGROUND: Ropivacaine (S (-)-1-propyl-2", 6"; pipecoloxylidide hydrochloride) a newer long-acting amide local anesthetic has various clinical and pharmacokinetic advantages over bupivacaine. AIMS: The aim of this study is to compare the onset as well as the duration of sensory block, hemodynamic variables, and postoperative analgesia with 0.5%, 0.75% ropivacaine and 0.5% bupivacaine after epidural anesthesia for lower limb orthopedic surgery. PATIENTS AND METHODS: Sixty American Society of Anesthesiologists I and II patients scheduled for lower limb orthopedic surgery were enrolled into this randomized, double-blind study...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28288050/pain-management-modalities-after-total-knee-arthroplasty-a-network-meta-analysis-of-170-randomized-controlled-trials
#3
Abdullah Sulieman Terkawi, Dimitris Mavridis, Daniel I Sessler, Megan S Nunemaker, Khaled S Doais, Rayan Sulieman Terkawi, Yazzed Sulieman Terkawi, Maria Petropoulou, Edward C Nemergut
BACKGROUND: Optimal analgesia for total knee arthroplasty remains challenging. Many modalities have been used, including peripheral nerve block, periarticular infiltration, and epidural analgesia. However, the relative efficacy of various modalities remains unknown. The authors aimed to quantify and rank order the efficacy of available analgesic modalities for various clinically important outcomes. METHODS: The authors searched multiple databases, each from inception until July 15, 2016...
March 13, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28277593/pain-management-with-adductor-canal-blockade-or-multimodal-periarticular-analgesia-in-elderly-total-knee-arthroplasty-patients
#4
Chukwuweike U Gwam, Nequesha Mohamed, Jaydev B Mistry, Melbin Thomas, Morad Chughtai, Sabahat Khan, Anton Khlopas, Michael A Mont, Ronald E Delanois
INTRODUCTION: Post-operative pain management in elderly total knee arthroplasty (TKA) patients has traditionally included opioids, epidurals, and femoral nerve blocks. Although these modalities are effective, they are often associated with adverse side effects, which may have a greater impact on this population. Alternative modalities, such as adductor canal blocks (ACB) and multimodal periarticular analgesia (MPA) have demonstrated great efficacy with a low side effect profile. However, it is unknown if one modality is advantageous over the other in the elderly...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28261560/knotting-of-a-cervical-epidural-catheter-in-the-patient-with-post-herpetic-neuralgia-a-rare-complication
#5
Jong Taek Park, Dong Woo Cho, Young Bok Lee
Epidural block is achieved either by single injection of local anesthetic through an epidural needle or as a continuous block by infusion pump through an epidural catheter. Complications associated with epidural catheters include breakage, entrapment, and knotting. Knotting of epidural catheters is very rare, but knotting in lumbar epidural catheters has been reported in a number of studies, and most of these cases involved removal difficulty. We report a case in which we inserted a cervical epidural catheter in a patient who was experiencing severe post-herpetic neuralgia and then removed the knotted catheter without complications...
January 2017: Journal of Lifestyle Medicine
https://www.readbyqxmd.com/read/28252539/continuous-erector-spinae-plane-block-for-rescue-analgesia-in-thoracotomy-after-epidural-failure-a-case-report
#6
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
The ultrasound-guided erector spinae plane (ESP) block is a newly described technique for providing thoracic analgesia. It is simple to perform and relatively noninvasive compared with thoracic epidural analgesia. In addition, the anatomy lends itself well to catheter insertion for continuous blockade. In this report, we describe the use of the ESP block as a rescue analgesic technique for postthoracotomy analgesia in a patient with failed thoracic epidural analgesia.
March 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28247084/anatomy-of-the-sacral-hiatus-and-its-clinical-relevance-in-caudal-epidural-block
#7
Hassan Bagheri, Figen Govsa
PURPOSE: Caudal epidural anesthesia (CEB) is widely used for the prevention of chronic lower back pain, the control of intraoperative analgesia such as genitourinary surgery and labor pain cases in sacral epidural space approach for the implementation of analgesia. CEB is an anesthetic solution used into the sacral canal via sacral hiatus (SH). For optimal access into the sacral epidural space, detailed anatomical landmarks of SH are required. This study aims at exploring the anatomical structures and differences of the SH by using the sacral bone as a guide point to failure criteria for reviewing the caudal epidural anesthesia and improving the criteria for success in practice...
February 28, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28243379/preemptive-caudal-ropivacaine-an-effective-analgesic-during-degenerative-lumbar-spine-surgery
#8
Shashwat Kumar, Jagannath Manickam Palaniappan, Anantha Kishan
STUDY DESIGN: This was a prospective, randomized, controlled trial comprising 60 patients undergoing lumbosacral spine (noninstrumentation/nonfusion) surgery. PURPOSE: The purpose of this study was to evaluate the efficacy of 0.2% ropivacaine (20 mL) administered alone as a single, preoperative, caudal epidural block injection versus that of intravenous analgesics in providing effective postoperative analgesia to patients undergoing lumbosacral spine surgery. OVERVIEW OF LITERATURE: Various studies have shown the effectiveness of a caudal epidural injection (bupivacaine or ropivacaine) in providing postoperative analgesia in combination with steroids or other analgesics...
February 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28235517/partial-displacement-of-epidural-catheter-after-patient-position-change-a-case-report
#9
Yoon-Jung Shon, Seung-Kil Bae, Jae-Woo Park, In-Nam Kim, Jin Huh
Epidural catheter migration is a well-known cause of failed anesthesia and complications. One of the factors that affect catheter movement is when patients change their position after skin fixation. We report a case of an epidural catheter placed without evidence of intravascular or subdural insertion that produced an insufficient block. A 36-year-old woman presented for ankle surgery under epidural anesthesia. Epidural block was conducted at the L3-4 intervertebral space with a catheter threaded 3 cm into the epidural space with the patient in a back flexion and lateral position...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235492/anesthesia-management-with-ultrasound-guided-thoracic-paravertebral-block-for-donor-nephrectomy-a-prospective-randomized-study
#10
Ozlem Yenidünya, Huseyin Yuce Bircan, Dilek Altun, Ismail Caymaz, Alp Demirag, Ayda Turkoz
STUDY OBJECTIVE: To determine the efficacy of ultrasound-guided thoracic paravertebral block intraoperatively and 24 hours postoperatively in patients undergoing donor nephrectomy. DESIGN: Prospective randomized controlled study. SETTING: Private foundation university hospital; November 2014 to June 2015. PATIENTS: Thirty-two patients undergoing donor nephrectomy (exclusion criteria: coagulation disorders, allergy to local anesthetics, and unwillingness to participate)...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28217068/fracture-of-epidural-catheter-a-case-report-and-review-of-literature
#11
Reena, A Vikram
Epidural blocks are a very important part of the anesthetic armamentarium. Among some of the known complications, fracture of epidural catheter, though is extremely rare, is a well-established entity. When it happens, it leaves the anesthesiologist puzzled and worried. We describe the occurrence of such an event where epidural catheter broke during insertion since it will also add to such an under-reported complication of a very commonly performed procedure. A brief review is also done which will delineate the recommendations for the prevention and management of such an event...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28217056/preprocedural-ultrasound-examination-versus-manual-palpation-for-thoracic-epidural-catheter-insertion
#12
Ahmed M Hasanin, Ali M Mokhtar, Shereen M Amin, Ahmed A Sayed
BACKGROUND AND AIMS: Ultrasound imaging before neuraxial blocks was reported to improve the ease of insertion and minimize the traumatic trials. However, the data about the use of ultrasound in thoracic epidural block are scanty. In this study, pre-insertion ultrasound scanning was compared to traditional manual palpation technique for insertion of the thoracic epidural catheter in abdominal operations. SUBJECTS AND METHODS: Forty-eight patients scheduled to midline laparotomy under combined general anesthesia with thoracic epidural analgesia were included in the study...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28217050/acoustic-puncture-assist-device%C3%A2-versus-conventional-loss-of-resistance-technique-for-thoracic-paravertebral-space-identification-clinical-and-ultrasound-evaluation
#13
Monaz Abdulrahman Ali, Ashraf Abualhasan Abdellatif
BACKGROUND: Acoustic puncture assist device (APAD™) is a pressure measurement combined with a related acoustic signal that has been successfully used to facilitate epidural punctures. The principal of loss of resistance (LOR) is similar when performing paravertebral block (PVB). We investigated the usefulness of APAD™ by comparing it with the conventional LOR techniques for identifying paravertebral space (PVS). SUBJECTS AND METHODS: A total of 100 women who were scheduled for elective breast surgery under general anesthesia with PVB were randomized into two equal groups...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28214220/comparison-of-the-hanging-drop-technique-and-running-drip-method-for-identifying-the-epidural-space-in-dogs
#14
Fernando Martinez-Taboada, José I Redondo
OBJECTIVE: To compare the running-drip and hanging-drop techniques for locating the epidural space in dogs. STUDY DESIGN: Prospective, randomized, clinical trial. ANIMALS: Forty-five healthy dogs requiring epidural anaesthesia. METHODS: Dogs were randomized into four groups and administered epidural anaesthesia in sternal (S) or lateral (L) recumbency. All blocks were performed by the same person using Tuohy needles with either a fluid-prefilled hub (HDo) or connected to a drip set attached to a fluid bag elevated 60 cm (RDi)...
January 8, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28208978/a-randomized-controlled-study-of-0-5-bupivacaine-0-5-ropivacaine-and-0-75-ropivacaine-for-supraclavicular-brachial-plexus-block
#15
Ranjan R Venkatesh, Prabhat Kumar, Ramachandran R Trissur, Sagiev Koshy George
INTRODUCTION: For any surgery in the upper extremity that does not involve the shoulder, a supraclavicular block is preferred, as it is a safe procedure associated with rapid onset and reliable anaesthesia. Although ropivacaine has been extensively studied for epidural anaesthesia, very few reports exist on its use in supraclavicular brachial plexus block. AIM: This study was conducted to investigate and compare the effectiveness of supraclavicular brachial plexus anaesthesia with two different concentrations of ropivacaine (0...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28203020/-effect-of-continuous-femoral-nerve-block-combined-with-periarticular-local-infiltration-analgesia-on-early-operative-functional-recovery-after-total-knee-arthroplasty-a-randomized-double-blind-controlled-study
#16
Y Deng, T L Jiang, X X Yang, M Li, J Wang, X Y Guo
OBJECTIVE: To investigate the effects of early rehabilitation training after total knee arthroplasty surgery by continuous femoral nerve block (CFNB) with or without periarticular local infiltration analgesia (PLIA). METHODS: In this randomized, double-blind, controlled study, 100 patients under-going primary unilateral total knee arthroplasty in patients with knee osteoarthritis were enrolled. All the patients received CFNB for postoperative analgesia before combined spinal epidural anesthesia...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28181346/comparison-of-caudal-ropivacaine-morphine-and-paravertebral-catheter-for-major-upper-abdominal-surgery-in-infants
#17
Makoto Sato, Takafumi Iida, Chika Kikuchi, Tomoki Sasakawa, Takayuki Kunisawa
BACKGROUND: The caudal epidural block is one of the most commonly used regional anesthetic techniques in children. Administration of morphine via caudal injection enables analgesia, even for upper abdominal surgery. The thoracic paravertebral block has also been successfully used to treat perioperative pain during upper abdominal procedures in pediatric patients. AIM: In the current study, we compared the two regional techniques for upper abdominal surgery in infants to determine whether one of them was preferable to the other...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28144162/thoracic-epidural-catheter-for-postoperative-pain-control-following-an-ineffective-transversus-abdominis-plane-block-using-liposome-bupivacaine
#18
Brian D Terrien, David Espinoza, Charles C Stehman, Gabriel A Rodriguez, Nicholas C Connolly
A 24-year-old female with a history of ulcerative colitis underwent colectomy. The patient received an ineffective transversus abdominis plane (TAP) block with liposome bupivacaine (Exparel) intraoperatively and was started on a hydromorphone patient-controlled analgesia 5 hours after the TAP block, which did not relieve her pain. A continuous thoracic epidural (CTE) was then placed after blood levels of bupivacaine were drawn, and the patient immediately experienced significant pain relief. The combined use of liposome bupivacaine and bupivacaine CTE infusion in the postoperative management of this patient demonstrated no safety concerns, provided excellent analgesia and plasma concentrations of bupivacaine remained far below toxic levels...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28122571/continuous-paravertebral-block-using-a-thoracoscopic-catheter-insertion-technique-for-postoperative-pain-after-thoracotomy-a-retrospective-case-control-study
#19
Yoshikane Yamauchi, Mitsuhiro Isaka, Kamon Ando, Keita Mori, Hideaki Kojima, Tomohiro Maniwa, Shoji Takahashi, Eiji Ando, Yasuhisa Ohde
BACKGROUND: Thoracic epidural analgesia (EDA) is the gold standard for pain control after thoracotomy. However, because of its severe side effects, it is contraindicated in patients taking anticoagulant or antiplatelet drugs. In addition, some patients' anatomy can make epidural catheter insertion challenging. We therefore investigated the safety and efficacy of paravertebral block (PVB) using a thoracoscopic insertion technique, which avoids damage to the parietal pleura, for postoperative pain after thoracotomy...
January 25, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28119773/psoas-compartment-block-for-treatment-of-motor-weakness-and-pain-following-herpes-zoster
#20
Sae Young Kim, Dong Gyeong Kim, Yong Min Park, Young Hoon Jeon
Reactivation of the latent varicella zoster virus in the sensory ganglion causes herpes zoster (HZ). Its characteristic symptom is a painful rash in the involved dermatome. HZ-induced motor weakness is rare and is usually resolved within one year of the onset, but some patients permanently experience motor dysfunction. Epidural steroid administration, with antiviral therapy, can be effective in treating pain from HZ and preventing postherpetic neuralgia. But an epidural block is contraindicated in patients receiving thromboprophylaxis...
January 2017: Korean Journal of Pain
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