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https://www.readbyqxmd.com/read/28444433/boundaries-of-the-thoracic-paravertebral-space-potential-risks-and-benefits-of-the-thoracic-paravertebral-block-from-an-anatomical-perspective
#1
Esther A C Bouman, Judith M Sieben, Andrea J R Balthasar, Elbert A Joosten, Hans-Fritz Gramke, Maarten van Kleef, Arno Lataster
PURPOSE: Thoracic paravertebral block (TPVB) may be an alternative to thoracic epidural analgesia. A detailed knowledge of the anatomy of the TPV-space (TPVS), content and adnexa is essential in understanding the clinical consequences of TPVB. The exploration of the posterior TPVS accessibility in this study allows (1) determination of the anatomical boundaries, content and adnexa, (2) description of an ultrasound-guided spread of low and high viscous liquid. METHODS: In two formalin-fixed specimens, stratification of the several layers and the 3D-architecture of the TPVS were dissected, observed and photographed...
April 25, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28428505/-neurolysis-and-spinal-analgesia-in-cancer-pain-management
#2
Seiji Hattori, Junko Tachibana
Cancer pain appears as a complex pain and often progressive.WhenWHO pain management strategy and/or palliative care failed to relieve their pain, patients are given high dose opioids or anonymous adjuvant drugs and have no chance to meet specialized pain treatment. This section briefly covers the outline of neurolysis and spinal analgesia for these cancer patients with severe pain. Purpose of nerve block and neurolysis are to block the incoming signal of pain in order to reduce pain, reduce analgesic dose, recover ADL, and finally to be discharged from the hospital...
April 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28422349/effects-of-extrinsic-cardiac-nerve-stimulation-on-atrial-fibrillation-inducibility-the-regulatory-role-of-the-spinal-cord
#3
Zixuan Dai, Congxin Huang, Qingyan Zhao, Shujuan Zhang, Hongyi Zhao, Youjing Zhang, Yongsheng Qian, Yanhong Tang
OBJECTIVE: To investigate the effect of the mutual regulation of the extrinsic cardiac nerves on atrial electrophysiology and atrial fibrillation (AF) vulnerability. METHODS AND RESULTS: Fourteen dogs were randomly divided into 2 groups: spinal cord stimulation (SCS) group (n = 7) and spinal cord block (SCB) group (n = 7). SCS was performed with 90% of the threshold voltage stimulating the T1 -T2 spinal level, while SCB was performed by injecting 2% lidocaine into the epidural space at the T2-3 level...
April 19, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28421314/the-impact-of-body-mass-index-on-the-risk-of-high-spinal-block-in-parturients-undergoing-cesarean-delivery-a-retrospective-cohort-study
#4
Agnes M Lamon, Lisa M Einhorn, Mary Cooter, Ashraf S Habib
PURPOSE: To investigate the hypothesis that the risk of high spinal block is not increased in obese parturients undergoing cesarean delivery compared to non-obese parturients. METHODS: This is a retrospective study at an academic center. We searched the perioperative database for women who underwent cesarean delivery under spinal or combined spinal epidural anesthesia with hyperbaric bupivacaine ≥10.5 mg. A body mass index (BMI) ≥30 kg/m(2) was defined as obese...
April 18, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28419420/reliability-of-pressure-waveform-analysis-to-determine-correct-epidural-needle-placement-in-labouring-women
#5
I Al-Aamri, S H Derzi, A Moore, M F Elgueta, M Moustafa, T Schricker, D Q Tran
Pressure waveform analysis provides a reliable confirmatory adjunct to the loss-of-resistance technique to identify the epidural space during thoracic epidural anaesthesia, but its role remains controversial in lumbar epidural analgesia during labour. We performed an observational study in 100 labouring women of the sensitivity and specificity of waveform analysis to determine the correct location of the epidural needle. After obtaining loss-of-resistance, the anaesthetist injected 5 ml saline through the epidural needle (accounting for the volume already used in the loss-of-resistance)...
April 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28416992/sphenopalatine-ganglion-block-for-relieving-postdural-puncture-headache-technique-and-mechanism-of-action-of-block-with-a-narrative-review-of-efficacy
#6
REVIEW
Abhijit S Nair, Basanth Kumar Rayani
The sphenopalatine ganglion (SPG) is a parasympathetic ganglion, located in the pterygopalatine fossa. The SPG block has been used for a long time for treating headaches of varying etiologies. For anesthesiologists, treating postdural puncture headaches (PDPH) has always been challenging. The epidural block patch (EBP) was the only option until researchers explored the role of the SPG block as a relatively simple and effective way to treat PDPH. Also, since the existing evidence proving the efficacy of the SPG block in PDPH is scarce, the block cannot be offered to all patients...
April 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/28416834/-efficacy-of-transforaminal-endoscopic-nerve-root-decompression-in-the-treatment-of-degenerative-lumbar-spinal-stenosis
#7
Z R Yu, C D Li, S N Zhu, H L Sun, Y Zhao, L T Qi
OBJECTIVE: To evaluate the feasibility of transforaminal endoscopic nerve root decompression for degenerative lumbar spinal stenosis (DLSS). METHODS: From July 2011 to April 2016, 96 cases of single segment DLSS were involved. All the patients had unilateral lower extremity neurological symptoms, signs, neurogenic intermittent claudication of less than 500 m. Imaging examinations (CT or MRI) or diagnostic nerve root block confirmed single segment degeneration. The mean age was (71...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28413286/transversus-abdominis-plane-catheters-for-postoperative-pain-relief-in-pediatric-patients
#8
Sumitra G Bakshi, Jeson R Doctor, Bhakti D Trivedi, Sajid S Qureshi
Regional techniques provides excellent post operative pain relief in pediatric patients. Transversus abdominis plane (TAP) block is a newer regional technique available. Though there is emerging evidence proving the efficacy of TAP blocks, there is limited literature on use of TAP catheters in pediatric patients. TAP catheters were placed in two children following laparotomy with transverse incisions and in both epidural was avoided, with good post operative pain relief. Ultrasound guidance was used in one child, while in the other the catheter was placed under direct vision after dissection of the plane between transversus abdominis and internal oblique...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28403104/effect-of-bipolar-pulsed-radiofrequency-on-refractory-chronic-cervical-radicular-pain-a-report-of-two-cases
#9
Min Cheol Chang
RATIONALE: Despite undergoing transforaminal epidural steroid injection (TFESI), many patients complain of persisting cervical radicular pain. For the management of chronic cervical radicular pain, clinicians are widely applying pulsed radiofrequency (PRF) stimulation to dorsal root ganglions (DRGs). To enhance the effect of PRF stimulation, we conducted bipolar PRF stimulation in 2 patients with chronic cervical radicular pain that was refractory to monopolar PRF and repeated TFESIs...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28396932/comparison-of-analgaesia-with-lumbar-epidurals-and-lumbar-plexus-nerve-blocks-in-patients-receiving-multimodal-analgaesics-following-primary-total-hip-arthroplasty-a-retrospective-analysis
#10
N Robert Harvey, Bethany J Wolf, Eric D Bolin, Sylvia H Wilson
PURPOSE: Significant post-operative pain occurs after hip arthroplasty. In a prior study, lumbar plexus nerve blocks provided comparable analgaesia to lumbar epidurals; however, multimodal analgaesics were not used consistently. METHODS: This study assessed a randomly selected cohort of 48 patients undergoing primary hip arthroplasty who received a regional anaesthesia technique for post-operative pain. Twenty-four patients with lumbar epidurals and 24 with single-injection lumbar plexus nerve blocks were reviewed using electronic medical records...
April 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28396863/real-time-ultrasound-mri-fusion-for-suprasacral-parallel-shift-approach-to-lumbosacral-plexus-blockade-and-analysis-of-injectate-spread-an-exploratory-randomized-controlled-trial
#11
Jennie Maria Christin Strid, Erik Morre Pedersen, Sinan Naseer Hussain Al-Karradi, Mathias Alrø Fichtner Bendtsen, Siska Bjørn, Mette Dam, Morten Daugaard, Martin Sejr Hansen, Katrine Danker Linnet, Jens Børglum, Kjeld Søballe, Thomas Fichtner Bendtsen
Fused real-time ultrasound and magnetic resonance imaging (MRI) may be used to improve the accuracy of advanced image guided procedures. However, its use in regional anesthesia is practically nonexistent. In this randomized controlled crossover trial, we aim to explore effectiveness, procedure-related outcomes, injectate spread analyzed by MRI, and safety of ultrasound/MRI fusion versus ultrasound guided Suprasacral Parallel Shift (SSPS) technique for lumbosacral plexus blockade. Twenty-six healthy subjects aged 21-36 years received two SSPS blocks (20 mL 2% lidocaine-epinephrine [1 : 200,000] added 1 mL diluted contrast) guided by ultrasound/MRI fusion versus ultrasound...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28389846/continuous-transversus-abdominis-plane-blocks-via-laparoscopically-placed-catheters-for-bariatric-surgery
#12
Alfred M Said, Hany A Balamoun
OBJECTIVES: The objective of the present study is to evaluate postoperative analgesic outcome of the continuous bilateral transversus abdominis plane (TAP) block using bupivacaine infusion through an epidural catheter inserted through laparoscopic ports. PATIENTS AND METHODS: Ninety patients assigned for laparoscopic sleeve gastrectomy (LSG) were divided into two equal groups according to postoperative analgesia: Control group received IV morphine, and TAP group received bupivacaine 0...
April 7, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28377309/abdominal-girth-vertebral-column-length-and-spread-of-intrathecal-hyperbaric-bupivacaine-in-the-term-parturient
#13
Chang-Na Wei, Yin-Fa Zhang, Feng Xia, Li-Zhong Wang, Qing-He Zhou
BACKGROUND: We aimed to test whether abdominal girth and vertebral column length were predictors of spinal hyperbaric bupivacaine spread in term parturients. METHODS: A total of 128 parturients having elective caesarean section under spinal anaesthesia were enrolled. Combined spinal-epidural anaesthesia was performed at the L3/4 interspace, confirmed by ultrasonography. Two millilitres of 0.5% hyperbaric bupivacaine was injected intrathecally and spinal spread assessed at three minute intervals...
February 27, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28367195/the-effect-of-bilateral-intrapleural-infusion-of-lidocaine-with-fentanyl-versus-only-lidocaine-in-relieving-pain-after-coronary-artery-bypasses-surgery
#14
Kamran Shadvar, Sarvin Sanaie, Ata Mahmoodpoor, Mitra Safarpoor, Bahman Nagipour
BACKGROUND AND OBJECTIVE: Pain control during surgery in order to cause analgesia and reduce the somatic and autonomic response may decrease the morbidity. Intrapleural catheter embedding during surgery under direct vision of surgeon is safe and easy and without potential risk of thoracic epidural block. The aim of this study was to investigate the effect of bilateral intrapleural infusion of lidocaine with fentanyl versus only lidocaine in relieving pain after coronary artery bypass surgery...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28364968/-sphenopalatine-ganglion-block-for-postdural-puncture-headache-in-ambulatory-setting
#15
José Miguel Cardoso, Miguel Sá, Rita Graça, Hugo Reis, Liliana Almeida, Célia Pinheiro, Duarte Machado
BACKGROUND AND OBJECTIVES: Postdural puncture headache (PDPH) is a common complication following subarachnoid blockade and its incidence varies with the size of the needle used and the needle design. Supportive therapy is the usual initial approach. Epidural blood patch (EBP) is the gold-standard when supportive therapy fails but has significant risks associated. Sphenopalatine ganglion block (SPGB) may be a safer alternative. CASE REPORT: We observed a 41 year-old female patient presenting with PDPH after a subarachnoid blockade a week before...
March 30, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28348504/epidural-dexamethasone-for-postoperative-analgesia-in-patients-undergoing-unilateral-inguinal-herniorrhaphy-a-comparative-study
#16
M R Razavizadeh, M R Fazel, N Heydarian, F Atoof
Background. This study was designed to evaluate the effect of adding dexamethasone to epidural bupivacaine on postoperative analgesia in unilateral inguinal herniorrhaphy. Methods. Forty-four patients were enrolled in this double-blind, clinical trial study. Patients were randomly allocated into dexamethasone or control group. In the dexamethasone group, patients received 18 ml of bupivacaine 0.5% and 2 ml (8 mg) of dexamethasone; in the control group, patients received 18 ml of bupivacaine 0.5% and 2 ml of normal saline...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28347895/metabolomic-changes-in-rat-model-of-cauda-equina-injury
#17
Yang Liu, Rui Yang, Qingjie Kong, Yuan Wang, Bin Zhang, Jingchuan Sun, Yong Yang, Bing Zheng, Hongbin Yuan, Jiangang Shi
BACKGROUND: To demonstrate the differences of metabolomic changes in a rat model of cauda equina injury (CEI) and find potent metabolic biomarkers of CEI. MATERIAL AND METHODS: A total of 28 Sprague-Dawley (SD) rats were used in this study. After the rats were given anesthesia and fixed in a prone position, a piece of silicone block was placed into the epidural space below the lamina. Behavior tests including the Basso, Beattie, and Bresnahan (BBB) open field locomotor scale and an inclined plane test were conducted 1 day and 2 days after surgery...
March 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28345418/a-coaxial-dual-element-focused-ultrasound-probe-for-guidance-of-epidural-catheterization
#18
Guo-Chung Dong, Li-Chen Chiu, Chien-Kun Ting, Jia-Ruei Hsu, Chih-Chung Huang, Yin Chang, Gin-Shin Chen
Ultrasound guidance for epidural block has improved clinical blind-trial problems but the design of present ultrasonic probes poses operating difficulty of ultrasound-guided catheterization, increasing the failure rate. The purpose of this study was to develop a novel ultrasonic probe to avoid needle contact with vertebral bone during epidural catheterization. The probe has a central circular passage for needle insertion. Two focused annular transducers are deployed around the passage for on-axis guidance. A 17-gauge insulated Tuohy needle containing the self-developed fiber-optic-modified stylet was inserted into the back of the anesthetized pig, in the lumbar region under the guidance of our ultrasonic probe...
March 1, 2017: Ultrasonic Imaging
https://www.readbyqxmd.com/read/28343842/cranial-nerve-palsy-following-central-neuraxial-block-in-obstetrics-a-review-of-the-literature-and-analysis-of-43-case-reports
#19
D J Chambers, K Bhatia
BACKGROUND: Cranial nerve palsy is a rarely reported complication of central neuraxial block in obstetrics. The aetiology is diverse and includes both decreased and increased intracranial pressure. METHODS: Medline, CINAHL, and EMBASE databases were searched to identify cases of cranial nerve palsy following obstetric central neuraxial block. Possible aetiology, clinical symptoms and signs, treatment, and time to resolution were assessed. RESULTS: Forty-one articles containing 43 case reports of cranial nerve palsy following obstetric central neuraxial block were identified...
February 20, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28339431/perioperative-ketamine-administration-for-thoracotomy-pain
#20
Daniel W Moyse, Alan D Kaye, James H Diaz, Muhammad Y Qadri, David Lindsay, Srinivas Pyati
BACKGROUND: Of all the postsurgical pain conditions, thoracotomy pain poses a particular therapeutic challenge in terms of its prevalence, severity, and ensuing postoperative morbidity. Multiple pain generators contribute to the severity of post-thoracotomy pain, and therefore a multimodal analgesic therapy is considered to be a necessary strategy. Along with opioids, thoracic epidural analgesia, and paravertebral blocks, N-Methyl-D-Aspartate (NMDA) receptor antagonists such as ketamine have been used as adjuvants to improve analgesia...
March 2017: Pain Physician
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