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epidural injections

Holger Joswig, Armin Neff, Christina Ruppert, Gerhard Hildebrandt, Martin Nikolaus Stienen
BACKGROUND: The predictive value of short-term arm pain relief after 'indirect' cervical epidural steroid injection (ESI) for the 1-month treatment response has been previously demonstrated. It remained to be answered whether the long-term response could be estimated by the early post-interventional pain course as well. METHODS: Prospective observational study, following a cohort of n = 45 patients for a period of 24 months after 'indirect' ESI for radiculopathy secondary to a single-level cervical disk herniation (CDH)...
March 14, 2018: Acta Neurochirurgica
Bin Yang, Feng Qian, Wenjia Li, Yang Li, Yangdong Han
The present study aimed to assess whether different anesthesia methods (general anesthesia and general anesthesia combined with epidural block) were associated with tumor metastasis during the perioperative period and the possible molecular mechanisms of tumor metastasis. A rat hepatoma tumor xenograft model was constructed via the subcutaneous injection of Morris hepatoma 3924A cells into the upper axillary fossa. General anesthesia and general anesthesia combined with epidural block prior to hepatectomy were conducted on tumor-bearing rats...
April 2018: Oncology Letters
Gang Wang, Jing Liang, Zishan Jia, Lei Wan, Mingxia Yang
RATIONALE: Spinal cord infarction is one of the complications of epidural steroid injections (ESIs), but has only been reported in cervical vertebra by transforaminal injection and lumbar vertebra by transforaminal injection; and up to now, there is no reporting about spinal cord infarction caused by caudal injection. Here, we report a case. PATIENT CONCERNS: A 52-year-old man was admitted to our hospital. He was diagnosed as lumbar disc herniation in other hospital, and the patient suffered bilateral lower limb motor and sensory disorders after administration of caudal ESI...
March 2018: Medicine (Baltimore)
Stefan Ignjatovic, Reza Omidi, Rahel A Kubik-Huch, Suzanne Anderson, Frank J Ahlhelm
Background Compared with other available injection techniques for lumbar transforaminal epidural steroid injections (LTFESIs), the traditionally performed subpedicular approach is associated with a higher risk of spinal cord infarction, a rare but catastrophic complication. Purpose To assess the short-term efficacy of the retroneural approach for computed tomography (CT)-guided LTFESIs with respect to different needle-tip positions. Material and Methods This retrospective analysis included 238 patients receiving 286 CT-guided LTFESIs from January 2013 to January 2016...
January 1, 2018: Acta Radiologica
Guen Young Lee, Joon Woo Lee, Jin S Yeom, Ki-Jeong Kim, Hyung-Ik Shin, Heung Sik Kang
Objective: To evaluate the incidence, types and association of systemic reactions after an epidural steroid injection (ESI) with patient demographics, ESI factors and repeated occurrence of an ESI. Materials and Methods: This prospective observational study was approved by the Institutional Review Board of our hospital, and written informed consent was obtained from all the participants. From October to December 2011, systemic reactions at 2 weeks after 960 ESIs among 885 patients were measured...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Erin Sweet, Christine S Shusterman, Marina S Nedeljkovic, Jean C Solodiuk
Pain is a complex physical and emotional experience. Therefore, assessment of acute pain requires self-report when possible, observations of emotional and behavioral responses and changes in vital signs. Peripheral nerve and epidural catheters often provide postoperative analgesia in children. Administration of chloroprocaine (a short acting local anesthetic) via a peripheral nerve or epidural catheter allows for a comparison of pain scores, observations of emotional and behavioral responses and changes in vital signs to determine catheter function...
March 1, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
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
R A Ajadi, O A Sobanke, A A Adeniyi, A A Adeusi, A Adebiyi, A K Akinloye
The influence of tramadol on the anaesthetic indices and physiological parameters of epidural injection of lignocaine was evaluated in West African Dwarf (WAD) sheep undergoing laparo-ovariectomy. Ten female sheep weighing (16.2 ± 1.3 kg) were randomly allocated into anaesthesia with epidural injection of lignocaine (4mg/kg) (LIG), or lignocaine (2mg/kg) and tramadol (2mg/kg) (LIG-TRA). Following anaesthesia, they were aseptically prepared and subjected to laparo-ovariectomy. Behavioural changes were noted as they occur, and onset of drug action (OAN) (time between epidural injection and loss of pedal reflex), duration of analgesia (DAN) (time between disappearance and reappearance of pedal reflex) were determined...
December 30, 2017: Nigerian Journal of Physiological Sciences: Official Publication of the Physiological Society of Nigeria
Sjaak Pouwels, Darryl M Coll, Alexander G J van Marle
A 70-year-old man was admitted to our hospital for a penile circumcision due to phimosis using continuous dose spinal anaesthesia. On postoperative day 10 he came to the emergency department with a superficial abscess localised at the injection site of the spinal catheter. He was treated with intravenous antibiotics for 10 days, and the superficial abscess was incised and drained. Ten days later, the patient was readmitted to the emergency department with complaints of back pain and fever. A repeat MRI scan of his lumbar sacral area was done and showed epidural abscesses without any compression of the medulla or the myelum...
February 23, 2018: BMJ Case Reports
Julio D Montejo, Joaquin Q Camara-Quintana, Daniel Duran, Jeannine M Rockefeller, Sierra B Conine, Alyssa M Blaise, Kristopher T Kahle, Michael L DiLuna
OBJECTIVE Lumbar disc herniation (LDH) in the pediatric population is rare and exhibits unique characteristics compared with adult LDH. There are limited data regarding the safety and efficacy of minimally invasive surgery (MIS) using tubular retractors in pediatric patients with LDH. Here, the outcomes of MIS tubular microdiscectomy for the treatment of pediatric LDH are evaluated. METHODS Twelve consecutive pediatric patients with LDH were treated with MIS tubular microdiscectomy at the authors' institution between July 2011 and October 2015...
February 23, 2018: Journal of Neurosurgery. Pediatrics
Stanley Sau Ching Wong, Qiu Qiu, Chi Wai Cheung
OBJECTIVE: Lumbar transforaminal epidural steroid injection is commonly used for treating lumbar radicular pain. We report a case of segmental spinal myoclonus that developed during lumbar transforaminal epidural injection with local anesthetic and steroid. CASE REPORT: A 58-year-old woman with failed back surgery syndrome presented with low back and right L3 and L4 radicular pain. As she had responded well previously to diagnostic selective nerve root injection with local anesthetic at the right L3 and L4 levels, lumbar transforaminal epidural steroid injection at the same levels was scheduled...
February 16, 2018: Regional Anesthesia and Pain Medicine
Basabjit Das, Melissa Conroy, David Moore, Joanne Lysaght, Connail McCrory
Radicular pain is a common cause of disability. Traditionally treatment has been either epidural steroid injection providing short-term relief or surgery with associated complications. Pulsed radiofrequency (PRF) applied to the Dorsal Root Ganglion (DRG) is a minimally invasive day-care treatment, which is gaining significant clinical acceptance in a selective group of patients with pure radicular pain. Greater insights into the immunomodulatory effects of this procedure may help to further optimise its application and find alternative treatment options...
February 16, 2018: Brain, Behavior, and Immunity
Tatsuya Kunigo, Takeshi Murouchi, Shuji Yamamoto, Michiaki Yamakage
Background: Serratus plane block is a thoracic truncal block that has been proposed as alternatives for analgesia such as epidural anesthesia and paravertebral block for the anterolateral chest wall. Previously, we performed the clinical study about optimal volume of the local anesthetic in serratus plane block. The primary aim of this study was to assess the pattern of distribution of dye into the serratus plane of cadavers after ultrasound-guided serratus plane injection. Findings: Ultrasound-guided serratus plane injection was performed at the level of the fourth rib on the mid-axillary line in nine adult Thiel-embalmed cadavers...
2018: JA Clin Rep
A Cotten, J-L Drapé, N Sans, A Feydy, J-M Bartoli, J-F Meder
No abstract text is available yet for this article.
February 14, 2018: Diagnostic and Interventional Imaging
Ömer Karaca, Ali Ahıskalıoğlu, Mehmet Aksoy, Rafi Doğan, Elif Oral Ahıskalıoğlu
Epidural block is an appropriate anesthesia method for outpatient operation. This technique is generally safe and efficient. We present the case of a 20-year-old female patient with accidental subdural block after a single dose of epidural block for pilonidal sinus surgery. Sudden apnea, unconsciousness, and bilateral mydriasis occurred within a few minutes after injection. Within 80 minutes after injection, the patient regained full consciousness and spontaneous respiration, with motor block in lower extremities and sensory block until the T4 level...
January 2018: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Julie Bonapace, Guy-Paul Gagné, Nils Chaillet, Raymonde Gagnon, Emmanuelle Hébert, Sarah Buckley
OBJECTIVE: To review the evidence relating to nonpharmacological approaches in the management of pain during labour and delivery. To formulate recommendations for the usage of nonpharmacological approaches to pain management. OPTIONS: Nonpharmacological methods available for pain management during labour and delivery exist. These should be included in the counselling and care of women. EVIDENCE: PubMed and Medline were searched for articles in French and English on subjects related to "breastfeeding," "pain," "epidural," "anaesthesia," "analgesia," "labour," "labor," and combined with "gate control theory," "alternative therapies," "massage," "position," "mobility," "TENS," "bathing," "DNIC," "acupuncture," "acupressure," "sterile water injection," "higher center," "control mind," "cognitive structuring," "holistic health," "complementary therapy(ies)," "breathing," "relaxation," "mental imagery," "visualization," "mind focusing," "hypnosis," "auto-hypnosis," "sophrology," "mind and body interventions," "music," "odors," "biofeedback," "Lamaze," "Bonapace," "prenatal training," "gymnastic," "chanting," "haptonomy," "environment," "transcutaneous electrical stimulus-stimulation," "antenatal education," "support," "continuous support," "psychosocial support," "psychosomatic medicine," "supportive care," "companion," "intrapartum care," "nurse," "midwife(ves)," "father," "doula," "caregiver," " hormones," "oxytocin," "endorphin," "prolactin," "catecholamine," "adrenaline," and "noradrenaline" from 1990 to December 2015...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Marija Damjanovska, Tatjana Stopar Pintaric, Erika Cvetko, Kamen Vlassakov
Purpose: The ultrasound-guided retrolaminar block is one of the newer and simpler alternatives to the traditional, often technically challenging, paravertebral (PV) block. Its feasibility, safety, and efficacy have already been clinically demonstrated in patients with multiple rib fractures using higher volumes of local anesthetic, when compared with the traditional approach. The primary aim of this observational anatomical study was to assess the spread of local anesthetic from the retrolaminar injection point to the PV space and its volume dependence...
2018: Journal of Pain Research
Seyhmus Guler, Moritz Dannhauer, Biel Roig-Solvas, Alexis Gkogkidis, Rob Macleod, Tonio Ball, Jeffrey G Ojemann, Dana H Brooks
Direct stimulation of the cortical surface is used clinically for cortical mapping and modulation of local activity. Future applications of cortical modulation and brain-computer interfaces may also use cortical stimulation methods. One common method to deliver current is through electrocorticography (ECoG) stimulation in which a dense array of electrodes are placed subdurally or epidurally to stimulate the cortex. However, proximity to cortical tissue limits the amount of current that can be delivered safely...
February 7, 2018: NeuroImage
O Vassal, P Del Carmine, F-P Desgranges, L Bouvet, M Lilot, N Gadot, Q Timour-Chah, D Chassard
Objective: Epidural blood patch is the procedure of choice to relieve postdural puncture headache. Hydroxyethyl-starch (HES) has been proposed as a patch in some circumstances such as in the case of hematological disease due to the theoretical risk of neoplastic seeding to the central nervous system. Acute neurological HES toxicity has been excluded by a previous animal study, but the long-term neurological toxicity has not been evaluated. Methods: Rats were randomly assigned to one of three groups: no intrathecal injection, 20 μL of intrathecal saline, or a 20-μL intrathecal HES (6% hydroxyethyl starch 130/0...
February 6, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Jung Eun Kim, Mi Kyoung Lee, Dong Kyu Lee, Sang Sik Choi, Jong Sun Park
Intractable hiccups, although rare, may result in severe morbidity, including sleep deprivation, poor food intake, respiratory muscle fatigue, aspiration pneumonia, and death. Despite these potentially fatal complications, the etiology of intractable hiccups and definitive treatment are unknown. This study aimed to evaluate the effectiveness of continuous cervical epidural block in the treatment of intractable hiccups.Records from 28 patients with a history of unsuccessful medical and invasive treatments for hiccups were evaluated...
February 2018: Medicine (Baltimore)
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